Head Injury In Adults

Head trauma also can cause swelling inside the brain and a potentially deadly increase in pressure inside the skull. Head injury also can seriously damage to brain cells (neurons). In some cases, these cells are destroyed immediately by the impact of a head injury. In other cases, the damaged neurons take longer to wither and die.

Each year, head injuries result in more than 2 million emergency department visits in the United States, with more than 72,000 deaths. An additional 80,000 to 210,000 people with moderate or severe head injuries become disabled or require extended hospital care. Overall, traumatic head injuries are the most common cause of death among Americans age 45 and younger. In addition, head injuries resulting from falls are a very common cause of hospitalization and death among people over the age of 75. Men are 3 to 4 times more likely to sustain head injuries than women, and alcohol use is involved in about 50% of cases.

In the United States, the most common causes of closed head injuries, as opposed to open injuries, such as gunshot wounds, are motor vehicle accidents, falls and violent assaults. Because of the extreme forces involved in these types of trauma, up to 75% of people with severe head injuries also suffer serious damage to the neck bones or to major organs in other parts of the body. These additional injuries often increase the person's risk of blood loss, breathing difficulties, very low blood pressure (hypotension) and other problems that can worsen the damage caused by the brain injury alone.

Symptoms

Head injuries can cause a wide variety of symptoms, depending on the type of injury, its severity and its location. Some doctors classify head injuries into three categories, based on symptoms:

• Mild head injury - There is minimal injury to the outside of the head with no loss of consciousness. The injured person may vomit once or twice and complain of a headache.

• Moderate head injury - There is a more obvious injury to the outside of the head, and the person may have lost consciousness briefly. Other symptoms can include memory loss (amnesia), headache, dizziness, drowsiness, nausea and vomiting, confusion, a bruise-like discoloration around the eyes or behind the ear, or a clear fluid oozing from the nose (this fluid is not mucus, but fluid from around the brain (cerebrospinal fluid) that has leaked through a skull fracture near the nose).

• Severe head injury - There is serious damage to the outside of the head, often together with injuries involving the neck, the arms or legs, or major body organs. In most cases, the person is either unconscious or barely responsive. However, some people become agitated or physically aggressive. About 10% of people with severe head injury have seizures.