Head injury
Presented by
Amer . M Nasir
Definition
• Is any sort of injury to brain,
skull, or scalp. This can range
from a mild bump or bruise
to a traumatic brain injury.
Head injuries may be either
closed or open.
Major types of head injuries
1. Hematoma
• A hematoma is a collection, or clotting, of blood
outside the blood vessels. It can be very serious if a
hematoma occurs in the brain. The clotting can cause
pressure to build inside the skull, which causing can
lose consciousness or result in permanent brain
damage.
2. Hemorrhage
A hemorrhage is uncontrolled bleeding. There can be bleeding in the space
around the brain, which is a subarachnoid hemorrhage, or bleeding within the
brain tissue, which is an intracerebral hemorrhage. The severity of
intracerebral hemorrhages depends on how much bleeding there is, but over
time any amount of blood can cause pressure to build.
3. Concussion :- A concussion is a
brain injury that occurs when the
brain bounces against the hard
walls of the skull. Generally
speaking, the loss of function
associated with concussions is
temporary.
4. Edema :- Any brain injury can lead to edema, or
swelling. Many injuries cause swelling of the
surrounding tissues, but it’s more serious when it occurs
in the brain. The skull can’t stretch to accommodate the
swelling, which leads to a buildup of pressure in the
brain. This can cause the brain to press against the skull.
5. Skull fracture
Unlike most bones in the body, the
skull doesn’t have bone marrow.
This makes the skull very strong
and difficult to break. A broken
skull is unable to absorb the impact
of a blow, making it more likely
that there will also be damage to
the brain.
6. Diffuse axonal injury
A diffuse axonal injury, or sheer
injury, is an injury to the brain
that doesn’t cause bleeding but
does damage the brain cells. The
damage to the brain cells results
in them not being able to
function and can also result in
swelling, causing more damage.
Causes of head injury
1- Motor vehicle accidents
2- Falls from high
3- Physical assaults
4- Sports-related accidents
Signs and symptoms of head injury
1- a headache
2- a spinning sensation
3- mild confusion
4- nausea
5- temporary ringing in the ears
6- a loss of consciousness
7- seizures
7. vomiting
8. balance or coordination problems
9. serious disorientation
10. an inability to focus the eyes
11. abnormal eye movements
12. a loss of muscle control
13. a persistent or worsening headache
14. memory loss
15. changes in mood
Diagnosis test for head injury
1. clinical feature
2. physical examination
3. laboratory study e.g. blood test
4. head X-ray
5. CT –SCAN
6. MRI
Management of head injuries
A. Medicine treatment
1. Mild injury Mild traumatic head injuries usually require
no treatment other than rest and over-the-counter pain
relievers to treat a headache. A person with a mild traumatic
head injury usually needs to be monitored closely at home
for any persistent, worsening or new symptoms.
2. Immediate Emergency care:- for moderate to
severe traumatic head injuries focuses on making sure the
person has an adequate oxygen and blood supply,
maintaining blood pressure, and preventing any further
injury to neck. People with severe injuries may also have
other injuries that need to be addressed
B. Medications: use medications to limit secondary damage to the brain
immediately after an injury may include:
• Diuretics. These drugs reduce the amount of fluid in tissues and
increase urine output. Diuretics, given intravenously to people with
traumatic brain injury, help reduce pressure inside the brain.
• Anti-seizure drugs. People who've had a moderate to severe traumatic
brain injury are at risk of having seizures during the first week after
their injury. An anti-seizure drug may be given during the first week to
avoid any additional brain damage that might be caused by a seizure.
Additional anti-seizure treatments are used only if seizures occur.
. Coma-inducing drugs.
Use drugs to put people into
temporary comas because a comatose
brain needs less oxygen to function.
This is especially helpful if blood
vessels, compressed by increased
pressure in the brain, are unable to
deliver the usual amount of nutrients
and oxygen to brain cells.
C. Surgery: Emergency surgery may be needed to minimize additional
damage to brain tissues. Surgery may be used to address the following
problems
1. Removing clotted blood (hematomas). Bleeding outside or within
the brain can result in a collection of clotted blood (hematoma) that
puts pressure on the brain and damages brain tissue?
2. Repairing skull fractures. Surgery may be needed to repair severe
skull fractures or to remove pieces of skull in the brain.
3. Opening a window in the skull. Surgery may be used to relieve
pressure inside the skull by draining accumulated cerebral spinal fluid
or creating a window in the skull that provides more room for swollen
tissues.
