Head injuries can be caused by many activities. Treatment options vary, based on the severity of the trauma.
Causes of Head Trauma
Most cases of head trauma are minor, requiring only basic first aid. Concern arises when the injury involves a severe headache or bleeding, confusion, vomiting, loss of balance, unconsciousness, unequal pupils, slurred speech, black and blue behind the ears or under the eyes, weakness in limbs, or if the patient’s breathing stops. If those symptoms present, it is crucial to make sure that the patient lies still, and isn’t moved unless necessary, until medical help can arrive.1 Most of traumatic brain injuries are caused by motor vehicle crashes and sports. Males account for the majority of cases of head injuries. There are two types of head injuries: penetrating (such as from a bullet), or closed (without lacerations). Symptoms may not be obvious at first. Swelling and bleeding can bring them on. They can range from the ones noted earlier to something even more severe, such as paralysis or a coma.2 Head injuries may also be accompanied by skull fracture. This can lead to an internal hemorrhage, where a hematoma in the skull can place pressure on the brain. A traumatic brain injury (TBI) is a concussion. Concussions can be mild, moderate (i.e., with amnesia), or severe. Skull fractures can lead to the nose, ear, or mouth leaking cerebrospinal fluid. A brain infection could result from this. Head injuries, in general, can be life threatening, even if the symptoms appear mild. Other causes of head injury, besides collisions and sports, are accidents, falls, and assaults.3 TBI is also a risk in the military, as many troops can be seriously injured in combat and from IED attacks.4
Head trauma in football has made headlines, from the professional arena, to the college teams, and down to the youth level. There is a history of players hiding concussion symptoms, but college football is making new rules, even ejecting players, for “kill shots”. New training and practice regulations are evolving as well.5 Football isn’t the only sport that can cause head trauma; ice hockey, lacrosse, soccer, wrestling, field hockey, basketball, and others can pose a risk.6 In terms of motor vehicles, helmets help prevent TBI in motorcycle riders, and helmet laws can go a long way in preventing lethal and non-lethal head injuries.7 Wearing helmets can save lives of bicyclists as well.8
Head trauma severe enough to require treatment may require various medications and surgery to prevent brain damage. Diuretics (to reduce fluid and pressure), anti-seizure drugs, and coma-inducing drugs may be necessary to make sure the brain can get nutrients and oxygen. At times, emergency surgery will be required. Surgery can remove hematomas (clotted blood), repair skull fractures, or relieve pressure in the skull by creating a “window”. Many professionals coordinate to care for head trauma patients, including physiatrists, occupational and physical therapists, speech pathologists, psychiatrists and social workers, rehabilitation nurses, and recreational and vocational counselors.9 Because many motor vehicle accidents, sports injuries, and other traumas lead people to seek chiropractic care, the chiropractor may be the first professional to diagnose head trauma in a patient.10 Upper cervical care may be beneficial to patients who have suffered a head injury, such as concussion or whiplash, in order to reduce irritation to nerves that cause pain and neurological symptoms.11