Diagnosis of head injuries
If a head injury seems serious enough to be seen by a medical professional, your doctor will likely work quickly to assess the situation, as many head injuries get rapidly worse with time. They will want to know what happened, whether the person has lost consciousness (and if so, for how long), and if there were any changes in alertness, speech, or coordination.
Your doctor will use the Glasgow Coma Scale, which is a test that assesses the severity of an injury by checking your ability to follow directions and move your eyes and limbs as well as your speech. This scale runs from 3 to 15, with higher scores meaning less severe injuries.
Your doctor may use imaging tests like a CT scan or MRI to uncover a more detailed view of the brain. These scans will show evidence of bleeding, bruises, swelling, and blood clots.
Treatment strategies depend on the type and severity of the head injury. Minor injuries, such as surface scalp wounds, usually heal with home management. For severe head injuries, dial 911 and follow these steps:
- Apply direct pressure to the wound unless you suspect a skull fracture. Do not attempt to clean or rinse the wound as this can make the bleeding worse. Instead, apply a sterile bandage.
- Do not move the person unless absolutely necessary. Do not pick up a child. Help the injured person remain still until medical help arrives.
- Do not remove any object embedded in the wound or head.
- Do not remove a helmet.
- Monitor breathing and pulse. Begin CPR (cardiopulmonary resuscitation) if necessary and continue until medical help arrives.
Most head injuries don’t require anything more than rest and over-the-counter pain medication to control headaches. You will need to be monitored closely for any changes in symptoms and follow your doctor’s advice about when it is okay to return to physical and mental activities.
In an emergency setting, where doctors need to treat a moderate to severe head injury, they will focus on ensuring there is adequate oxygen and blood supply, maintain blood pressure, and keep the head and neck immobile. Doctors may administer medications such as anti-seizure drugs or diuretics to control the risk of seizures and reduce the amount of fluid, which relieves pressure in your brain.
In severe cases, surgery may be needed to remove blood clots, repair fractures, or control bleeding. Surgery may also be used to open a “window” in the skull to reduce pressure buildup.
Most people who have mild to moderate head injuries will be able to make a full recovery. It is essential to follow your care team’s instructions about when to return to work, sports, school, or other activities so that you do not re-injure yourself or cause the injury to last longer.
Those with severe head injuries will generally require rehabilitation. This could take place at a hospital, inpatient rehab unit, or through outpatient work. The extent of rehabilitation needed will depend on the severity of the head injury and what part of the brain was involved. A team of professionals, including psychiatrists, physical therapists, speech and language pathologists, neuropsychologists, and social workers, will work together to guide your treatment.
The information contained in this article is meant for educational purposes only and should not replace advice from your healthcare provider.