FAQ's on Head Surgery

Q- What are the exam and tests for Head Injury?
Ans- The physical examination and the history of the exact details of the injury, the person's past medical history, and the symptoms are often the most important information the doctor uses to make treatment decisions.
Skull x-rays to look for any fracture or penetrating injuries is important. The fracture itself will seldom need treatment, but an underlying brain injury may.
It may be easier to see where foreign bodies are located and how many there are with a regular x-ray than with a CT scan.
One reason for doctors to order skull x-rays for a child is in anticipation of a possible leptomeningeal cyst. Also known as growing skull fractures, this is a rare complication of skull fracture seen in children younger than 3 years. It occurs when a skull fracture fails to heal properly. Six or more months after the initial injury, the fracture may begin to widen instead of healing. Usually parents will notice swelling, which gradually increases in size. This is not predictable or preventable but should be treated by a neurosurgeon if it occurs. Swelling or masses noted in the first few weeks to months after a head injury in children are referred to as a "pseudo-growing fracture." They do not need treatment and will go away on their own but should be brought to your pediatrician's attention so it can be watched.
CT scan is the test used most often to evaluate acute head injuries. Even small spots of blood may be seen as little white dots.
MRI scans are also used for additional information about a brain and spine injury.
In some cases of bleeding in or around the brain, angiography may be performed to visualize the blood vessels which involve injecting dye into the arteries of the head. X-rays are taken that show the blood vessels and may show exactly where bleeding is occurring. In some cases it is possible to stop the bleeding following angiography. This involves injecting special materials, which are released into the bleeding blood vessel and cause a clot to form.
Other x-rays and lab tests may be performed to look for other illnesses or injuries. For example, neck injuries are common in people with severe head trauma. Spine x-rays are usually ordered before the head is moved if there is any neck pain or other symptoms of a neck injury. In a car accident, there may also be chest or abdominal injuries.

Q- What are the treatments for Head Injury?
Ans- (A) Self-Care at Home
PFE (Neuro) # 86
Minor head injuries may be cared for at home.
Bleeding under the scalp, but outside the skull, creates "goose eggs" or large bruises at the site of a head injury. They will go away on their own wit time. Using ice immediately after the trauma may help decrease their size and ice should be applied for 20-30 minutes at a time and can be repeated about every 2-4 hours as needed. There is little benefit after 24 hours.
When a minor head injury results from a fall onto carpet or other soft surface and the height of the fall is less than the height of the person who fell and there is no loss of consciousness, a doctor's visit is not usually needed. Apply ice to lessen swelling.

(B) Medical Treatment
Treatment varies widely depending on the type and severity of injuries.

Minor head injuries are often treated at home as long as someone is available to watch the person.

Bed rest, fluids, and a mild pain reliever such as acetaminophen may be prescribed. Ice may be applied to the scalp for pain relief and to decrease swelling.
Cuts will be numbed with a medication usually given by injection. They will then be cleansed. The doctor will then look for foreign matter and hidden injuries. The wound usually is closed with skin staples, stitches (sutures), or special skin glue. An immunization to prevent tetanus will be given if needed.

People with  serious closed head injuries  are always admitted to the hospital for observation and repeated studies to assure that the condition does not worsen.

Occasionally a head injury may cause elevated pressure within the skull. An intracranial pressure (ICP) monitor probe may be surgically inserted into the brain through the skull to measure the pressure. If the pressure rises too high, it may be necessary to do surgery to decompress the brain. Death is possible.
Medication to prevent seizures may be given to prevent or treat seizures that occur from the head injury.
Antibiotics are usually not required in closed head injuries.

 PFE (Neuro) # 86
   When there is a closed head injury with bleeding inside the skull or penetrating head injuries, the doctor must consider the location of the bleeding, severity of the symptoms, any other injuries, and progression of symptoms. Surgery may be needed along with antibiotics to prevent infection and a breathing tube inserted (intubation) to help prevent further brain injury. Angiography may be performed.

Q- What are the prevention for Head Injury?
Ans- Wearing helmets when bike riding, inline skating, driving motorcycles, and other similar activities.
Safety belts, car seats, and airbags when used properly can prevent head injuries in motor vehicle accidents.
Drinking while driving should be avoided strictly.
Fall-proofing includes checking your home for areas where someone may fall: stairs, bathtubs, throw rugs, and furniture.

Q- What is the prognosis for Head Injury?
Ans- Prognosis varies and depends on the severity of the injury. It is now commonly recognized that even minor head injuries can have long-term consequences (usually psychological or learning disabilities). Serious head injuries can result in anything from full recovery to death or a permanent coma.