Head Injury

Head Injury

Trauma is one of the leading causes of death and disability in the Indian population. It is estimated that nearly 1.5 to 2 million persons are injured and 1 million succumb to death every year in India.

What is a head injury?

Head injury or Traumatic brain injury (TBI) happens when a sudden, external, physical assault damages the brain. It is one of the most common causes of disability and death in adults. TBI is a broad term that describes a vast array of injuries that happen to the brain. The damage can be focal (confined to one area of the brain) or diffuse (happens in more than one area of the brain).

The various major causes of head injury are :

  • motor vehicle accidents
  • falls
  • physical assaults
  • sports-related accidents
  • Firearm-related injuries

Road traffic injuries are the leading cause (60%) of TBIs(traumatic brain injury) followed by falls (20%-25%) and violence (10%). Alcohol involvement is known to be present among 15%-20% of TBIs at the time of injury.


What is primary and secondary brain injury?

Primary brain injury refers to the sudden and profound injury to the brain that is considered to be more or less complete at the time of impact. This happens at the time of the car accident, gunshot wound, or fall.

Secondary brain injury refers to the changes that evolve over a period of hours to days after the primary brain injury. It includes an entire series of steps or stages of cellular, chemical, tissue, or blood vessel changes in the brain that contribute to the further destruction of brain tissue.

What are the major types of head injuries?

  • Scalp Lacerations
  • Skull Fracture
  • Minor Head Trauma
  • Major Head Trauma

Minor Head Trauma(Concussion):

Concussion: A sudden transient mechanical head injury with disruption of neuronal activity and a change in the LOC It occurs When the brain suddenly shifts inside the skull and knocks against the skull's bony surface. It is characterized by a brief period of loss of consciousness.

Concussions can last from a few moments to an unconscious state for over 3 minutes, and can lead to amnesia regarding the event and headache.


Major Head Trauma


  • Contusion: It is the bruising of the brain tissue within a focal area. It is usually associated with a closed head injury.

Epidural hematoma: A most common type of intracranial hemorrhage. Results from bleeding between the dura and the inner surface of the skull.


Subdural hematoma - Acute or Chronic :Subdural hematoma occurs from bleedingbetween the dura matter and thearachnoid layer of the meninges.

Subarachnoid hemorrhage: Bleeding occurs between the arachnoidand pia mater.

Diffuse axonal injury (DAI) is a form of traumatic brain injury. It happens when the brain rapidly shifts inside the skull as an injury is occurring. The long connecting fibers in the brain called axons are sheared as the brain rapidly accelerates and decelerates inside the hard bone of the skull.


Symptoms of Major Head Trauma:

Physical symptoms

  • Loss of consciousness from several minutes to hours
  • Persistent headache or headache that worsens
  • Repeated vomiting or nausea
  • Convulsions or seizures
  • Dilation of one or both pupils of the eyes
  • Clear fluids draining from the nose or ears
  • Inability to awaken from sleep
  • Weakness or numbness in fingers and toes
  • Loss of coordination

Cognitive or mental symptoms

  • Profound confusion
  • Agitation, combativeness or other unusual behavior
  • Slurred speech
  • Coma and other disorders of consciousness


Traumatic brain injuries may be emergencies. In the case of more-severe TBIs, consequences can worsen rapidly without treatment. Doctors or first responders need to assess the situation quickly.

Imaging tests

  • Computerized tomography (CT) scan. This test is usually the first performed in an emergency room for a suspected traumatic brain injury. A CT scan uses a series of X-rays to create a detailed view of the brain. A CT scan can quickly visualize fractures and uncover evidence of bleeding in the brain (hemorrhage), blood clots (hematomas), bruised brain tissue (contusions), and brain tissue swelling.
  • Magnetic resonance imaging (MRI). An MRI uses powerful radio waves and magnets to create a detailed view of the brain. This test may be used after the person's condition stabilizes, or if symptoms don't improve soon after the injury.



When does a head injury require medical attention?

Head injuries shouldn’t be taken lightly. See your doctor right away if you think you have the symptoms of a serious head injury.

In particular, you should always seek immediate medical attention if you experience any of the following:

  • loss of consciousness
  • confusion
  • disorientation

 Even if you don’t go to the ER immediately after the injury occurs, you should seek help if you still have symptoms after a day or two.

Category:Head Injury

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