Head Injury

Head injuries, which involve damage to the scalp, skull, or brain caused by trauma, are a serious matter. When the brain is affected, they are classified as traumatic brain injuries, or TBIs. While many individuals consider head injuries an acceptable risk during sports and recreational activities, they can pose significant dangers. These injuries have the potential to lead to permanent disability, mental impairment, or even prove fatal. Fortunately, steps can be taken to reduce the risk and protect both yourself and your children from head injuries.

Types of Head Injuries

Head injuries encompass a variety of types:

1. Concussion: This is the most common form of head injury, classified as a traumatic brain injury (TBI). Concussions occur when the brain is jolted or shaken with sufficient force to impact the skull. Their severity can range from mild to severe, and it’s worth noting that a blow to the head isn’t always necessary to induce a concussion. Forceful impact elsewhere on the body can transmit enough energy to jostle the brain.

2. Contusion: When the brain itself sustains a bruise, it is referred to as a contusion. This condition may result in bleeding and swelling.

3. Intracranial Hematoma (ICH): ICH is characterized by bleeding beneath the skull within the brain, leading to the formation of a clot. Brain hematomas can range in severity and are categorized based on their location.

4. Skull Fracture: In some instances, a fractured skull bone can affect the brain. Fragments of broken bone may penetrate the brain, resulting in bleeding and other forms of injury.

Head Injury Causes

Head injuries have a variety of root causes, including:

1. Car or Motorcycle Accidents

2. Falls

3. Child Abuse

4. Acts of Violence

Head injuries can also occur during athletic activities when two athletes collide, or when a player is struck in the head by sporting equipment. In sports such as soccer, even “heading” the ball can lead to a concussion.

The sports and recreational activities that contribute to the highest number of head injuries, across all age groups, include:

1. Cycling

2. Football

3. Basketball

4. Baseball and Softball

5. Riding Powered Recreational Vehicles (e.g., dune buggies, go-karts, mini bikes)

As per the Brain Injury Association of America, the top five activities responsible for causing concussions in children and adolescents aged 5-18 years are:

1. Cycling

2. Football

3. Basketball

4. Playground Activities

5. Soccer

Head injuries are not exclusive to sports; they can also be attributed to other causes like:

• Long-term High Blood Pressure (in adults)
• Bleeding Disorders
• Use of Blood Thinners or Certain Recreational Drugs

Signs and Symptoms of Head Injuries

The signs and symptoms of a concussion may manifest immediately, but they can also have a delayed onset, emerging hours or even days after the injury. It’s important to note that not all individuals lose consciousness during a concussion. Nevertheless, a concussion induces alterations in mental status and disrupts normal brain function. Multiple concussions can have long-lasting, life-altering consequences.

Common signs of a traumatic brain injury, such as a concussion, include:

• Confusion
• Depression
• Dizziness or Balance Problems
• Double or Fuzzy Vision
• Feeling Foggy or Groggy
• Feeling Sluggish or Tired
• Headache
• Memory Loss
• Nausea
• Sensitivity to Light or Noise
• Sleep Disturbance
• Trouble Concentrating
• Trouble Remembering

Signs or symptoms suggesting that a head injury may extend beyond a concussion and necessitate immediate medical attention include:

• Changes in the Size of Pupils
• Clear or Bloody Fluid Draining from the Nose, Mouth, or Ears
• Convulsions
• Distorted Facial Features
• Facial Bruising
• Fractures in the Skull or Face
• Impaired Hearing, Smell, Taste, or Vision
• Inability to Move One or More Limbs
• Irritability
• Lightheadedness
• Loss of Consciousness
• Low Breathing Rate
• Restlessness, Clumsiness, or Lack of Coordination
• Severe Headache
• Slurred Speech or Blurred Vision
• Stiff Neck or Vomiting
• Sudden Worsening of Symptoms After Initial Improvement
• Swelling at the Site of the Injury
• Persistent Vomiting

Head Injury Treatment

If you suspect that you or someone else has sustained a concussion or another type of head injury, the paramount step to take is to prevent further harm. Cease the current activity and inform someone that you may have been injured. Subsequently, seek medical attention. In a team sports context, request to be removed from the game and apprise the coach of the incident. If a fellow player displays signs of confusion or a sudden loss of coordination, ensure this is reported to the coach. For coaches, if you notice a potential injury, promptly withdraw the individual from the game and facilitate access to medical care.

For moderate to severe TBIs, receiving prompt medical attention is of the essence. Undiagnosed injuries that do not receive adequate care can result in long-term disability and impairment. It’s imperative to remember that while death from sports-related injuries is rare, brain injuries stand as the primary cause of sports-related fatalities.

Symptoms of head injuries should be closely monitored, especially in cases of moderate to severe injuries. In certain instances, overnight hospitalization may be necessary. X-rays may be conducted by a physician to assess the potential presence of a skull fracture or spine stability. In more severe cases, a doctor may request a CT scan or MRI to gauge the extent of damage sustained. Surgical intervention may be required for more severe injuries to alleviate pressure resulting from swelling.

If a child experiences a head injury, an immediate X-ray is not always necessary. Instead, monitor the child for age-appropriate symptoms of a traumatic brain injury, such as confusion or behavioral changes. Avoid administering any medications, including aspirin, without consulting a healthcare professional.

For individuals who are discharged by a doctor, close monitoring of the injured party is crucial. This might involve periodic waking to ask questions, ensuring that the person is oriented and responsive. It’s essential to consult with the doctor to understand which symptoms to watch for and which necessitate immediate medical attention.

Guidelines dictate that individuals who have sustained an injury should not return to activities that pose a risk of further harm until they are completely free of symptoms. While most teenagers recover within two weeks, younger children may require up to four weeks for recovery. However, symptoms of severe injuries may persist for months or even years. Individuals with moderate to severe injuries will likely require rehabilitation, which may encompass physical and occupational therapy, speech and language therapy, medication, psychological counseling, and social support.

Head Injury Risk Prevention

The foremost step in safeguarding against head injuries is the acquisition and proper use of protective headgear that complies with the standards set by the American Society for Testing and Materials (ASTM). It is essential to select the correct size to ensure a proper fit and wear the helmet or headgear appropriately. According to the American Association of Neurological Surgeons, helmets or headgear should be worn at all times for activities such as:

• Baseball and Softball
• Cycling
• Football
• Hockey
• Horseback Riding
• Riding Powered Recreational Vehicles
• Skateboarding and Riding Scooters
• Skiing
• Snowboarding
• Wrestling

Furthermore, the FDA has sanctioned a noninvasive device called the Q-Collar, which athletes can wear to help prevent head injuries. This C-shaped collar applies compressive force to the neck, increasing blood volume to reduce brain movement that might occur due to head impacts. The device shows promise in mitigating specific changes in the brain associated with injury.

To enhance safety, here are additional measures you can adopt to protect yourself and your children:

• Wear light-reflecting clothing when cycling at night.
• Avoid diving into water that is shallower than 12 feet or into murky water where the bottom is not visible.
• Ensure that children’s play areas and equipment are both safe and well-maintained.
• Prevent children from participating in sports that are unsuitable for their age.
• Supervise and instruct children on the proper use of sports equipment.
• Refrain from wearing clothing that obstructs vision.
• Adhere to all regulations at water parks and swimming pools.
• Avoid skateboarding or cycling on uneven or unpaved surfaces.
• Abstain from participating in sports when fatigued or unwell.