Head Injury: From 3 Different Sources
Injury to the head may occur as a result of a blow or a fall. The severity of the injury depends on whether the brain is affected. A blow may shake or bruise the brain (see brain damage). If the skull is broken (see skull, fracture of), foreign material or bone may enter the brain and lead to infection. A blow or a penetrating injury may cause swelling of the brain, or tear blood vessels, which may lead to brain haemorrhage.
If the head injury is mild, there may only be a slight headache. In some cases there is concussion. More severe head injuries may result in unconsciousness or coma, which may be fatal. Amnesia may occur. After a severe brain injury, there may be some muscular weakness or paralysis and loss of sensation. Symptoms such as persistent vomiting, double vision, or a deteriorating level of consciousness could suggest progressive brain damage.
Investigations may include skull X-rays and CT scanning. A blood clot inside the skull may be life-threatening and requires surgical removal; severe skull fractures may also require surgery. Recovery from concussion may take several days. There may be permanent physical or mental disability if the brain has been damaged. Recovery from a major head injury can be very slow, but there may be signs of progressive improvement for several years after the injury occurred.
Any injury to the head, whether associated with a skull fracture (see BONE, DISORDERS OF – Bone fractures) or not. Patients with head injuries should be assessed for signs of neurological damage, which may not develop at once. Patients who after a head injury are or have been UNCONSCIOUS or who are drowsy, vomiting, confused or have any focal neurological signs – for example, blurred vision or a motor or sensory malfunction – should be seen by a doctor. Particular care should be taken with individuals who have consumed alcohol and sustained a head injury in a ?ght, fall or vehicle accident. Symptoms indicative of a severe head injury may be attributed (wrongly) to the effects of alcohol, and crucial time thus lost in treating the injury.
In hospital the possible need for urgent action is monitored by use of the GLASGOW COMA SCALE.
People suffering the results of such injuries and their relatives can obtain help and advice from Headway – the brain injury association.
an injury usually resulting from a blow to the head and often associated with *traumatic brain injury. It may result in *contusion or – if the blood vessels in the head are torn – a *haematoma. The level of consciousness of a patient following a head injury can be monitored using the *Glasgow Coma Scale. Head injuries are an important cause of death due to accidents: legislation to impose protective headgear at industrial sites and on construction workers and motorcyclists has reduced their incidence.
An injury to the neck region caused by the neck being forcibly bent backwards and forwards (or the other way around). Car accidents are a common cause, when a driver or passenger is suddenly decelerated. The injury usually affects the ligaments, spinal joints and soft tissues of the neck. Subluxation (partial dislocation) of a cervical joint sometimes occurs and cervical vertebra may occasionally be fractured if the forces are severe. Pain and sti?ness of the neck result and these may worsen after a day or so. Treatment includes immobilisation of the neck in a collar, and analgesic and muscle-relaxing drugs. PHYSIOTHERAPY may be necessary. The patient usually recovers fully but may take several weeks to do so.... whiplash injury
See BRAIN; FACE; SCALP; SKULL.... head
Accidental perforation of the skin by an injection needle, commonly of the hand or ?nger and usually by a nurse or doctor administering a therapeutic injection. The term also refers to accidental injuries from injection needles discarded by drug abusers. Dangerous infections such as viral HEPATITIS or HIV may be acquired from needle-stick injuries, and there are strict procedures about the disposal of used syringes and needles in medical settings.... needle-stick injury
See child abuse.... nonaccidental injury
(RSI) An overuse injury that affects keyboard workers and musicians, causing weakness and pain in the wrists and fingers.... repetitive strain injury
The term describing the abnormally dilated veins that form around the umbilicus in CIRRHOSIS of the liver.... caput medusae (medusa’s head)
Negative effect resulting from a medical treatment.... iatrogenic illness (or injury)
(See also CHILD ABUSE). Though NAI has traditionally been seen as abuse against children – and they are still the main victims – such injuries can also be in?icted on vulnerable adults. Adults with learning diffculties, dementias or physical disabilities su?ciently serious as to require institutional care (or who make heavy demands on relatives) are sometimes the victims of NAI. Health professionals, social workers and relatives should bear this possibility in mind when discovering unusual, severe or repeated bruising or fractures in vulnerable adults, even in circumstances where NAI may seem unlikely. (See also MUNCHAUSEN’S SYNDROME; PAEDOPHILIA.)... non-accidental injury (nai)
See UPPER LIMB DISORDERS.... repetitive strain injury (rsi)
Trauma Injury to the urethra is often the result of severe trauma to the pelvis – for example, in a car accident or as the result of a fall. Trauma can also result from catheter insertion (see CATHETERS) or the insertion of foreign bodies into the urethra. The signs are the inability to pass urine, and blood at the exit of the urethra. The major complication of trauma is the development of a urethral stricture (see below).
Urethritis is in?ammation of the urethra from infection.
Causes The sexually transmitted disease GONORRHOEA affects the urethra, mainly in men, and causes severe in?ammation and urethritis. Non-speci?c urethritis (NSU) is an in?ammation of the urethra caused by one of many di?erent micro-organisms including BACTERIA, YEAST and CHLAMYDIA.
Symptoms The classic signs and symptoms are a urethral discharge associated with urethral pain, particularly on micturition (passing urine), and DYSURIA.
Treatment This involves taking urethral swabs, culturing the causative organism and treating it with the appropriate antibiotic. The complications of urethritis include stricture formation.
Stricture This is an abrupt narrowing of the urethra at one or more places. Strictures can be a result of trauma or infection or a congenital abnormality from birth. Rarely, tumours can cause strictures.
Symptoms The usual presenting complaint is one of a slow urinary stream. Other symptoms include hesitancy of micturition, variable stream and terminal dribbling. Measurement of the urine ?ow rate may help in the diagnosis, but often strictures are detected during cystoscopy (see CYSTOSCOPE).
Treatment The traditional treatment was the periodic dilation of the strictures with ‘sounds’
– solid metal rods passed into the urethra. However, a more permanent solution is achieved by cutting the stricture with an endoscopic knife (optical urethrotomy). For more complicated long or multiple strictures, an open operation (urethroplasty) is required.... urethra, diseases of and injury to
(ears). See: TINNITUS. ... noises in head
Damage sustained during birth. Minor injuries, such as bruising and swelling of the scalp during a vaginal delivery (see cephalhaematoma) are common. More serious injury can occur, particularly if the baby is excessively large and has difficulty in passing through the birth canal. A breech delivery may result in injury to nerves in the shoulder, causing temporary paralysis in the arm. The face may be paralysed temporarily if the facial nerve is traumatized by forceps. Fractured bones are another hazard of difficult deliveries, but the bones usually heal easily. (See also birth defects; brain damage.)... birth injury
The persistent, rhythmic banging of the head against a wall or hard object. Head-banging is seen in some people with severe learning difficulties, particularly those who lack stimulation. It also occurs in some normal toddlers, often when they are frustrated or angry; most children grow out of the behaviour.... head-banging
Accidental puncture of the skin by a contaminated hypodermic needle. Hospital staff are most likely to be at risk. Needlestick injuries carry the risk of serious infections, such as HIV and hepatitis, and need immediate attention. The wound should be cleaned thoroughly; blood tests may be needed to determine whether infection has been transmitted.... needlestick injury
Damage to the tissues (see ligament; tendon; muscle) that surround bones and joints.... soft-tissue injury
a quick method for determining the severity of a case of serious trauma. It can be used for purposes of *triage and *clinical audit.... abbreviated injury scale
see AKI.... acute kidney injury
an orthoptic eye test used mainly to differentiate between a weakness of the superior oblique muscle and a weakness of the contralateral superior rectus muscle (see extrinsic muscle). [A. Bielschowsky (1871–1940), German ophthalmologist]... bielschowsky head tilt
(EHS, episodic cranial sensory shock) an auditory *hallucination, characterized by the perception of a sudden loud noise in the head or ears, that is experienced during a transition between sleep stages. The cause is not currently known.... exploding head syndrome
a manoeuvre for opening the airway of an unconscious patient. With the patient lying on his or her back, the neck is extended and the chin simultaneously pulled gently upwards to pull the tongue away from the back of the pharynx. This method is often used when mouth-to-mouth ventilation is to be given and is an alternative to the *jaw thrust manoeuvre.... head tilt, chin lift
(injury severity scale, ISS) a system used, particularly in *triage, for grading the severity of an injury. See also abbreviated injury scale.... injury scoring system
(OASIS) a spectrum of injuries that encompasses both third- and fourth-degree *perineal tears. Injury to the anal sphincter mechanism during childbirth may arise secondarily to direct disruption of the sphincter muscles and/or traction of the pudendal nerves. Disruption of the anal sphincter muscles is best assessed by anal ultrasound examination. This is usually performed using a high-frequency (10 MHz) endoanal probe. In selected cases with complex injury and/or suspected rectovaginal *fistula, magnetic resonance imaging (MRI) may also be employed.... obstetric anal sphincter injury
a penetrating injury by a ski stick.... ski-stick injury
any injury related to the practice of a sport, often resulting from the overuse and stretching of muscles, tendons, and ligaments.... sports injury
(TBI) injury to the brain due to external force, such as occurs following falls, road traffic accidents, and violence. It is a major cause of death and chronic disability worldwide, especially in young males.... traumatic brain injury
Health Encyclopedia