Road traffic accidents are one of the most common causes of head injury. A sudden blow, jolt or penetrating injury to the head can damage the scalp, skull and brain. Head injuries range from mild concussion to severe traumatic brain injury (TBI), and prompt assessment is essential because some serious injuries do not cause obvious symptoms at first.
Types of Head Injury
- Concussion: A temporary disturbance of brain function, often with brief confusion, headache or loss of consciousness.
- Skull Fractures: Breaks in the skull bone, which may be linear, depressed or involve the base of the skull.
- Brain Contusion: Bruising of the brain tissue at or opposite the site of impact.
- Diffuse Axonal Injury: Widespread damage to nerve fibres caused by rapid acceleration and deceleration of the head.
Bleeding Inside the Skull
- Extradural Haematoma: Bleeding between the skull and the outer covering of the brain, which can worsen rapidly.
- Subdural Haematoma: Bleeding beneath the covering of the brain, which may be acute or develop slowly over days to weeks.
- Intracerebral Haemorrhage: Bleeding within the brain tissue itself.
Warning Signs
Seek emergency medical care immediately if any of the following occur after a head injury:
- Loss of consciousness, or increasing drowsiness and difficulty staying awake.
- Severe or worsening headache.
- Repeated vomiting.
- Seizures (fits).
- Confusion, unusual behaviour or slurred speech.
- Weakness or numbness in the arms or legs.
- Unequal pupils or blurred vision.
- Clear fluid or blood leaking from the nose or ears.
Diagnosis
- Neurological examination, including assessment of consciousness using the Glasgow Coma Scale (GCS).
- CT scan of the brain to detect fractures, bleeding and swelling.
- MRI in selected cases to assess subtle or diffuse brain injury.
- Evaluation of associated injuries, especially to the cervical spine.
Treatment
- Observation and Medical Care: Mild injuries are monitored closely, with pain relief and repeat imaging if symptoms change.
- Intensive Care: Moderate to severe injuries may need ICU care to control brain swelling, blood pressure, oxygenation and seizures, sometimes with intracranial pressure monitoring.
- Surgery: Emergency procedures such as craniotomy to remove a blood clot, elevation of depressed skull fractures, or decompressive craniectomy to relieve dangerous pressure on the brain.
Recovery and Rehabilitation
- Recovery depends on the severity of the injury. Many patients benefit from physiotherapy, occupational therapy, speech therapy and cognitive rehabilitation, along with regular neurosurgical follow-up.
Prevention
Wearing a helmet on two-wheelers, using seat belts, following speed limits and never driving under the influence of alcohol greatly reduce the risk of serious head injury in road accidents.
Head injuries are time-critical. Early assessment and, when needed, timely surgery can be life-saving and greatly improve long-term recovery.
