Head injury

Head | Neurology | Head injury (Disease)


Description

A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head. Head injuries are also commonly referred to as brain injury, or traumatic brain injury (TBI), depending on the extent of the head trauma.

Causes and Risk factors

Blows to the head most often cause brain injury, it is important to remember that the face and jaw are located in the front of the head. Brain injury may also be associated with injuries to these structures. It is also important to note that a head injury does not always mean that there is also a brain injury.

Head injuries may be closed or open. A closed (non-missile) head injury is where the dura mater remains intact. The skull can be fractured, but not necessarily. A penetrating head injury occurs when an object pierces the skull and breaches the dura mater. Brain injuries may be diffuse, occurring over a wide area, or focal, located in a small, specific area.

If intracranial hemorrhage occurs, a hematoma within the skull can put pressure on the brain. Types of intracranial hemorrage include subdural, subarachnoid, extradural, and intraparenchymal hematoma. Craniotomy surgeries are used in these cases to lessen the pressure by draining off blood.

If the impact causes the head to move, the injury may be worsened, because the brain may ricochet inside the skull causing additional impacts, or the brain may stay relatively still (due to inertia) but be hit by the moving skull (both are contrecoup injuries).

Diagnosis and Treatment

Computerized tomography (CT) is a specialized X-ray technology that can produce thin cross-sectional images of the brain. Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to produce cross-sectional or 3-D images of soft tissues. Doctors rarely use MRIs during emergency assessments of traumatic brain injuries because the procedure takes too long to complete. The device may be used after a persons condition has been stabilized.

Emergency care for moderate to severe traumatic brain injury focuses on making sure the person has an adequate oxygen and blood supply, maintaining blood pressure, and preventing any further injury to the head or neck. ...