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Vital Signs


Vital Signs

Summer 2009

Fast Action Can Save Lives After Head Injury


UCLA Health Vital Signs publication - Summer 2009 issue: Fast action can save lives after head injuryThe death in March of actress Natasha Richardson following a ski accident focused the nation’s attention on the issue of head injuries, which kill more than 50,000 Americans each year. But that number is just a small percentage of the estimated two-million significant head traumas that are sustained by people of all ages.

While these types of injuries are not always life threatening, experts caution people who have had a head trauma and those around them to pay careful attention to early signs of serious injury. These signs may include drowsiness, abnormal behavior, persistent headache, stiff neck, vomiting, memory loss or loss of consciousness. If the head injury is minor, symptoms often dissipate quickly, says Dr. Wally Ghurabi, director of emergency medicine at UCLA Medical Center, Santa Monica. A potentially severe head injury can cause symptoms such as confusion and disorientation, or a brief loss of consciousness followed by lucidity and then a loss of consciousness. “These are probably the most serious cases,” he says. People with persistent symptoms should seek immediate emergency evaluation, which usually includes a computed tomography (CT) scan of the head and neck.

Most serious head injuries involve either a concussion to the entire brain, which extensively damages nerve cells and fibers and usually results in a coma, or mass lesions. These lesions include an accumulation of blood between the skull and the lining of the brain, known as an epidural hematoma; a collection of blood between the dura and the brain (subdural hematoma); and bleeding within the brain tissue (intracerebral hemorrhage), explains Neil Martin, M.D., FAANS, chair of the UCLA Department of Neurosurgery.

The outlook for patients with serious brain injuries depends on their overall health and how quickly they are evaluated and treated. “An epidural hematoma can be removed by emergency surgery, and the patient will most often recover completely,” Dr. Martin says. “When there are more serious types of bleeding, such as a subdural hematoma or an intracerebral hemorrhage, patients may survive with surgery but will most likely experience long-term neurological problems.”

While surgical intervention and intensivecare monitoring are required for severe head injuries, mild head injuries usually require no specific treatment, but they should still be monitored closely.

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