Head Injury – Swift Evaluation and Treatment May Prevent Tragedy

The recent death of actress Natasha Richardson after a skiing accident focused the nation’s attention on the issue of head injuries.  Head injuries kill more than 50,000 Americans each year with approximately two million more suffering significant head trauma.

Head injuries, also known Traumatic Brain Injuries, can be deadly. Paying early attention to symptoms saves lives. Signs of a significant head injury include:

  • Drowsiness
  • Unusual or abnormal behavior
  • Headaches
  • Vomiting
  • Memory Loss
  • Loss of Consciousness
  • Feeling off Balance
  • Light Sensitivity

People with persistent symptoms should be evaluated by a qualified physician. An emergency evaluation in a traumatic brain injury case usually includes a computed tomography scan of the head and neck. Two types of magnetic resonance imaging — Diffusion Weighted Imaging (DWI) and Consequent Apparent Diffusion Coefficient (ADC) have been very helpful when used to aid in the prediction of the medical effects of head injuries in adults and children. Early identification of patients at high risk for poor outcomes can be obtained using these tools and the knowledge gleaned from the imaging can assist physicians in making a determination of what treatment is most appropriate.

Serious head injuries usually involve a concussion to the entire brain or lesions: the accumulation of blood between the lining of the brain and the skull (epidural hematoma), blood between the dura and the brain  (subdural hematoma), and bleeding within the brain tissue (intercranial hemorrhage).

The most important factor related to recovery is the speed with which the injured person is evaluated and treated. The victim’s general health is also important. Surgery can remove epidural hematomas. Often patients can recover fully. Subdural hematoma and intracranial bleeding are more serious. State of the art medical treatment helps patients survive with surgery but many patients who suffer from subdural hematomas or intracranial bleeding experience long term neurological problems.

While mild head injuries usually require no specific treatment, all victims of head injuries must be monitored carefully. Although Natasha Richardson’s case was tragic, most sports related head injuries are mild concussions that resolve without serious or lasting complications. Individuals suspected of having a head injury should cease the physical activity in which they are engaged, and should be evaluated sooner rather than later. If the victim has persistent problems with speech, coordination or vision, immediate medical attention must be obtained.

In serious cases among children, the patients, parents and doctors face different challenges than those faced by adults. Neurological problems in children who suffer head trauma may not be revealed for years. Frontal lobe functions develop late in a child’s growth.  Injury to the frontal lobes may not become apparent until the child reaches adolescence. Injury to reading and writing centers in the brain may not become apparent until the child reaches school age and shows signs of delayed reading and writing skills. Studies show that children’s skulls are only 1/8 as strong as that of adults. Thus, children are much more vulnerable to traumatic brain injury through deformation and fracture of the skull.

Although medical treatment for traumatic brain injury is always improving, prevention is preferred. Safety helmets are critical for bicycling, skiing, skateboarding and any sport in which the participant risks injury to the head.