A Minor Head Injury Can Get Worse Rapidly – What Do the Experts Say?
If you or anyone you know has been injured in an accident, be it a car accident or a slip in the driveway, it is essential to get yourself checked for any injuries to the brain. Experts say that even seemingly minor injuries can be serious.
Take the case of actress Natasha Richardson who was injured when she fell during a skiing lesson in a resort in Canada. She seemed perfectly fine after the incident and was enjoying her time with acquaintances. However, after returning to the room, she suffered from severe headache and was admitted to a hospital in close proximity. Her condition deteriorated and she had to be airlifted to a larger hospital in Montreal. Later the actress was flown to another hospital in New York but succumbed to her injuries.
Neurosurgeons and physicians call this the “talk and die” syndrome. The patient appears deceptively normal in the initial stages, but there is bleeding in the brain and the classic symptoms associated with brain bleeding appear only later. It may take anywhere from a few hours to a few days for the symptoms to appear, depending on the type and extent of injury.
Dura mater is a hard skin layer between our skull and the brain. If an artery associated with the brain gets ruptured, it can release blood into the dura mater. This blood exerts pressure on our brain, causing it to swell up. This in turn results in a reduction in blood supply to the brain. This is called epidural hemorrhage. Graffagnino, the director of Duke University Medical Center’s Neurosciences Critical Care Unit says that most cases of epidural hemorrhage are associated with fracture of the temporal bone, located just above the ears. An artery runs in this region. Fracture of the temporal bone can result in bleeding from this artery. Even a small accident can cause such injuries. This is particularly true in case of people taking blood thinners since it increased risk of hemorrhages.
Graffagnino describes another kind of bleed in the brain, called subdural bleed. In this case, the bleed develops between the brain and the dura. This kind of bleeding can exert immense pressure on our brain and practically squeeze the brain. It can take several days for the symptoms of brain injury to appear.
Sometimes, accidents can result in bruising of the brain. This does not any of the classic symptoms of brain injury, nor does any damage appear on CAT scans. As time progresses, the nerves surrounding the bruise begin to stretch resulting in axonal injury.
These facts stress the importance of getting oneself evaluated after car accidents or sports injuries. It is also essential to be aware of the classic symptoms of brain trauma including nausea, headache, sudden sleepiness, and glossy eyes. Dr Philip Stieg, chair of neurosurgery at NYP/Weil Cornell, says that it is essential to get the patient checked for brain injury even if there is no external injury. Getting to the hospital within a few hours of the incident can help prevent permanent brain damage.
Once at the hospital, surgeons may check for signs of brain trauma by examining the pupils, which is often followed by a question answer session. Questions include asking the patient his or her name and other general information to determine response and cognitive skills. If any sign of brain trauma is observed, it is essential to undergo a CAT scan. In case there is bleeding and swelling of the brain an emergency craniotomy needs to be done. The skull is opened to relieve pressure on the brain and stop bleeding. Brain activity is monitored and the extent of damage analyzed. The patient may have to spend years in cognitive and physical rehabilitation to regain normal brain function.
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