FAQ's on Head Surgery

Q- What is Head Injury?
Ans- Head injury is a general term used to describe any trauma to the head, and most specifically to the brain itself.

Q- How many types of head injury?
Ans- Skull fracture: A break in the bone surrounding the brain and other structures within the skull.
Linear skull fracture:  Common in children. It is a simple break in the skull that follows a relatively straight line which can occur after minor head injuries (falls, blows such as being struck by a rock, stick, or other object; or from motor vehicle accidents).
Depressed skull fractures:  These are common after forceful impact by blunt objects which cause “dents” in the skull—most commonly, ammers, rocks, or other heavy but fairly small objects. If the depth of a depressed fracture is at least equal to the thickness of the surrounding skull bone (about 1/4-1/2 inch), surgery is often required to elevate the bony pieces, to remove dirt and other debris and to inspect the brain and its coverings for evidence of injury.
Basilar skull fracture:  A fracture of the bones that form the base (floor) of the skull and results from severe blunt head trauma of significant force. It commonly connects to the sinus air cavities. This connection may allow CSF fluid to leak through the nose or ears and allow for air and bacteria to enter into the inside of the skull and may cause infection. Surgery is usually not necessary unless other injuries are also involved or for persistent CSF leak.
Intracranial (inside the skull) hemorrhage (bleeding)
Subdural hematoma:  It is the bleeding between the brain tissue and the dura mater (a tough fibrous layer of tissue between the brain and skull). The stretching and tearing of "bridging veins" between the brain and dura mater causes this type of bleeding. It may be acute, developing suddenly after the injury, or chronic, slowly accumulating after injury. They are potentially serious and often require surgery.
Epidural hematoma:  It is the bleeding between the dura mater and the skull bone. These occur when arteries are injured after skull fractures PFE (Neuro) # 86 particularly after injury in the temple area. It is potentially serious and often requires surgery.
Intraparenchymal hemorrhage/cerebral contusion:  It is the bleeding into the brain tissue itself. A contusion is like a bruise to the brain tissue and usually requires close observation in hospital for increase in size over time. An intraparenchymal hemorrhage is a pool of blood within the brain tissue. Minor bleeding may stop without any surgical treatment. More serious or large bleeds usually require intracranial pressure monitoring and surgery.
Closed head injuries: It is an injury to the brain or structures within the skull that are not caused by a penetrating injury (such as a gunshot wound or stab wound). They range from very minor to potentially fatal injuries.
 Q- What are the causes of Head Injury?
Ans- All types of head injuries can be caused by trauma. In adults such injuries commonly result from motor vehicle accidents, assaults, and falls. In children falls are the most common cause followed by recreational activities such as biking, skating, or skateboarding. A small but significant number of head injuries in children are from abuse.
Penetrating trauma:  Missiles such as bullets or sharp instruments (also knives,screwdrivers, ice picks) may penetrate the skull. This often require surgery toremove debris from the brain tissue. The initial injury itself may cause immediatedeath, especially if from a high-energy missile such as a bullet.
Blunt head trauma:  These injuries may be from direct blow (a club or large missile) or from a rapid deceleration force (a fall or striking the windshield in a car accident).

Q- What are the symptoms of Head Injury?
Ans- Symptoms of head injuries vary with the type and severity of the injury.

Minor blunt head injuries  may involve only symptoms of brief loss of consciousness. They may result in headaches or blurring of vision or nausea and vomiting.
Severe blunt head trauma  involves a loss of consciousness lasting from several minutes to many days or longer. Seizures may result. The person may suffer from severe and sometimes permanent neurological deficits like paralysis, seizures, PFE (Neuro) # 86 difficulty in speaking, seeing, hearing, walking, or understanding or may even die.
Penetrating trauma  may cause immediate, severe symptoms or only minor symptoms despite a potentially life-threatening injury. Death may follow from the initial injury.

Q- When to seek medical care?
Ans- (A) Call the doctor  to ask about any of the following situations. Your doctor will recommend home care, set up an appointment to see you, or direct you to go to a hospital's Emergency Department.
A person is pushed to the ground or struck a hard object with the head but did not lose consciousness, vomiting more than once, confusion or speech difficulty after trauma, drowsiness, weakness or inability to walk and severe headache
(B) Go to the Emergency Department  by ambulance in the following situations. People with less severe injuries may be taken by car.

Severe head trauma or a fall from more than the height of the person or a hard fall onto a hard surface or object
Loss of consciousness for more than 1 minute, vomiting more than once, confusion, drowsiness, weakness or inability to walk, or severe headache
Prevent movement of the neck in severe head injury or if the injured person has any neck pain. If the person needs to vomit, carefully roll them onto their side without turning the head.
Should an injured person be allowed to fall asleep? Many people mistakenly believe that it is important to keep a person awake after they have been struck on the head.
You do not need to keep a head injury victim awake. In many cases it is even helpful to the emergency doctor to be able to awaken a person who is now calm and rested and able to behave normally. This gives the doctor a much better assessment of the severity of the head injury.
If a person who was initially normal after a head injury cannot be awakened or is extremely difficult to awaken, he or she may have a more serious head injury and should be evaluated by a doctor.