Head Injury In Adults

Diagnosis

All head injuries should be evaluated promptly by a doctor, so either call for emergency help or have a friend or family member drive you to an emergency department. Once you arrive at the emergency department, the doctor will want to know:

• How you hurt your head, including the height of your fall or your position (front seat, back seat, driver) in a car accident

• Your immediate reaction to the injury, especially any loss of consciousness or memory loss

• Any symptoms that occurred soon after the injury, such as vomiting, headache, confusion, sleepiness or seizures

• Your current medications, including alcohol and nonprescription drugs

• Your past medical history, especially any neurological problems (stroke, epilepsy, etc.) and any prior episodes of head injury

• Whether you are having pain in your neck, chest, abdomen, arms or legs

If you are not able to answer these questions, the information can be provided by a family member, friend or the emergency medical personnel who brought you to the hospital.

The doctor will give you a physical and neurological examination, including assessments of your pupil size, reflexes, sensation and muscle strength. If the results of these exams are normal, you may not need further tests. However, the doctor may decide to monitor your condition in the hospital.

For someone with more severe head injuries, emergency personnel will try to stabilize the person's condition as much as possible before arrival at the hospital. To do this, they may pass a tube down the person's throat and windpipe (trachea) to help breathing with a mechanical ventilator, control any bleeding from open wounds, give medication intravenously (injected into a vein) to maintain blood pressure, and immobilize the person's neck in case of a cervical fracture. Once the injured person arrives at the hospital and is stabilized, the doctor will do a brief physical and neurological evaluation. This will be followed by a computed tomography (CT) scan of the head and spinal X-rays, if necessary. In most cases, a CT scan is the best way to detect skull fractures, brain injury or bleeding inside the head.