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| Head Injury, Causes, Diagnosis, Treatment, Prevention, Complications |
Head injury (head trauma) is a problem with the structure of the head due to an impact that has the potential to cause disturbances in brain function. These problems can include minor injuries, bruising to the scalp, swelling, bleeding, skull fractures, or concussions.
Symptoms experienced by people with head injuries vary, depending on the severity of the condition. Based on the severity, head injuries are divided into two, namely mild head injury and moderate to severe head injury.
Causes of Head Injury
Head injuries occur when there is a hard impact, especially one that hits the head directly. The severity of the injury will depend on the mechanism and the severity of the impact experienced by the patient.
The following is a list of activities or situations that can increase a person's risk for a head injury:
- Falling from a height or slipping on a hard surface
- Traffic accident
- Injuries while exercising or playing
- Domestic violence
- Use of explosive devices or noisy weapons without protective equipment
- Excessive body shaking in babies (shaken baby syndrome)
Although it can happen to everyone, the risk of head injury is higher in the productive and active age groups, namely those aged 15–24 years, and in the elderly aged 75 years and over. Newborns up to 4 years old are also susceptible to this condition.
Symptoms of Head Injury
Symptoms experienced by people with head injuries vary, depending on the severity of the condition and the location of the impact. Not all symptoms will be felt immediately after the injury occurred. Sometimes new symptoms appear a few days to several weeks later.
Symptoms of minor head injury
- Lumps or swelling on the head
- Non-deep scalp wounds
- Dazed or having a blank stare
- Dizziness or headache
- Nauseous
- Easy to feel tired
- Easily drowsy and sleeps longer than usual
- Hard to sleep
- Loss of balance
- Sensitive to light or sound
- Blurred vision
- Ears ringing
- The ability to smell or taste changes
- Difficulty remembering or concentrating
- Depression
- Mood swings
Symptoms of moderate and severe head injury
- Loss of consciousness for minutes to hours
- There is a deep wound on the head
- There is a foreign object stuck in the head
- Prolonged severe headache
- Nausea or vomiting on an ongoing basis
- Loss of body coordination
- Seizure
- Dilation of the pupil of the eye
- There is fluid coming out through the nose or ears
- Difficulty recognizing the faces of family, close friends, or even your own face (prosopagnosia)
- Weak or stiff fingers and toes
- Difficult to wake up during sleep
- Feeling very confused
- Drastic behavior change
- Slurred talk
- Coma
Symptoms of a head injury in children can look different and are sometimes difficult to detect. The following are some of the symptoms that can indicate a possible head injury in a child:
- Crying constantly
- Seizure
- Easy cheap
- No appetite
- Difficult to concentrate
- Sleep patterns change
- Often feel sad or depressed
- Not active
When to go to the doctor
Go to the doctor immediately if you or your child has just had a hard blow to the head, even if you don't feel any symptoms.
If the injury is followed by a change in behavior or any of the above symptoms, including symptoms of a minor head injury, visit the nearest doctor or emergency room immediately for immediate treatment.
Head Injury Diagnosis
The doctor will ask how the head injury occurred. This can help the doctor determine the severity of the head injury the patient has. Besides that. The doctor will perform a physical exam, such as looking for signs of bleeding, swelling, or bruising.
To confirm the diagnosis, the doctor will also perform supporting examinations in the form of:
- Glasgow Coma Scale (GCS) examination
GCS examination is useful to determine the patient's level of consciousness. This examination can determine the severity of the head injury. The normal GCS value is 15. The lower the score, the greater the impact of the injury on the brain.
- Nerve exam
Disorders of the brain can have an impact on the body's nervous function. In the case of a head injury, evaluation of nerve function by measuring muscle strength, ability to control muscle movement, and ability to feel sensations may need to be done to determine the condition of the brain.
- Radiological examination
Radiological examination with X-rays, CT scans, or MRIs can see the possibility of skull fractures, bleeding, and swelling of the brain, as well as to check the condition of the tissue and blood flow in the brain.
The doctor will also ask family or relatives to monitor the patient's condition for several days, for example by looking at the patient's eating patterns, sleeping patterns, speech, and mood.
As previously explained, the symptoms of a head injury may appear after a few days or weeks. Monitoring aims to ensure that no symptoms develop to become more severe or only appear some time after the incident.
Head Injury Treatment
Treatment will be tailored to the severity of the injury. In general, doctors will help with medication, therapy, or surgery if needed. The explanation is as follows:
Drugs
Patients with minor head injuries usually do not require special medical treatment because the condition can improve with rest. To relieve pain that may be felt, the doctor will recommend the patient to take paracetamol.
Patients need to avoid using NSAIDs, such as ibuprofen or aspirin, without a doctor's instructions. The reason is, it is feared that it can increase the risk of bleeding in the brain.
If the head injury is moderate or severe, the doctor may prescribe anticonvulsants to reduce the risk of seizures, which usually occur a week after the trauma. Doctors can also give diuretic drugs to reduce pressure in the brain by removing fluid from brain tissue.
In severe head injuries that cause blood vessel damage, doctors can give a sedative so that the patient can sleep for a long time (induced coma). This is done to relieve the pressure and workload of the brain that cannot receive oxygen and nutrients as usual.
In addition, for patients who experience memory, cognitive, or behavioral disorders due to brain damage, doctors may prescribe neuroprotective drugs, such as citicoline. This drug can help improve brain function in patients with head injuries.
Therapy
For patients with moderate to severe head injuries, therapy or rehabilitation may be needed to improve and restore physical condition and nerve function. The range of therapies commonly suggested includes:
- Physiotherapy, to restore impaired nerve or muscle function due to disturbances in the brain due to injury
- Cognitive and psychological therapy, to improve behavioral, concentration, thinking, or emotional disturbances that occur after a head injury
- Occupational therapy, to help patients re-adjust in carrying out daily activities
- Speech therapy, to improve the patient's speaking and communication skills
- Recreational therapy, to train patients to enjoy their free time and establish social relationships through fun activities
Doctors will usually educate the patient's family and relatives about further therapy that can be done at home after the patient is discharged from the hospital.
Operation
The type and purpose of the surgery will depend on the severity of the condition and the problems caused by the head injury. Generally, surgery is performed if the head injury has caused the following conditions:
- Heavy bleeding in the brain
- Fracture of the skull that injures the brain
- There is a foreign object in the brain
Complications of Head Injury
If not treated properly, people with moderate to severe head injuries are very susceptible to complications, either shortly after the trauma or several weeks after. Some of the complications that can occur are:
- Loss of consciousness
- Vertigo
- Empty sella syndrome
- Recurrent seizures or epilepsy after trauma
- Nerve and blood vessel damage
- stroke
- Infections, such as meningitis
- Degenerative diseases of the brain, such as dementia, Alzheimer's disease, and Parkinson's disease
- Language and communication disorders (aphasia)
Head Injury Prevention
Prevention of head injury can be done by the following steps:
- Using safety equipment when exercising
- Always use safety equipment, such as a helmet or headgear, when working in an environment where there is a risk of head injury
- Install iron railings in bathrooms and beside stairs to reduce the risk of slipping
- Make sure the floor is always dry and not slippery
- Install good lighting throughout the house
- Check the condition of the eyes regularly, especially if you experience symptoms of visual disturbances, such as blurry or blurred vision
Children are also prone to head injuries while playing. Here are steps parents can take to prevent it:
- Lock the door of the house when there is no supervisor
- Installing window shutters, especially if you live in a terraced house
- Putting a dry mat in front of the bathroom door so it doesn't slip
- Supervise children and make sure they play safely
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