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HEAD TRAUMA

What is head trauma? What are the symptoms of head trauma?

Head trauma, which can be experienced for various reasons, can lead to serious problems and can be fatal. Symptoms such as confusion, drowsiness, bleeding from the ears or nose, and gushing vomiting after severe head trauma should be taken seriously. In head traumas in infants, these situations are; Symptoms such as decreased interest in the environment, sucking or eating disorders may also be added. The first 24-48 hours after head trauma are of great importance, but severe head traumas can cause problems even years later. First aid after head trauma can be life-saving.

What is head trauma?

Head trauma to the skull or brain; It is an injury that occurs as a result of a blow to the head after traumas such as accident, fall, impact, collision, physical attack, traffic accident. It is a disease characterized by damage to the brain, which is protected in the skull, as a result of trauma, resulting in muscle, skeletal and nervous system problems. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature.
Yetişkinlerde trafik kazaları, düşmeler, spor kazaları veya saldırılar önde gelen kafa travması sebeplerindendir. Çocuklar da en sık kafa travması nedeni düşmelerdir.

What are the symptoms of head trauma?

Traffic accidents, falls, sports accidents or assaults are the leading causes of head injury in adults. Falls are the most common cause of head trauma in children.
The symptoms experienced after mild head trauma can be listed as follows;
  • – Swelling, bruising and scratches may be observed in the trauma area.
  • – In the neurological examination of the patient, complaints such as headache and dizziness are present.
The symptoms experienced after severe head trauma can be listed as follows;
  • – Large swellings in the trauma area due to subcutaneous hemorrhages
  • – Deep skin incisions
  • – Skull collapses and fractures can be observed.
In the neurological examination of patients with severe head trauma, the symptoms can be listed as follows;
  • – Loss of consciousness, confusion, fainting, trouble understanding and speaking
  • – Sleeping during the hours expected to be awake
  • – Clear fluid or blood coming from the nose or ear
  • – Severe headache complaint
  • – Vomiting 5-6 times in a gush
  • – Loss of balance or trouble walking
  • – Blurred, double vision or sudden loss of vision
  • – Weakness in both arms or legs
  • – Epilepsy ie epilepsy or convulsions
  • – In addition to these symptoms, after head traumas in babies; Conditions such as decreased interest in the environment, sucking or eating disorders can be seen.

What are the causes of head trauma?

Head traumas; It can happen for many reasons such as traffic accidents, falls from height, physical attack or sports accidents.
Traffic accidents, falls, sports accidents, or assaults are the leading causes of head injury in adults.
Falls are the most common cause of head trauma in children.
Since the brain is not an organ that can renew itself, the effects of brain damage last a lifetime and affect the patient’s life deeply.

How is a head injury diagnosed?

In head traumas, the first thing to do is a detailed neurological examination. The examination takes place within the information in the patient’s history, such as the severity of the trauma, before and after the event.
Symptoms such as severe headache, dizziness, loss of balance, blurred vision are taken into account.
If the doctor deems it necessary, examinations such as brain tomography, head or neck X-ray, magnetic resonance can be applied.

How is head trauma treated?

In head traumas, the first intervention is done in the emergency room. In cases where the examination and examination do not require emergency surgery, after the patients are followed up in the observation room for a while, if no problem is detected in their follow-up, medical advice is given to the patient and his relatives, neurosurgery emergencies are explained and neurosurgery outpatient control is recommended.
In cases where further examination and treatment is required, follow-up is performed in neurosurgery clinics. Consciousness monitoring and medical treatment are usually sufficient in head traumas.
Head trauma patients requiring emergency surgery are operated by neurosurgery clinics. The aim of the surgical intervention is to reduce the intracranial pressure as early as possible, to minimize brain damage and to provide vital support.
After the surgery, the patient is followed up in the intensive care units. The duration of intensive care is proportional to the severity of the brain damage. People who stay in intensive care for a few weeks are more likely to return to their active lives, while patients who stay in intensive care and coma for a few months or more are less likely to fully return to active life.
A qualified and comprehensive rehabilitation is essential for patients leaving the intensive care unit to return to their active lives.

How long does it take to show head trauma in babies?

In head traumas, the first 24 and 48 hours are important.
Although the child is completely normal after trauma, new findings may occur in the follow-up. These new findings may indicate a pathology that may require urgent surgical intervention.
For this reason, it is recommended that the child be followed up for 24-48 hours after the trauma, either by the family or, if necessary, by the doctor in the hospital, and re-checked at the end of this period.

How long does it take to show head trauma?

The first 24 and 48 hours after a head injury are very important.
Head fractures or cerebral hemorrhage may occur even if there is no open wound after trauma. If the bleeding is in the form of leakage, it may not give any symptoms in the first hours. For this reason, it is recommended to have a companion with the patient for the first 24 hours. It is recommended that the patient stay awake as much as possible, and if he is asleep, he should be checked at short intervals, awakened and spoken.
Vomiting in the first 48 hours after trauma may be a sign of cerebral edema or cerebral hemorrhage that increases intracranial pressure.

What is blunt head trauma?

Blunt trauma can occur due to a blow, injury or physical attack on the human body.
Blunt head trauma also means that the blow hit the person’s head. Blunt trauma, also known as force trauma, can sometimes be caused by high speed effect. However, a fall from a height can cause blunt trauma, and the speed of falling and the height of the place of fall also cause a difference in the degree of trauma.

Can head trauma cause problems years later?

Head trauma can cause problems months or years later, depending on its severity. Some neurological findings that begin months after trauma in elderly patients suggest a slowly developing cerebral hemorrhage. Hemorrhages in the form of leakage between the meninges may be asymptomatic at the beginning and may appear days or even months after the trauma with symptoms such as headache and balance disorder. Repetitive or severe head trauma in children can cause seizures in the future.
The term Organic Brain Syndrome, which develops after head trauma, is defined in terms of the classification of symptoms that last 12 months and later, sometimes years after the injury.
Although mild head traumas are thought to be harmless, in the majority of people, even if no abnormality is seen in brain tomography or MRI scans, complaints may occur weeks, months or even years later.
In organic brain syndrome;
  • – Lack of attention
  • – Difficulty with adjustment
  • – Mood disorders
  • – Memory and socialization problems
  • – Frequent headaches
  • – Symptoms such as personality changes may occur.

Can brain edema be experienced after head trauma?

After head trauma, decrease in cerebral blood flow, cerebral edema and increased intracranial pressure, which occur with physiological and metabolic mechanisms in connection with the severity of the trauma, constitute secondary brain damage.
Since brain edema can occur hours, sometimes days after head trauma, it is theoretically possible to reduce secondary brain damage and most of the treatment protocols that start at the trauma site and continue in the intensive care unit are aimed at this.

What can a persistent headache after a head injury be a sign of?

Even if there is no headache, skull fracture or brain damage after head trauma, it can last for up to a week and ends with a decrease in severity.
After severe head trauma, fractures of the skull bones, bleeding in the brain tissue or between the meninges may occur. Less frequently, hemorrhages in the form of leakage between the meninges may be asymptomatic at first and may present with symptoms such as headache and balance disorder days or even months after the trauma.
Headaches that start after trauma, last longer than a week or increase in severity, indicate a bleeding or brain edema that increases intracranial pressure. In such cases, neurosurgery doctor control is recommended.

What does sleepiness after head injury mean?

If the patient who has had a head injury has difficulty remembering how the trauma happened, before and after the trauma, if there is sleepiness or if he cannot be woken up, his life may be at risk.
Increased sleepiness may be a symptom of cerebral hemorrhage and cerebral edema that increase intracranial pressure.

Is there memory loss after head trauma?

The patient who has had a head injury may have difficulty remembering how the trauma occurred, before and after it.
People who have brain damage due to head trauma and therefore fall into a coma may experience memory loss in the first days they wake up. In particular, the event that caused the traumatic event and the short-term memory before it can be completely erased. Apart from memory loss, the person may not know where they are, may be irritable, and act overly emotional. They may neglect social rules, speak inappropriately, swear, and lose their ability to control themselves.
Post-Traumatic Amnesia (Post-Traumatic Memory Loss)
This period after a coma is a normal part of recovery. It is medically referred to as post-traumatic amnesia. A person who wakes up from a coma after a brain injury may not remember who he is, what happened to him, or where he is. He may not even remember basic information such as the name of himself or his relatives, the current season, the days of the week.

How should first aid be given in head trauma?

First aid after head trauma is generally done as follows;
  • – The trauma patient’s consciousness is checked.
  • – His vital signs are evaluated. Medical assistance is sought immediately (112).
  • – If he is conscious, he will not move.
  • – If there is any danger, it will be dragged in straight position.
  • – Head-neck-body axis should not be disturbed.
  • – When help arrives, it should be taken to the stretcher without disturbing the head-neck-body axis.
  • – It should not be exposed to vibration during transportation and shipment.
  • – All the action and information about the injured should be recorded and reported to the incoming team.
  • – A patient with a head injury should never be left alone.

What does nausea mean after a head injury?

Nausea or vomiting may occur after a head injury. It is often seen in blows to the back of the skull. Vomiting is not always an indication of brain damage. However, severe nausea and recurrent gurgling vomiting may be signs of increased intracranial pressure, cerebral hemorrhage or cerebral edema.

Is bleeding from the ear after a head injury dangerous?

Bleeding from the ear is not usually a sign of cerebral hemorrhage. Ear bleeding following a head injury usually stops on its own in a short time, but the patient may need to be hospitalized and examined due to additional problems due to head trauma and fracture of the skull bones.

Is there a fever after a head injury?

Symptoms such as nuchal rigidity, fever, and unconsciousness are seen when bleeding occurs between the cerebral membranes after head trauma.
Open and dirty wounds after trauma can cause infection and high fever.
Fever after head trauma is a development that worsens the situation in the patient. The increase in body temperature will increase the carbon dioxide level and the brain metabolic rate. The patient’s fever is tried to be reduced with antipyretic drugs and cold compress application.

Is there a loss of smell after head trauma?

Severe head injuries cause a condition called a brain contusion. Symptoms such as inability to speak (aphasia), lack of smell (anosmia), half vision (hemianopsia) and paralysis (hemiplegia) may occur in people who have had a brain contusion. Some people who have had a head injury may develop epileptic seizures later on.

How many hours should one not sleep after a head injury?

After head trauma, in children with normal neurological examination and no complaints, normal nutrition and sleep patterns should be continued and the child’s symptoms should be checked every 2-3 hours. If he is sleeping, he should be awakened and his speech and alertness should be checked. It is usually sufficient to wake up once from a night’s sleep.
If spontaneous and gushing vomiting occurs within the first 24 hours, if complaints such as confusion, sleepiness, speech disorder, loss of strength in the arms and legs, seizures occur, a well-equipped health institution should be consulted as soon as possible. In such cases, patients are usually hospitalized for follow-up purposes, necessary examinations (brain tomography-CT) are made and it is investigated whether there is an emergency surgical pathology.
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