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.

Considerations

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 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, however, have improved the outlook for many of these injuries.

Every year, approximately two million people sustain a head injury. Most of these injuries are minor because the skull provides the brain with considerable protection -- thus symptoms of minor head injuries usually resolve with time. However, over half a million head injuries a year are severe enough to require hospitalization.

In patients who have suffered a severe head injury, there is also often one or more other organ systems injured. An important consideration in early management of these cases is that there is approximately a 5% incidence of associated spine fractures with significant head injury.

Causes

Accidents are the leading cause of death or disability in men under age 35, and over 70% of accidents involves head injuries and/or spinal cord injuries. Common causes of head injury include traffic accidents, industrial/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 (intracranial hematoma), or high shearing forces that damage the nerve cells of the brain (diffuse axonal injury). These more serious head injuries cause deficits that vary with the degree of brain injury. These deficits may include:

• Personality changes
• Emotional disturbances
• Speech and language deficits
• Cognitive deficits
• Loss of sensation, hearing, vision, taste, or smell
• Seizures
• Paralysis
• Coma

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