Neurological Treatment .
Head Injury

Head Injury – Treatment, Surgery & Operation

Head injury is a very serious condition. Many a times a patient may recover from the effects with proper medicines and treatment. But sometimes it is life threatening.

Sometimes a patient may become comatose or may take a long time to recover.

So it is all the more important to know about this disease, and take preventive steps so that we are not affected by it.

What do you mean by head injury?

Any event that causes injury to our head and skull may lead to head injury. It may include,
1) Injury to scalp or skin over the head
2) Fracture of the skull bone , it may be linear fracture or the depressed fracture
3) Intracranial hematoma or clot in brain which is of many types including extra Dural hematoma , subdural hematoma , contusion hematoma , subarachnoid hemorrhage etc ( different types of blood clot in brain )
4) Swelling of the brain without hematoma or clot
5) Diffuse axonal injury in this type of injury the CT scan of the patient is normal or with minimal findings but the patient is unconscious.

What is mild head injury or concussion?
Sometimes the duration of unconscious state after the injury is very short, but the patient feels head ache ,dizziness , occasional vomiting and confessional state . This is called concussion injury. This can persist for up to 2 weeks.

What are the various causes of head injury?
It occurs due to various causes like road traffic accidents, fall from height, assault or machine injury.

How can we recognize that a person may have head injury after an accident?
The main cardinal symptoms of head injury include
1) Headache
2) Vomiting
3) Dizziness
4) Seizures or fits
5) Blood from mouth ear or nose
6) Loss of consciousness this is the most serious and should not be overlooked

What should be done in case of unfortunate case of head injury to a person?
If you suspect head injury, the patient ust immediately be shifted to a good hospital, where a Neurosurgeon will asess the patient and will order a CT scan of the head of the patient.

Usually a full trauma team, which includes a number of doctors, namely a surgeon , orthopedic doctor, a physician will examine the patient for other injuries and concurrent illness and their management .

The patient is immediately given all the required medicines and care. Depending on the condition of the patient, sometimes there is need to put the patient on ventilator.

What are the investigations required for a head injury patient?
A CT scan is the investigation of choice it clearly delineates the injury to brain, hematoma , cot , swelling or fracture in skull. Sometimes CT scan has to be repeated after a few hrs or days

Sometimes MRI brain is done to assess Diffuse Axonal Injury

Is operation necessary for the head injury?
Depending on the findings in the CT scan of the patient, the neurosurgeon will decide regarding the further management of the patient sometimes only medicines are necessary to treat the patient.

But sometimes if the swelling in the brain is too much or the clot in brain too big, then a immediate operation of the head is done. This operation is called craniotomy .

Sometimes if the fracture of the skull is depressed too much that it may have damaged the underlying brain in these conditions also immediate operation of the patient is done.

What are the other aspects of the treatment in head injured patient?
Sometimes the patient may have to be kept on ventilator for respiratory support and for reducing the swelling of the brain . a tracheostomy is a artificial opening made made in the neck of the patient . A tube , tracheostomy tube is inserted in this opening so that the patient can breathe properly and for suctioning of the secretions .

A ryeles tube is inserted in the stomach via the nose so that the patient can be given liquid feeds.

What are the other common complications of  head injury ?
Prolonged unconscious state can lead to development of pneumonia , pressure sores , weight loss and various other problems
A dedicated neuro trauma team must work tirelessly to provide state of the art care to the patient .

For how long the patient will remain unconscious ??
In some case the patient will wake up from the unconscious state within a few minutes or hours. In some case the patient may remain comatose for prolonged periods . In these cases the nerves of the brain take time for the recovery to occur and function to return .

It may take up to 6-8 mnts for the complete recovery in a head injury patient . Even after this prolonged period some unfortunate patients are not able to recover fully .

These patients may have to live life long with disabilities or are bedridden .

Is there a medicine so that the patient recovers quickly ?
Unfortunately not . Research is going on various molecules for the quick recovery from the unconscious state in a head injured patient . But till date there is no definite therapy for early recovery .

I have heard that head injury can lead to development of cancer in brain ?
No. there is no truth in this statement . it does not lead in anyway to cancer

After recovery from severe head injury , what are the long term sequelae ?
After prolonged illness , some patients may develop seizures for which medications have to be taken for prolonged periods.

The patient may develop other neurological sequelae like poor memory , agitation , forgetfulness, behavioural problems , poor concentration etc.
Other psychological problems may also occur in long term .