A head injury is a trauma or damage to the skull, scalp, brain, neck, or the tissues and blood vessels in the head. A severe head injury is a traumatic brain injury (TBI) that occurs because of a blow, jolt, or forceful bump to the head. Although not all jolts result in a traumatic brain injury, all head injuries must be addressed immediately.
Head injury is categorized as open (penetrating) and closed (non-penetrating). Depending on the clinical presentation, it is also categorized as mild, moderate, or severe. A mild head injury causes short-term or temporary issues. Moderate to serious head injury may lead to permanent disability or even death.
Head injury in adults can cause a wide variety of signs and symptoms, including headache, dizziness, seizures, slurred speech, hearing problems, etc.
Severe head injuries in adults are treated as an emergency, as consequences can worsen without treatment. Doctors or first responders should promptly assess the situation. Diagnosis of head injury in adults is done with the help of the following techniques and tests.
- Glasgow Coma Scale: It is a 15-point test. It aids in assessing the initial extent of an injury. Using this scale, medical professionals check the patient’s ability to follow directions, speech coherence, and move their eyes and limbs. Glasgow Coma Scale provides crucial clues regarding the severity of the injury. Higher scores mean the patient has suffered less serious injuries.
As the head injury’s initial assessment does not predict the extent of disability, neuroimaging and other tests are carried out. The doctors do a neurological and physical examination. They assess the size of the pupil, sensation, reflexes, and muscle strength. If the results are satisfactory, further radiological tests are not carried out. However, the doctor may advise monitoring the condition in the hospital or at home.
If there are signs of moderate-to-severe head injury, then the doctors try to stabilize the patient and focus on preventing further injury. Sometimes, besides imaging tests, FDA-regulated medical devices are used to assess the traumatic head injury.
- Radiological tests: The most common types of radiological tests used to diagnose a brain injury are computerized tomography (CT) and magnetic resonance imaging (MRI).
- Magnetic Resonance Imaging (MRI): It uses radio waves and magnets to look for damage in the brain. MRI is best for detecting tumors, lesions, minor bleeding, excessive fluids, and even signs of dementia. An MRI test is done once the patient is stable as it takes a longer time to test. The information obtained with this test is used for determining prognosis.
- Computerized Tomography (CT): A CT scan uses X-rays to detect swelling, bleeding, and skull fractures after the head injury. It is the gold standard for the imaging assessment of a head injury patient. The results from a CT scan help to understand whether the patient needs monitoring or emergency neurosurgery.
- Functional MRI (fMRI): A standard CT scan and MRI cannot detect a concussion. These tests only detect structural issues in the head. However, a concussion leads to neurovascular coupling system damage within the brain. To detect this dysfunction sometimes, a patient may need a functional MRI (fMRI). It shows the flow of blood through the brain in real-time.
As each brain injury is unique, its recovery is too. There is no set timeline for the recovery, and it depends on the location and severity of the injury. Mild head injury may only lead to occasional headaches, fatigue, and dizziness. These are temporary symptoms and rest or medication can help to ease them. Moderate to severe traumatic brain injury needs an extended hospital stay and prolonged rehabilitation. The recovery time of patients with a severe head injury is also more. Sometimes, disability may be permanent. The doctor may advise the following things during the recovery period.
- Get plenty of rest
- Avoid stressful situations
- Avoid drinking alcohol
- Avoid sleeping pills unless prescribed
- Don’t take illegal drugs
- Avoid non-steroidal anti-inflammatory drugs (NSAIDs) unless prescribed
- Don’t play contact sports and speak to the doctor before playing sports again
- Don’t return to work until there is the complete recovery
- Avoid driving a car, motorbike, or a bicycle
- Don’t operate machinery until it is safe to do so
- Don’t miss therapy sessions and
- Visit rehabilitation center as per the appointment
- Seek immediate medical attention if you develop any delayed symptoms of a head injury while recovering at home.
It is essential to understand the long-term effects of a head injury in adults. Correct diagnosis, prompt treatment helps in the speedy recovery. With time, improvement in the condition and recovery may slow down. The rate of recovery and improvement varies from one patient to another. If needed, get support services like rehabilitation programs and community outreach.