What is a head injury?
A head injury is basically any sort of injury to your brain, skull, or scalp. With me, we were hit by a minivan, and I was under the van. However, anything that hits your head can result in an injury.
| It can be anything from a bump or bruise, to an Acquired Brain Injury, or ABI. An ABI is the doctor-talk term that’s in Canada. In the US, and many other places, it’s called a Traumatic Brain Injury, or TBI. We use ABI in Canada because it’s an inclusive term, whereas TBI is exclusive. This chart shows that, where ABI’s include TBI contact, TBI non-contact, and Non-Traumatic. | |
| Head injuries may be either closed or open. A closed head injury is any injury that doesn’t break your skull, but the fact that it's not seen doesn't mean that it's not felt. The impact on the brain means that the brain is "splashed" in your skull, and hits when going, and coming back. An open (penetrating) head injury is one in which something breaks the skin (and maybe your skull) and enters your brain. |  |
| Brain injuries can be nasty, of that there's no doubt, but what makes it difficult is that it's hard to diagnose. I was run over by the van, banged around a lot, but I don't think that I broke bones, and other than needing to use a walker, my brain injury can't be seen. | |
How is a head injury diagnosed? |
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| What are major types of head injuries? | |
| Hematoma | A hematoma is a collection, or clotting, of blood outside the blood vessels. It can be very serious if a hematoma occurs in the brain. The clotting can lead to pressure building up inside your skull. This can cause you to lose consciousness or result in permanent brain damage. |
| Hemorrhage | A hemorrhage is uncontrolled bleeding. There can be bleeding in the space around your brain, called subarachnoid hemorrhage, or bleeding within your brain tissue, called intracerebral hemorrhage. Subarachnoid hemorrhages often cause headaches and vomiting. The severity of intracerebral hemorrhages depends on how much bleeding there is, but over time any amount of blood can cause pressure buildup. |
| Concussion | A concussion occurs when the impact on the head is severe enough to cause brain injury. It’s thought to be the result of the brain hitting against the hard walls of your skull or the forces of sudden acceleration and deceleration. Generally speaking, the loss of function associated with a concussion is temporary. However, repeated concussions can eventually lead to permanent damage. |
| Edema | Any brain injury can lead to edema, or swelling. Many injuries cause swelling of the surrounding tissues, but it’s more serious when it occurs in your brain. Your skull can’t stretch to accommodate the swelling. This leads to pressure buildup in your brain, causing your brain to press against your skull. |
| Skull fracture | Unlike most bones in your body, your skull doesn’t have bone marrow. This makes the skull very strong and difficult to break. A broken skull is unable to absorb the impact of a blow, making it more likely that there’ll also be damage to your brain. Learn more about skull fractures. |
| Diffuse axonal injury | A diffuse axonal injury (sheer injury) is an injury to the brain that doesn’t cause bleeding but does damage the brain cells. The damage to the brain cells results in them not being able to function. It can also result in swelling, causing more damage. Though it isn’t as outwardly visible as other forms of brain injury, a diffuse axonal injury is one of the most dangerous types of head injuries. It can lead to permanent brain damage and even death. |
What are the symptoms of a head injury? |
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| Your head has more blood vessels than any other part of your body, so bleeding on the surface of your brain or within your brain is a serious concern in head injuries. However, not all head injuries cause bleeding. It’s important to be aware of other symptoms to watch out for. Many symptoms of serious brain injury won’t appear right away. You should always continue to monitor your symptoms for several days after you injure your head. Common symptoms of a minor head injury include: |
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| • a headache | • mild confusion |
| • lightheadedness | • nausea |
| • a spinning sensation | • temporary ringing in the ears |
| The symptoms of a severe head injury include many of the symptoms of minor head injuries. They can also include: | |
| • a loss of consciousness | • seizures |
| • vomiting | • balance or coordination problems |
| • serious disorientation | • an inability to focus the eyes |
| • abnormal eye movements | • a loss of muscle control |
| • a persistent or worsening headache | • memory loss |
| • changes in mood | • leaking of clear fluid from the ear or the nose |
| One of the first ways your doctor will assess your head injury is with the Glasgow Coma Scale (GCS). The GCS is a 15-point test that assesses your mental status. A high GCS score indicates a less severe injury. I was likely unconscious, or in such a state that I wasn't coherent, because I have absolutely no memory of this being done. |  |
| The doctor who you'll see will need to know the circumstances of your injury. While they'll likely be able to diagnose based on what they hear, if they don't hear everything, then what they'll recommend might not work. You might not remember everything, so why not bring someone with you who was there? Because something small might seem like it's "not a biggie", but in fact, it might be huge. You might be sent for a CT Scan. It's a cool thing, but if you're claustrophobic you might be scared. It's a tube that you're slid into, and it makes cool noises as it zaps into you. A CT scan will help your doctor look for fractures, evidence of bleeding and clotting, brain swelling, and any other structural damage. CT scans are fast and accurate, so they’re typically the first type of imaging you’ll receive. You might also get an MRI scan. This can offer a more detailed view of the brain. An MRI scan will usually only be ordered once you’re in stable condition. Basically, when it comes down to it, if you hit your head, or are hit on the head, take it seriously. |
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Eric Lindros was the top of the top player in the NHL, of that there’s no doubt, but his retirement that was forced upon him by concussions has changed his view on hockey a bit.
