Head injury

Question 1

define head injury

Answer 1

Any injury that results in trauma to the skull or brain

Question 2

Aetiology/risk factors of head injury

Answer 2

• Age
• Frailty
• Alcohol
• Male

Question 3

Epidemiology of head injury

Answer 3

•	Incidence = 229 in 100,000 people every year
•	Mortality = 6-10 in 100,000 people every year
•	Three distinct peaks in incidence 
o	Children (0-4yrs)
o	Young adults  (15-24yrs)
o	Elderly (75+yrs)
•	Generally a male predominance
•	Causes
o	Falls (28%)
	Elderly
	Alcoholics
o	MTA (20%)
o	Struck (19%)
	Occupaiton
o	Assault (11%)

Question 4

Presenting symptoms of head injury

Answer 4

•	Cognitive
o	Confusion
o	Decreased mental speed
o	Difficulty concentrating
o	Amnesia
•	Physical
o	Headache
o	Blurry vision
o	Nausea and vomiting
o	Dizziness
o	Sensitivity to noise or light
o	Anosmia
o	Balance problems
o	Fatigue
o	Impaired consciousness
•	Emotional
o	Irritability
o	Sadness
o	Nervousness
•	Altered sleep

Question 5

Signs of head injury?

Answer 5

•	Cranial haematoma/haemorrhage
•	Dilated pupils
•	Limb weakness
o	Pronator drift  mild hemiparesis
•	Hypertension with bradycardia
•	CSF leak

Question 6

Investigations of head injury

Answer 6

• GCS
o Helps to categorise severity of head injury
• Minor = GCS 13-15
• Moderate = GCS 9-12
• Severe = GCS 3-8
• Neurological examination
o Consciousness and pupillary reactions first
o Cranial and peripheral nerve examination secondary
• External examination
o Look for signs of bruising and lacerations
• Head CT