Symptoms of Head Injury | Dr VK Gupta Explains

Symptoms of Head Injury | Dr VK Gupta Explains

A head injury is any harm that causes trauma to the head i.e. brain, scalp, and skull of an individual. It is often referred to as Traumatic Brain Injury (TBI).  Head injuries can be mild to very dangerous. These can cause physical or mental disability, brain damage, or even death of the injured in certain cases.  These injuries are the most common reason for disabilities in adults although people of all ages and all genders are prone to this kind of injury.

Some of the most common causes of a head injury are accidents, physical violence/fights, abuse, playing outdoor sports like football, basketball, racing, getting hurt by hitting something hard, or working in jobs with containing head injury risk such as construction jobs.


Immediate or delayed symptoms may include:-

  • A state of confusion, being dazed or disorientation
  • Loss of consciousness for a few minutes or more
  • Headache
  • Anxiety and depression
  • Nausea or vomiting
  • Fatigue or drowsiness
  • Problems with speech
  • Having a blurry vision
  • Dizziness or loss of balance
  • Sensory problems, like ringing in the ears, a bad taste in the mouth or changes in the ability to smell
  • Sensitivity to light or sound
  • The problem in concentrating or Memory problems
  • Mood swings
  • Neck pain or stiffness
  • Pupil dilation
  • amnesia
  • Infants may cry persistently or be irritable.

Head Injury can be broadly categorized in the following:-

  • Concussion. This is the most common type of head injury that happens when the brain is jerked or shaken so hard that is recoils against the skull. It can be mild or severe. It is not necessary that the person is hit on the head, an impact anywhere else on the body can also create enough pressure to jar the brain. There can be a loss of consciousness or the person can be conscious of headache or confusion. Symptoms may also include vomiting, dizziness, memory loss, loss of balance, etc. The symptoms may occur for a few seconds or last for weeks.
  • Contusion. A contusion is a traumatic brain injury in which there is a bruise or injury on the brain itself. It causes the breaking of blood vessels which can lead to constant bleeding under the skin and swelling. The symptoms may include loss of consciousness, headache, vomiting or nausea, difficulty sleeping, swelling, etc.
  • Intracranial hematoma (ICH). This is a life-threatening Head injury and is most severe in nature. It is referred to as bleeding under the skull inside the brain. Brain hematomas range from mild to severe and are grouped as follows according to their area of occurrence. They are of the following four types:
  • Epidural hematoma- A hematoma is referred to a collection of blood, in a clot form, outside the blood vessel. This happens when the blood vessel breaks and the blood moves out of the blood vessels and collects in surrounding tissue.  An epidural hematoma occurs when the bleeding occurs between your skull and the outermost (tough) covering of your brain.
  • Subdural hematoma-   A subdural hematoma occurs when the bleeding occurs on the surface of the brain i.e. between the brain and its outermost layer. It is a medical emergency and happens mostly as the result of your head moving rapidly forward and stopping, such as in some vehicular accident. However, it could also suggest abuse in children when being shaken.
  • Subarachnoid hemorrhage- A subarachnoid hemorrhage is also considered a medical emergency and occurs when there is bleeding between the brain and the thin tissues that surround the brain. It can lead to permanent brain damage if not treated properly. The main symptom is sudden and severe headache. Its most common cause is trauma, and can even lead to the death of a person if not treated on time.
  • Intracerebral hemorrhage- An Intracerebral hemorrhage is commonly known as cerebral bleed.  It is referred to when there is breaking of the blood vessels which causes bleeding inside of the brain. This is the most common type of ICH and also a medical emergency and needs close monitoring and medication in intensive care. In some rare cases, surgery may also be required. It is mostly caused due to trauma or high blood pressure. It can also occur due to the use of blood-thinning drugs. The symptoms are mostly progressive from over minutes to many hours. They include:
    • a mild and long-lasting headache or sudden and severe headache
    • stiffness of the neck
    • confusion
    • drowsiness
    • Nausea
    • seizure
    • difficulty speaking
    • trouble swallowing
    • coma or numbness in the face
  • Skull fracture- A skull fracture occurs when there is a fissure or breaks in one or more of the eight bones that form the human skull. The skull is a hard bone that protects the brain and other internal organs. But when it is fractured, the broken pieces of the skull can cut into the brain and cause bleeding and other harm to the brain. Its symptoms mainly include swelling, constant pain, skull deformation, leakage of fluid from nose or ear etc. Skull fracture may occur with or without causing damage to the brain. Computed tomography is used to confirm a skull fracture.

Skull fractures can be categorized as:

  • Closed Skull Fracture: It is also called a simple fracture in which the skin around the fracture is not broken or cut. These types are mostly not very painful and heels over time.
    • Open Skull Fracture: It is also known as a compound fracture in which the skin on the fracture breaks and the bone comes out. This type of fracture needs medical attention and most cases minor surgery to stitch the cut and cover the bone.

These can further be of the following types:

  • Depressed Skull Fracture: It is a more complex type of fracture. In this fracture, the skull notches or sinks in towards the brain cavity when high force impact is done on a small area of the skull. Based on the severity, it may need surgery to correct the deformation which is caused by this type of fracture.
    • Basilar Skull Fracture: It is a fracture that occurs in the base of the skull and mostly caused due to very high impact. It may include bruising behind the ears, the areas around the eyes, nose or blood behind the eardrum, top of the neck, and near the neck. The symptoms may include leakage of fluid from the nose or ear.
    • Linear Skull Fracture: It is a fracture that resembles a thin line and the break in the bone resembles a thin line with no distortion of bone or compression. The patients usually recover in a short time and resume their normal life in a few days.
    • Comminute Skull Fracture: This type of fracture is further to the depressed skull fracture. In this type of fracture, the bone breaks into multiple pieces and notches inwards. These types of fractures often need surgery to repair the damage caused to the inner tissues and other parts.
    • Diastatic skull fracture: This type of fracture is mostly seen in newly born babies or in infants. It occurs along the suture lines in the skull. The sutures are wide spaces in the bone joints of the skull when we are infants and fuse together when we are children. This fracture leads to the widening of the suture lines.

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