Head injury: Damage to any of the structures of the head as a result of trauma.

While the
term "head injury" is most often used to refer to an injury to the brain, head injuries may
also involve the bones, muscles, blood vessels, skin, and other organs of the face or head.
A head injury does not always mean that there is an associated brain injury.

Classifications:

1. Skull:

• Linear skull fracture: A common injury, especially in children. A linear skull fracture is a
simple break in the skull that follows a relatively straight line.

• Depressed skull fractures:These are common after forceful impact by blunt objects-most
commonly, hammers, rocks, or other heavy but fairly small objects. These injuries cause
"dents" in the skull bone. If the depth of a depressed fracture is at least equal to the thickness
of the surrounding skull bone (about 1/4-1/2 inch).

• Basilar skull fracture: A fracture of the bones that form the base (floor) of the skull and
results from severe blunt head trauma of significant force.

2. Intracranial (inside the skull) hemorrhage (bleeding)

• Subdural hematoma: Bleeding between the brain tissue and the dura mater(a tough
fibrous layer of tissue between the brain and skull) is called a subdural hematoma. The
stretching and tearing of "bridging veins" between the brain and dura mater causes this type of
bleeding.

• Subarachnoid hemorrhage: Subarachnoid hemorrhage can be caused by trauma and

often does not require surgery. Blood accumulates in the space beneath the arachnoid layer
that surrounds the brain. While this can irritate the brain and cause symptoms of headache,
vomiting, and stiff neck, treatment may be watchful waiting without surgery unless symptoms
worsen.

• Intraparenchymal hemorrhage/cerebral contusion: These terms describe bleeding into

the brain tissue itself. A contusion is like a bruise to the brain tissue and usually requires no
special intervention, much like a concussion.
 BRAIN SUFFERS TRAUMATIC
INJURY

BRAIN SWELLING OR BLEEDING INCREASES

INTRACRANIAL VOLUME

RIGID CRANIUM ALLOWS NO ROOM FOR EXPANSION OF CONTENTS

SO INTRACRANIAL PRESSURE INCREASES

PRESSURE ON BLOOD VESSELS WITHIN THE BRAIN CAUSES BLOOD

FLOW TO THE BRAIN TO SLOW

CEREBRAL HYPOXIA AND ISCHEMIA

OCCUR

INTRACRANIAL PRESSURE CONTINUES TO RISE.

BRAIN MAY HERNIATE

CEREBRAL BLOOD FLOW

CEASES

Etiology:
- falls (28%)

- motor vehicle crashes (20%)

- being struck by objects (19%)

- assaults (11%)

- people at high risk for traumatic brain injuries are those in the 15 to
19 year age group

- home and occupational accidents

Diagnostic test/procedures:

• X-ray
• CT-Scan
• MRI
• Angiography
Signs and Symptoms:

• Minor blunt head injuries may involve only symptoms of being "dazed" or brief loss of
consciousness. They may result inheadaches or blurring of vision or nausea and vomiting. There
may be longer lasting subtle symptoms including, irritability, difficulty concentrating, insomnia,
and difficulty tolerating bright light and loud sounds. These post concussion symptoms may last
for a prolonged period of time.

• Severe blunt head trauma involves a loss of consciousness lasting from several minutes
to many days or longer. Seizuresmay result. The person may suffer from severe and sometimes
permanentneurological deficits or may die. Neurological deficits from head trauma resemble
those seen in stroke and includeparalysis, seizures, or difficulty with speaking, seeing, hearing,
walking, or understanding.

• Penetrating trauma may cause immediate, severe symptoms or only minor symptoms
despite a potentially life-threatening injury. Death may follow from the initial injury. Any of the
signs of serious blunt head trauma may result.

Management:

• Bed rest, fluids, and a mild pain reliever, for example, acetaminophen(Tylenol) may be
prescribed. Ice may be applied to the scalp for pain relief and to decrease swelling.

• Cuts will be numbed with a medication usually given by injection. They will then be
cleansed. The doctor will then look for foreign matter and hidden injuries. The wound usually is
closed with skin staples, stitches (sutures), or skin glue. Tetanus immunization will be updated if
needed.
• Medication to prevent seizures may be given to prevent or treat seizures that occur from
the head injury.
• Do not apply ice directly to the skin. Ice should be applied for 20-30 minutes at a time
and can be repeated about every 2-4 hours as needed.

• Use a light washcloth as a barrier and wrap the ice in it.