Injuries to the head are so common that almost everyone
in their lifetime will sustain some form of trauma to the head. Learning to
recognize a serious head injury, and implementing basic first aid, can make the
difference in saving someone’s life. Medical advances in detecting and treating
these injuries, have improved the outlook for many of these
Every year, millions of people sustain a head injury. Most of
these injuries are minor because the skull provides the brain with considerable
What are the types?
Head injuries can range from relatively minor damage to the scalp and face such as lacerations, abrasions and bruising to more serious consequences involving damage to the brain. Head injury can be classified as either closed or penetrating. In closed head injury, the head sustains a blunt force by striking against an object. In penetrating head injuries, a high velocity object breaks through the skull and enters the brain.
What are the causes?
Accidents are the leading cause of death or disability in men under age 35y.
Over 70% of accidents are associated with head injuries and/or spinal cord
injuries. Common causes of head injury include traffic accidents, industrial or
occupational accidents, recreational accidents, falls, physical assault, and
accidents in the home. Some head injuries result in prolonged or
non-reversible brain damage. This can occur as a result of bleeding inside the
brain or high shearing forces that damage the nerve cells of the brain. These
more serious head injuries cause various changes that vary with the degree of
trauma. These may include:
Speech and language deficits
Loss of sensation, hearing, vision, taste or smell
What are the symptoms?
The signs and symptoms of a head injury may occur immediately or develop slowly
over several hours. If a child begins to play or run immediately after getting a
bump on the head, serious injury is unlikely. However, the child should still be
closely watched for 24 hours, since the symptoms of a head injury may be
delayed. It is always important to try to find out how the injury
occurred. Loss of consciousness, even for a very brief period, is one of the
clearest indications that the brain may have been affected by a blow to the
head. A state involving uncertainty about time, date, and location and/or a
period of memory loss for the events surrounding the head injury are also
indicators of trauma to the brain. Any of these symptoms following a blow to the
head should be taken seriously. The following symptoms suggest a more serious
head injury that requires emergency medical treatment:
Altered level of consciousness
Bleeding or fluid drainage from nose, mouth, or ears
Decreased rate of breathing
A doctor’s help needed when:
there is severe head or facial bleeding
there is a change in the level of consciousness
you suspect a serious head or neck injury
What is the treatment?
Treatment varies according to the severity, type and location of the injury, and
development of complications. For mild head injuries, no specific treatment may
be needed other than observation for complications. For moderate to severe head
injuries, urgent treatment is required. The following first aid treatment is
indicated if the victim is comatose or symptoms are severe.
Check his airway, breathing, and circulation. If necessary, begin rescue
breathing and CPR (CPR is an emergency lifesaving procedure. It is performed
when the breathing or the heartbeat has stopped).
If the breathing and heart rate are satisfactory but the patient is
unconscious, treat him as if there is a spinal injury. Stabilize the head and
neck by placing your hands on both sides of his head, keeping the head in line
with the spine and preventing movement. And wait for medical help.
Unless there has been a skull fracture, attempt to stop any bleeding by
firmly pressing a clean cloth on the wound. If the injury is serious, be careful
not to move his head. If blood soaks through the cloth, do not remove it; just
place another cloth over the first one.
If you suspect a skull fracture, do not apply direct pressure to the
bleeding site and do not remove any debris from the wound. Cover the wound with
sterile gauze dressing and get medical help immediately.
If the head wound is superficial, wash it with soap and warm water and pat
If the patient is vomiting and you do not suspect a spinal injury, turn his
head to the side to prevent choking. If you do suspect a spinal injury, roll the
head, neck and body as one unit. Children often vomit once after a head injury.
But even if the child does not vomit again and is not behaving differently,
contact a doctor.
Apply ice packs to swollen areas.
Over-the-counter pain medicine usually helps reduce headache.
Over the next 24 hours, observe the patient for any signs of a serious head
injury. During the night, awaken him every 2 to 3 hours and check for alertness.
Ask him specific questions, such as an address. If he becomes unusually drowsy
develops a severe headache or stiff neck, vomits more than once, or behaves
abnormally, get medical help immediately.
Refrain from vigorous activity for 24 hours after a serious head
Do not remove his helmet if you suspect a serious head injury.
Do not wash a head wound profusely.
Do not remove any object sticking out of a wound.
Do not move him unless absolutely necessary.
Do not shake him if he seems dazed.
Do not let other, more obvious, injuries distract you from the head injury.
Do not allow him to consume alcohol within 48 hours of a serious head
Can there be brain injury if there is no physical evidence of trauma to the head?
Even if the skull is not fractured, the brain can bang against the inside of the
skull and be damaged. If there is bleeding inside the skull, complications may
How can it be prevented?
Always wear a helmet when riding a two-wheeler.
Make sure that children have a safe area in which to play.
Provide adequate supervision for children of any age.
Obey traffic signals when riding a bike. Be predictable so that other
drivers will be better able to determine your course.
Be visible. Do not ride a bike at night.
Do not drink and drive, and do not allow yourself to be driven by someone
whom you suspect is drunk.