A strong blow on the head or a strong pressure may, in some cases, damage the brain, i.e. ”shake” it, even though its protection – skull – is not broken. In such cases, the area of the brain that suffered damage may be much greater than the area of the skull that has been hit by the blow. Sometimes, the blow is so brutal that it shakes the brain in the skull – not just at the spot just below the point of impact, but on the opposite side where the brain will hit as well. This can cause swelling of the brain tissue with certain symptoms, since the solid “box” of the skull does not allow the spread outward. If the skull is broken, it is more likely that brain damage will occur. The extent of damage, and whether it will be temporary or permanent, depends largely on the type and strength of the injury.
Symptoms of brain injuries depend on the point of impact and its force; a headache is a typical symptom after minor injuries. An ordinary headache that disappears after a day or two is a sign of the rapid “repair” of the brain tissue and, except in very rare cases, a sign of complete recovery. A severe injury is usually accompanied by loss of consciousness immediately after the impact; unconsciousness may take only a few seconds (a so-called brain concussion) or last for weeks (in this case, we say that the patient is in a coma).
A person who has been temporarily “knocked out” is always dazed and confused after he/she regains consciousness. The condition may also be accompanied by loss of memory (amnesia), headache, psychological disturbances, and weakness of the muscles or paralysis (including speech difficulties). Symptoms usually gradually disappear during the healing process, but in very severe cases a residual damage that leads to permanent physical or psychological problems such as paralysis, abnormal irritability and depression is also possible.
Head injuries are common in traffic accidents; in about 50% of traffic injuries, there is a head injury. Men are more prone to head injuries than women (ratio is 4 : 1), which is not surprising because men are more likely to participate in fights (and usually get hit by various dull objects, such as bottle) and work in dangerous environment.
A severe head injury can cause a rupture of one or more blood vessels, resulting in subdural, extradural or, rarely, subarachnoid haemorrhage. Symptoms of haemorrhage (bleeding) as a consequence of an injury may occur hours, days or even weeks after the injury. The danger is even greater if the skull is broken. Microbes can reach the brain through a broken place and infect cerebral tissue, causing meningitis. Permanent brain damage caused by severe injury can lead to frequent seizures or spasms.
What to do?
If someone loses consciousness because of injury, you should take first aid measures and immediately call for medical help. An injured person who has not lost consciousness, but shows other symptoms of brain damage, must immediately go to the doctor. If you are a “victim” and do not remember exactly what happened, it would be advisable for some of the eyewitnesses to go to your doctor to describe what happened. The degree of possible amnesia will point to the seriousness of head injury – if the “gap” in the injured person’s memory is greater, it means that the injury is greater, too.
If your head hurts for no apparent reason, and at the same time you begin to feel weakness or psychological distress, try to remember what happened in the last few days. Have you ever hit your head somewhere recently or experienced aminor accident? In any case, contact your doctor. Depending on the severity of symptoms and your doctor’s observations, you may need to go to the hospital for diagnostic tests to determine the extent of the damage. In the hospital, you will first have to take X-rays of the skull, one or more times, to detect any possible fracture. After that, especially if the symptoms persist, a computerized axial brain tomography and perhaps arteriography will be needed to determine if a blood vessel has ruptured.
Self-help: mild symptoms of brain injury can be controlled by various drugs – analgesics and sedatives. However, a person who has lost consciousness should not take any medication before a medical examination. If you’ve suffered a pretty strong blow, your doctor may recommend staying in a hospital for a day or two for observation and for any possible complications. However, most minor injuries are healed by themselves and, in most cases, just resting for two or three days after a small accident are enough for a person to recover.
Professional help: an unconscious person must be in a hospital where intensive professional care is of crucial importance. Inflammation of the brain tissue can be reduced by administering a corticosteroid drug by intravenous infusion. If there is a broken skull, it may be urgently needed a surgical procedure to fix and stabilize the bone.
Recovery after severe brain injury usually lasts for many weeks, but the prospects for complete cure are pretty good. In some cases, the injury leaves traces such as vague pronunciation or weakness of the muscles of the arms or legs. In such persons, encouragement and support of family and friends are an important part of the recovery process; most such cases also require physical therapy due to paralysis, muscle weakness, or disturbed coordination.