Dr. MJ Bazos MD, Patient Handout
Head Injuries

What are the main causes of head injuries?
A serious head injury is most likely to happen to someone who is in a car wreck and isn’t wearing a seat belt. Other major causes of head injuries include bicycle wrecks, falls from windows (especially among children who live in the city) and falls around the house (especially among toddlers and the elderly). Another cause in babies is being shaken by an adult.

Are head injuries serious?
They can be. Bleeding, tearing of tissues and brain swelling can occur when the brain moves inside the skull at the time of an impact. But most people recover from head injuries and have no lasting effects.
How can my doctor tell how bad the damage is?
Your doctor will want to know how the injury occurred, about past medical problems, and about vomiting, seizures (fits) or problems breathing after the injury. The person who has been injured may need to stay in the hospital to be watched. Sometimes, special pictures of the brain may be needed to find out more about the damage.

What to watch for afterward - Get help if you notice:

• Any symptom that is getting worse, such as headaches, nausea or sleepiness
• Nausea that doesn’t go away
• Changes in behavior, such as irritability
• Dilated pupils (pupils that are bigger than normal) or pupils of different sizes
• Trouble walking
• Drainage of bloody or clear fluid from ears or nose
• Vomiting
• Seizures
• Weakness or numbness in the arms or legs

Will the head injury cause permanent brain damage?
This depends on how bad the injury was and how much damage it did. Most head injuries don’t cause permanent damage.
What happens after the injury?
It’s normal to have a headache, and feel dizzy and nauseous right after a head injury. Other symptoms include ringing in the ears, neck pain, and feeling anxious, upset, irritable, depressed or tired. The person who has had a head injury may also have problems concentrating, remembering things, putting thoughts together or doing more than one thing at a time. These symptoms usually go away in a few weeks, but may go on for over a year if the injury was severe.

Is it true that the person must be kept awake after the injury?
No. If your doctor thinks the person needs to be watched this closely, your
doctor will probably want to keep the person in the hospital. Sometimes, doctors will send someone who has had a head injury home if the person with them is reliable enough to watch the injured person closely. In this case, your doctor may ask you to wake the person frequently and ask questions such as “what’s your name?” and “where are you?” to make sure everything is okay.

Will the injury cause epilepsy?
Sometimes epilepsy can start after a head injury. This is much more common if the injury was from something that went through the skull, such as from a gunshot or knife wound. Your doctor might prescribe medicine to lessen the likelihood of epilepsy if he or she thinks the risk is high.

Will memory be lost?
It’s common for someone who’s had a head injury to forget the events right before, during and right after the accident. Memory of these events may never come back. Following recovery, the ability to learn and remember new things almost always returns.

Types of head injuries

• A concussion is a jarring injury to the brain. A person who has a concussion passes out for a short while. This usually lasts for several seconds to several minutes. The person may feel dazed and may lose vision or balance for a while after the injury. Children who have a concussion don’t cry right away.
• A brain contusion is a bruise of the brain. This means there is some bleeding in the brain, causing swelling. A contusion is a more serious injury than a concussion.
• A skull fracture is when the skull cracks. A skull fracture is often a more serious injury. Sometimes the edges of broken skull bones cut into the brain and cause bleeding or other injury. This is most likely if the skull is broken by something sharp or pointed. Skull fractures are more common in adults than in young children because skulls of young children are softer and “give” more without breaking.
• A hematoma is when a head injury causes bleeding in the brain and the blood collects and clots. Sometimes a hematoma may not be apparent for a day or even as long as several weeks after the head injury. This is why it’s important to tell your doctor about anything unusual in how the person with the head injury is feeling. Even a minor head injury can sometimes cause a hematoma, especially in an older person.

The brain may move inside the skull during impact, causing tissue damage.

• head trauma,
• cerebral contusion,
• cerebral laceration,
• impaired consciousness,
• stupor,
• coma,
• vegetative state,
• skull penetration,
• postconcussion syndrome,
• amnesia