Head injuries are the most unexpected injury in the human population. It happens due to blow to the head usually associated with road traffic accident, fall from a height, assault, fall of a foreign object over the head. It is the most common cause of death in the adult population.

The impact of head injury varies from transient loss of consciousness to coma and death. It can be associated with facial injuries and injury to the other organs. Most common symptoms are transient loss of consciousness, vomiting, seizures, giddiness, loss of consciousness. Sometimes if the injury occurs in the vital parts of the brain, it can result in weakness of the limbs, hearing loss and vision loss, coma and death.

Head injury and its symptoms are because of the movement of brain inside the skull bone. The cerebrospinal fluid acts as a cushion and protects the brain from shock. Transiently brain stops to function, and it thereby causes loss of consciousness, memory loss, giddiness and vomiting.

Major types of head injury are Hematoma, Hemorrhage, Concussion, cerebral edema, Skull fracture, Diffuse axonal injury.

Head injury may cause blood clots in the brain. There are various types of blood clots in the brain.

Extradural hematoma (EDH)

Acute subdural hematoma (SDH)

Contusion

Chronic subdural hematoma

1. Extradural hematoma

It is an accumulation of blood between the inner table of skull and striped off dural membrane. It occurs following traumatic head injury and is often associated with skull fracture and arterial laceration. The blood vessel in proximity to the fracture is the source of blood. It is more common in young individuals because the membrane covering the brain is not as closely attached to the skull as in older people and in children younger than 2 years. It does not cause much damage to the underlying brain, and so the prognosis is excellent when treated early and aggressively. The requirement of surgery is based on the patient’s neurological condition.

2. Acute Subdural hematoma

It is a serious condition where in Blood collects between the skull and surface of brain. It occurs due to rupture of blood vessel and the clot may cause pressure on the brain. It occurs usually following a severe head injury. It can occur following a minor injury when the age of the patient is above 60 years or when the patient is on blood thinning medication for associated medical condition or with alcohol abuse. The surgical technique in the management of subdural hematoma are

Craniotomy

Burr hole

Brain Contusion

It is a bruise of the brain tissue. Just like bruises that occur on other parts of the body, a brain contusion is caused by small blood vessel leaks. Because they involve structural brain damage, contusions are more serious than concussions.

Brain contusions are most often caused by an impact to the head, such as those sustained in a car accident, a fall, or a sports-related accident. In some cases the brain is injured right below the site of impact, while in other cases the injury occurs on the opposite side of the impact.

Contusions are most often found in cortical tissue, in areas that are near sharp ridges on the inside of the skull, such as under the frontal and temporal lobes and on the root of the ocular orbit. The prognosis for contusion depends upon the severity of the injury. Small contusions are able to heal on their own but larger contusions may need surgical interventions depends on patient’s condition. Extremely severe contusions can cause herniation of the brain, and eventually coma.

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