Head Injuries in Trauma Patients

Head injuries can be mild, moderate or severe. If severe, they can lead to mental impairment, disability or death. Head injuries can happen in falls, motor vehicle accident and sports injuries. They involve injuries just to the scalp, to the skull or to the brain. The most common type of head injury is the concussion. Up to 3.8 million sports-related concussions occur per year. It happens when the brain is shaken or jarred to the point where the brain bounces against the skull. Concussions cause a change in mental status that can be short-lived or long-lasting. You may or may not lose consciousness when you have a concussion and you may not even have direct trauma to the head to experience a head injury. The symptoms can show up right way or may take days to show up.

You can also get a contusion on the brain, which is bruising of the brain tissue. This can cause bleeding in the brain or swelling of the brain. Skull fractures can add to the chances of getting bleeding around the brain.

The top sports-related causes of brain injury and other head injuries include cycling, football, baseball, softball, basketball, and riding recreational vehicles like ATVs. In kids under the age of 18, the most common causes of sports-related injuries include football, cycling, basketball, soccer, and playground activities.

The major signs of a brain injury include depression, confusion, dizziness, a sensation of being groggy, having double vision, headache, feeling tired, having memory loss, light or noise sensitivity, and difficulty concentrating or remembering things.
If there are things like pupillary reflex changes, clear fluid from the nose or ears, seizures, low blood pressure, loss of consciousness, bruising of the face, a skull fracture, restlessness, clumsiness or lack of coordination, stiff neck, vomiting or sudden worsening of symptoms, this could represent signs of severe head injury.

If a head injury is believed to have happened, you need to prevent signs of additional injury. The sports-related injury must involve rest and stoppage of play. You need to see the team doctor or the coach if there are signs of a possible concussion or worse. You also need to make sure the patient receives proper medical attention immediately, especially if severe symptoms are present. Some symptoms require that the patient stay overnight at the hospital and to have a CT scan of the head or an MRI scan of the head.

In one study, 100 patients with a severe head injury were treated at a trauma center. Serious brain injuries were found in 44 patients and low blood pressure was noted in 13 cases. Twelve patients had anemia and 4 cases had an elevated CO2 level. Many who had serious brain injuries also had multiple other injuries that were caused by motor vehicle accidents. Hypoxia or low blood oxygen levels happened in 30 patients. These kinds of systemic problems were associated with increased morbidity and mortality. It is believed by the researchers that patients with probable brain injury should be taken to a trauma center where a full time neuro staff can take care of these patients and maximize their survival.

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