An injury to the brain, skull, or scalp is classified as a head injury. These can range from a minor impact or bruise to a severe traumatic brain injury.

Common head injuries include concussions, skull fractures, and scalp wounds.

Head injuries can be categorized as either closed or open. A closed head injury is one where the skull remains unbroken. Conversely, an open (penetrating) head injury involves something piercing the scalp and skull to enter the brain.

Causes of Head Injuries:

Head injuries are broadly categorized into two types based on their origin:

1. Injuries resulting from direct blows to the head.

2. Head injuries caused by shaking.

Shaking-related injuries are frequently observed in infants and young children, but they can occur whenever an individual experiences violent shaking.

Head injuries stemming from blows to the head are typically linked to:

• Motor vehicle accidents

• Falls

• Physical assault

• Sports-related incidents. Etc

While the skull generally offers significant protection to the brain from serious harm, injuries forceful enough to cause a head injury can also lead to damage to the spine.

Types of Head Injury:

Hematoma:

This describes an accumulation or clot of blood outside a blood vessel. When such a clot forms within the brain, it can lead to increased pressure inside the skull. This elevated pressure may result in loss of consciousness or even permanent brain damage.

Examples of hematomas include:

• Epidural hematoma

• Subdural hematoma

Hemorrhage:

A hemorrhage signifies uncontrolled bleeding. Bleeding can occur in the spaces surrounding the brain, known as a subarachnoid hemorrhage, or directly within the brain tissue, termed an intracerebral hemorrhage.

Subarachnoid hemorrhage commonly presents with headaches and vomiting. The severity of intracerebral hemorrhages can lead to significant pressure buildup.

Concussion:

This type of injury occurs when the head sustains an impact severe enough to cause brain trauma. It results from the brain striking the rigid inner walls of the skull or from the forces of sudden acceleration and deceleration, which can lead to unconsciousness.

Although concussions involve the head, they are generally not considered life-threatening and usually resolve within a few days.

Symptoms:

• Memory difficulties

• Disorientation

• Drowsiness

• Dizziness

• Blurred or double vision

• Headache

• Nausea and vomiting

• Issues with balance

• Delayed reactions to stimuli

• Seizures

• Impaired coordination

• Unusual eye movements

Diagnosis:

Diagnosis often relies on assessing signs and symptoms through a physical examination. Imaging techniques such as CT scans or MRIs may also be performed.

Treatment:

Surgical intervention might be necessary if any of the following conditions are present:

• Bleeding within the brain

• Swelling of the brain tissue

• A severe injury to the brain

Over-the-counter painkillers like ibuprofen or acetaminophen can be used for headaches. Complete bed rest is also often recommended.

Complication:

• Post-traumatic vertigo or dizziness that persists for months

• Brain damage

• Post-traumatic headaches

• Post-concussion syndrome.

Edema:

This refers to swelling caused by fluid retention.

While many injuries cause swelling in surrounding tissues, it is particularly critical when it occurs in the brain. The skull’s inability to expand means that swelling leads to pressure buildup within the brain, forcing it against the skull.

Skull fracture:

This is any break in the cranial bone, also known as the skull. Although there are various types of skull fractures, the primary cause is a significant impact or blow to the head capable of breaking the bone.

Unlike most bones in the body, the skull lacks bone marrow, which contributes to its exceptional strength and resistance to breakage.

Symptoms of a fractured skull:

• Swelling and tenderness localized around the impact area

• Bruising on the face

• Bleeding from the nostrils or ears

• Intense pain at the site of trauma

• Redness or warmth at the trauma site

Other symptoms:

• Headache

• Nausea

• Vomiting

• Blurred vision

• Restlessness

• Irritability

• Loss of balance

• Stiff neck

• Pupils unresponsive to light

• Confusion

• Excessive sleepiness

• Fainting

Diagnosing skull fracture:

Diagnosis can be achieved through:

• Performing a physical examination

• Various imaging tests, including X-rays, CT scans, and MRIs

Treatment:

Treatment strategies may vary based on several factors, including the patient’s age, overall health, medical history, as well as the specific type and severity of the fracture.

Pain relievers such as diclofenac may be prescribed to manage pain. For severe pain, a narcotic like pethidine might be administered.

Surgery may be required, for instance, in cases of basal and depressed fractures, especially if there is significant leakage of cerebrospinal fluid (CSF) from the nose and ears.

Note: Some fractures that are not associated with injuries to other parts, such as the brain, may heal without intervention.

Prevention:

Wearing protective headgear is essential when cycling or participating in sports activities where head injuries are a possibility, such as football, rugby, rock climbing, etc.

RX…neurosurgery may be necessary for more severe injuries.

Types of skull fractures:

The specific type of skull fracture depends on the force of the impact, the location on the skull where the impact occurred, and the shape of the object striking the head. For example, a pointed object is more likely to penetrate the skull than a blunt one.

• Closed fracture: Also referred to as a simple fracture, this occurs when the skin covering the fractured area remains unbroken or uncut.

• Open fracture: Known as a compound fracture, this type occurs when the skin is broken, and the bone becomes exposed.

• Depressed fracture: This fracture causes the skull to indent or extend inward into the brain cavity.

• Basal fracture: This occurs in the base of the skull, affecting areas around the eyes, ears, nose, or the upper neck near the spine.

Other types:

In addition to the aforementioned types, these fractures can also be classified as:

• Linear (a straight-line break)

• Comminuted (broken into three or more sections)

Causes of skull fractures:

• Being struck by an object

• Falling and hitting the ground

• Head injuries sustained in a car accident or other traumatic events.

Diffuse axonal injury:

This is a brain injury that does not involve bleeding but causes damage to the brain cells. This damage prevents the cells from functioning correctly and can also lead to swelling, exacerbating the injury.

This is considered the most dangerous form of head injury, with potential outcomes including permanent brain damage and even death.

Common symptoms of head injury:

• Headache

• Lightheadedness

• Mild confusion

• Nausea

• Temporary ringing in the ears

• Loss of consciousness

• Seizures

• Vomiting

• Balance or coordination problems

• Inability to focus the eyes

• Abnormal eye movement

• Loss of muscle control

• Persistent or worsening headache

• Memory loss

• Changes in mood

• Leakage of clear fluid from the ear or nose.

Diagnosis of head injury:

This can be conducted through:

• The Glasgow Coma Scale (GCS).

This is a 15-point assessment used to evaluate mental status. A higher GCS score indicates a less severe injury.