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When are head injuries serious?

by Mariela Salazar March 15, 2023

When are head injuries serious?

For us to understand when head injuries are serious, we need first to understand, what is a Traumatic Brain Injury?

I, like most people, have at some point bumped my head or been struck in the head by something. In my case, this was a falling object. For most of the time these knocks have resulted in nothing more than a bruise to my head and my ego but on one occasion it resulted in a concussion. Fortunately for me, this resulted in nothing more than some dizziness, nausea, and a noticeably short loss of memory, but it could well have been worse.

A traumatic brain injury (TBI) is a head injury caused by a bump, blow, or jolt to the head or body or a penetrating head injury. A TBI results in disruption of normal brain function.

TBIs can occur from direct hits to the head, vehicle accidents, or inflicted injuries (like an assault or suicide attempt). They can be Industrial or Sport related, for example tripping over on a construction site or being hit in the head by a ball playing soccer; however, the majority of TBIs occur from falls either from the same level or sometimes even higher. Falls are the second leading cause of TBI-related deaths. According to the Centers for Disease Control and Prevention (CDC), about 64,000 people died from TBI’s in 2020 and there were 223, 135 TBI related hospitalisations in 2019.

Now you have a better understanding of what a TBI is, I can hear you asking the question, ‘How does that impact me?’ and to answer that, we need to understand a bit more.

TBIs occur on a spectrum—the most common being a mild TBI or concussion. Hitting your head on a cabinet door, falling, or getting injured playing a sport might cause one of these mild TBIs.

While you might experience pain and some neurological symptoms from a concussion, a brain scan may not show any findings like bleeding, bruising, or swelling.

People who have a mild TBI or concussion usually feel better within a few weeks and, in some instances, sooner.

Moderate or severe TBIs, however, will show up on brain scans, usually in a variety of ways. Hematomas, specifically epidural hematomas or subdural hematomas are one way a TBI can manifest. Moderate to severe TBIs can also include contusions, bruising of the brain tissue or haemorrhages both intracerebral haemorrhages and subarachnoid haemorrhages which is when active bleeding is present. TBIs can also progress from one degree to another, which is why it is so important to seek medical care if you are concerned. Some Hematomas can occur several days or even weeks following an injury to the head, so it is important to stay vigilant and monitor your symptoms.

To help, here are some symptoms of a mild TBI and concussion

  • Sensitivity to light or noise
  • Dizziness or balance problems
  • Feeling tired, no energy
  • Headaches
  • Nausea or vomiting (early on)
  • Vision problems
  • Attention or concentration problems
  • Feeling slowed down
  • Foggy or groggy
  • Problems with short- or long-term memory
  • Trouble thinking clearly
  • Anxiety or nervousness
  • Irritability or easily angered
  • Feeling more emotional
  • Sadness
  • Sleeping less than usual
  • Sleeping more than usual
  • Trouble falling asleep

It is always a good idea to be evaluated by a medical professional after a head injury, even if it is mild. Concussions can exacerbate existing issues like migraines, motion sickness, anxiety, and mood disorders. Because head injuries can worsen over time, a healthcare provider's input can also help you monitor your symptoms and impairments to make sure they are not getting worse.

Seeking a healthcare provider's input is also essential for reducing your risk of other health complications from a TBI. 

Moderate and severe TBIs, however, require emergency care right away. If you have any of these "red flag" symptoms after a head injury, seek medical attention immediately.

  • Loss of consciousness for any amount of time
  • A severe headache
  • One pupil that is larger than another
  • Dizziness
  • Any type of weakness or decreased coordination
  • Speech problems
  • Confusion or difficulty thinking
  • Seizure (shaking or twitching) for any duration
  • Drowsiness or inability to wake up
  • Repeated nausea or vomiting

So, to summarise, head injuries can be as severe as a concussion, fractured skull, internal bleeding, and damage to the brain or as mild as a bump, bruise, or cut on the head. While TBIs can result in severe medical complications, including death, knowing when to seek emergency medical care for yourself or another person can be lifesaving.

Article written by Christopher Tidy, Head Safety Specialist and Consultant

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