20MAR

Protect your head

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Concussion, contusion, skull fracture… these are all types of head injuries. Today 20 March 2018, marks World Head Injury Awareness Day – a day dedicated to the prevention of head injuries. Brain injuries may be as mild as concussion or as debilitating as severe brain injuries. ER24 is urging people to use their heads to protect their health.

ER24’s Dr Vernon Wessels explains the types of head injuries one can suffer from.

Understanding head injuries

According to Dr Wessels, head injuries could range from simple lacerations to devastating bleeding inside the skull cavity that causes pressure on the brain. This pressure can cause death if the patient is not urgently treated

“Although injuries involving the skull cavity are usually the most catastrophic, external head injuries can also cause permanent damage or death especially if the airway or major blood vessels are affected,” said Dr Wessels.

Types of head injuries include:

Concussion

A concussion is the most common type of head injury. A concussion occurs when the brain undergoes impact that shakes the brain tissue but does not cause bleeding or visible damage to the cells.

“A patient may lose consciousness for a short while and is often confused, disorientated or has poor coordination. However, the effects return to near normal fairly quickly,” says Dr Wessels.

“Some functions like short-term memory may take much longer to recover and headaches and dizzy spells can last for months after a concussion episode,” he says.

Usually, a concussion is sustained through impact to the head, however indirect force can also cause this. A sad example of bleeding that can occur in the brain of a child is through violent shaking as typically occurs in abuse scenarios.

Contusion

With a contusion, the brain tissue is bruised by the impact and this can cause swelling. As the brain is inside a bony cavity that cannot expand, pressure will build up due to the swelling. This prevents adequate blood supply to the brain, which suppresses its function and can cause permanent damage to the cells and potentially lead to death. The same happens when there is a bleed inside the skull cavity.

Skull fracture

With a skull fracture there is a risk of bony fragments causing direct damage to the underlying brain tissue. In addition, skull fractures are often associated with a wound of the overlying skin that then causes a pathway for germs to travel from outside into the skull cavity, and potentially causing infection of the brain (encephalitis) or the membranes covering the brain (meningitis). This infection can be life threatening or cause permanent disability.

Although any head injury should be assessed by a health professional, we should also be realistic – especially when it comes to children.

“Children will sustain minor head injuries mainly due to the relatively large size of the head during early childhood and immature motor skills.

“However, there are certain signs that can be used to determine when a medical consultation is needed. These include any loss of consciousness, no matter how brief, convulsions after the injury, vomiting, a headache that worsens or does not improve with rest or oral paracetamol, and any visual disturbances or behaviour that is not typical for the child. If there is any doubt, rather consult a doctor,” said Dr Wessels.

People must seek medical attention if a head injury leads to loss of consciousness or coordination, visual disturbances and loss in memory no matter how short the effects may have been.

“Life threatening brain injuries can initially present very subtly and a medical assessment will determine if further tests or admission for observation are required. Bleeding and swelling of the brain is potentially treatable with good outcomes if done before serious complications occur.

“The most catastrophic event is a missed bleed inside the skull cavity that can cause severe disability or death. There are however, subtle effects that can present at a later stage such as personality changes, coordination problems, speech difficulty and memory and concentration problems,” said Dr Wessels.

ER24 offers some recommendations of how to protect your head to reduce accidents and brain injury:

  • Buckle up.
  • Strap children under 3 years (or less than 21kg) in an SABS approved car seat. It’s the law.
  • Never drive under the influence of alcohol or drugs.
  • Always wear a helmet when on a bicycle, motorcycle, scooter or when horse riding.
  • Provide adequate lighting on stairs/rails to hold on to.
  • Do not place obstacles in pathways.
  • Provide the correct safety equipment for workers.
  • Avoid contact sport until fit to return after a concussion.
  • Place bars on high windows/secure balconies to avoid children falling from a height.
  • Be gun safe.

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