Head injuries occur when force is applied to the skull from the outside. This can always involve the brain. Head injuries, even if they look harmless on the surface, should be examined by a doctor so that serious and perhaps irreversible damage to the brain can be ruled out or prevented by early treatment.
What are head injuries?
Head injuries can occur when an external force is applied to the skull bone. Different types and degrees of severity are distinguished. If only the skull bone is affected, it is either a skull contusion or a skull fracture (fracture of the skull bone). If the force was so severe that the brain was also injured, it is called a traumatic brain injury. Brain injuries are divided into three stages. Concussion (commotio cerebri) is the lightest form, it heals without consequences. In the case of brain contusion (contusio cerebri), there may be an injury to the brain tissue, possible late effects are possible. The most severe form of head injury is cerebral contusion (compressio cerebri), in which cerebral hemorrhage and permanent damage are not excluded.
Causes
Head injuries occur particularly often during sports activities. However, road traffic, the home, and work are also among the places where head injuries frequently happen. The violent impact on the skull usually occurs as a result of a blow or impact. One possibility is that the head is at rest and a blow hits it from the outside. This happens, for example, in sports by a bat or kick. The other possibility is that the head is moving and is stopped suddenly and hard by a solid object. This can be a wall against which one is thrown or the floor on which the head hits after a fall. In both cases, the brain is struck from the inside against the skull bone because it cannot follow the sudden change in motion due to gravity. Another type of head injury occurs when the force is so strong that the bone of the skull cannot withstand the force and breaks. If the meninges are torn in the process, it is called an open skull brain injury, which is one of the most serious head injuries.
Symptoms, complaints and signs
Head injuries can come in different forms and severities, so symptoms that occur can vary greatly. Lacerations to the head are usually associated with heavy bleeding, which should be stopped promptly. Otherwise, there will be significant blood loss. If the head injury was caused by a bruise or by a strong external force, then there is very often a long-lasting headache. It is not uncommon for affected individuals to also complain of severe nausea, which may even last for several days. Head injuries can also be triggered by allergic reactions. Constant scratching can cause open wounds that become infected very easily. Such an infection is usually noticeable by severe pain and visible pus production. Whoever forgoes a visit to the doctor at this point must reckon with a considerable aggravation of the symptoms that occur. However, those who choose to seek medical and drug treatment can expect a quick and complete recovery. Head injuries can be very versatile, so that the possible symptoms can also occur in a wide range of severity. However, prompt care will ensure a smooth recovery without any possible complications.
Diagnosis and course
First aid for traumatic brain injury as well as the typical symptoms. Click image to enlarge. Diagnosis is one of the most important factors in head injuries. The physician must clarify the severity and extent to which the head and brain are affected in order to initiate the proper treatment. Head injuries may appear harmless at first and later turn out to be serious. Conversely, head injuries sometimes appear more dramatic than they are if, for example, the scalp is injured. Because the scalp has many blood vessels running through it, a cut or laceration to the head bleeds relatively heavily and appears to the layperson to be a serious injury.The extent of a head injury and whether or not the brain is affected is determined by the doctor on the basis of the symptoms and through various examinations. The symptoms start with mild nausea and range up to severe disturbances of consciousness, disturbances of nerve functions, unconsciousness or even coma. X-rays, a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan reveal the extent to which the bones and brain are damaged in head injuries.
Complications
Head injuries, of course, can be many and varied in severity. Superficial head injuries usually heal completely without complications. However, it is important to note that an open wound on the head should always be kept clean and pure. If hygiene is neglected at this point, then there is a risk of inflammation. In this context, further complications are possible if the visit to the doctor is put on the back burner. If a visit to the doctor is not made even in the case of pus formation, then this can even lead to blood poisoning. If blood poisoning is present, there is an acute danger to life. In the case of minor and not too deep injuries on the surface of the head, it is not necessary to glue or sew the wound. The wound should heal without any complications, provided strict hygiene is observed. However, if there is a deeper head injury, then serious complications are to be expected and should usually always be evaluated by a physician. In particularly bad cases, suturing of the existing wound is unavoidable. Again, there is a high risk of inflammation. Especially in the case of deep wounds, even stricter attention should be paid to cleanliness and purity. This is because it is possible to avoid various complications that can significantly inhibit the healing process.
When should you go to the doctor?
Head injuries must be taken seriously and observed. After a serious fall or collision, medical advice is always required. If there is a loss of consciousness, the emergency physician must be alerted immediately. Even minor injuries must be clarified if pain, bleeding or other symptoms develop. Since the symptoms of a traumatic brain injury often do not appear until hours later, the affected person must be kept well under observation. If he or she complains of missing memories, dizziness, disorientation or nausea, a doctor must be consulted. Loss of consciousness indicates a serious injury that must be treated immediately. In case of respiratory or cardiac arrest, life-sustaining measures must be started immediately. Accompanying emergency medical services must be alerted. The patient must then spend a few days in hospital and should have regular check-ups even after initial treatment has been completed. With children, any head injury should be taken to a pediatrician. This is especially true if the child vomits or complains of increasing headache and dizziness.
Treatment and therapy
Treatment of head injuries depends on the severity. A laceration should first be dressed sterilely to prevent germs from entering. Rapid care by a physician who will stitch or staple the wound is necessary. If no injury is visible externally, but the victim is dazed or even unconscious, he should immediately be placed in the recovery position. This will prevent vomit from closing the airway or the tongue from falling into the throat, which could lead to asphyxiation. For further treatment, people with head injuries should always be taken to the hospital. There they will be monitored to rule out or prevent brain injuries with late effects. If there is only a mild concussion, a few days of bed rest will suffice. If there are severe head injuries with bleeding in the brain, surgery is performed to relieve the pressure and a drainage tube (drainage tube for blood and wound water) is placed. The skull remains open until the swelling has subsided and the wound has stopped bleeding. If the facial skull is fractured, this is also treated surgically. A skull base fracture usually does not require surgery; it is treated with bed rest and antibiotics to prevent brain infection. Patients with head injuries usually remain under observation as inpatients.
Outlook and prognosis
The prognosis for head injuries depends very much on the symptoms.Basically, mild and severe forms of progression can be distinguished according to the nature of the complaints. In the case of a mild head injury, there is a good chance of complete healing. Complaints usually subside after the second week. Only in very rare cases do they last for months or even years. Patients with a single head injury are statistically prone to a second one. It is advisable to completely heal wounds before exposing oneself to new stresses. The situation is different for severe head injuries. The prognosis is mixed. Older people in particular no longer have sufficient regenerative powers. For them, the outlook is sometimes the worst. Patients need at least six months before recovery is possible at the earliest. Depending on the severity of the injury, the healing process can also take years. Some sufferers have to live with long-term problems afterwards. They can no longer perform basic skills properly. Permanent disorders then result in a permanent need for care. It is considered proven that unconscious people improve their chances of recovery if they wake up in the first week.
Prevention
To prevent head injuries, it is recommended to wear a helmet during sports activities or activities with a potential fall hazard. Many head injuries could be prevented by wearing a helmet.
Aftercare
The extent to which follow-up care is needed depends on the extent of the head injury. If brain functions are not affected, a full recovery occurs. Follow-up care is then not necessary. However, head injuries can recur at any time. The reasons for this are so varied, however, that they cannot be named conclusively. A certain degree of caution and attentiveness is programmed into people. However, overestimating oneself or having the wrong view of the risk make the recurrence of a head injury incalculable. When engaging in certain sports, such as skiing, motorcycling, or bicycling, individuals should be sure to wear a helmet as protective gear. If permanent damage to the brain remains, aftercare can only consist of medical support for everyday life. Support services such as therapies and medication become important – also to prevent complications. The extent of medical treatment depends, among other things, on the damage. Examination of the nervous system in the brain also provides information about neurological disorders. In principle, more frequent examinations are to be expected if doctors expect an improvement in the symptoms. If damage exists for years, recovery tends not to be expected.
What you can do yourself
In the case of serious head injuries, especially severe blows or violent falls, a doctor should always be consulted immediately because of the risk of concussion or skull fracture. In the case of small children, a doctor should always be consulted as a precaution in the event of blows or falls on the head, as the bones of the skull are not yet fully formed here. In healthy adults, minor head injuries can initially be treated by the patient. Small cuts or lacerations after a fall with the bicycle or another accident should be cleaned and disinfected. It is then best to apply an antibacterial healing ointment and protect the wound with a plaster. Alternatively, a spray dressing can be used. For blunt injuries associated with tissue swelling or hematomas, immediate cooling is best. A washcloth dipped in cold water or an ice pack can be used for this purpose. Cold compresses, which can be bought in pharmacies and drugstores, are also helpful. To promote the decongestion of the tissue, compresses with healing earth or acetic acid clay can be used. Over-the-counter painkillers from the pharmacy help against mild headaches. If certain symptoms develop after the head injury, in particular dizziness, nausea, vomiting, visual disturbances or severe headaches, a doctor must be consulted immediately. This applies even if the injury seems harmless, as serious complications can arise in the event of a protracted concussion or other initial disorders.
