HEADACHES: DEALING WITH A HEAD INJURY
Three important questions need to be answered following any head injury.
Has there been concussion or any other form of brain damage?
Is there any bleeding in or around the brain?
Is there a neck injury as well?
As far as the direct head injury is concerned, the following facts are important to take into consideration.
If the victim has been knocked out, or cannot remember the exact incident or the few seconds leading up to it, then he needs to be admitted to hospital for at least twenty-four hours observation. .
If any of the following occur in the first twenty-four hours after a head injury, the injury to the brain may be more severe than previously thought, or there may be internal bleeding. The symptoms are: severe, increasing headache; vomiting; double vision; incoordination; drowsiness. (There’s a great difference between drowsiness and sleepiness: when you feel sleepy you want to sleep, but can be roused to full consciousness. When you’re drowsy, you can’t be roused properly.)
If any of these occur; if there is any odd behaviour; if there is a general deterioration of the patient’s condition; or if there is anything else that is causing concern, you should go to Casualty immediately.
Usually the above symptoms occur within the first twenty-four hours, but in some cases they can occur much later, perhaps over ten days. This is particularly
the case with sub-dural haemorrhages in older people. Even when the injury is several days old, if the patient starts showing some of these symptoms, they should see a doctor immediately.
The only reason why patients are admitted to hospital following a head injury is to be certain that they do not have any hidden bleeding inside the skull causing pressure on the brain, or else swelling of the brain substance itself. Any extra pressure needs to be relieved as soon as possible, whether caused by stoved-in bones in the skull; from high-pressure bleeding; or from slow low-pressure bleeding, as in a sub-dural haemorrhage. An urgent operation may be necessary to elevate stoved-in bones and suck out any blood clots: swelling of the brain substance itself can be treated with steroids.
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