Head injury refers to trauma to the head. This may or may not include injury to the brain. However, the terms traumatic brain injury and head injury are often used interchangeably in the medical literature.
traffic accidents,
home and occupational accidents,
falls,
assaults
Concussion: Mild concussions are associated with sequelae. However, a slightly greater injury is associated with both anterograde and retrograde amnesia (inability to remember events before or after the injury).
Epidural hematoma: Epidural hematoma (EDH) is a rapidly accumulating hematoma between the dura mater and the cranium. These patients have a history of head trauma with loss of consciousness, then a lucid period, followed by loss of consciousness.
Subdural hematoma: Subdural hematoma occurs when there is tearing of the bridging vein between the cerebral cortex and a draining venous sinus.
Cerebral contusion: Cerebral contusion is bruising of the brain tissue. The majority of contusions occur in the frontal and temporal lobes.
Diffuse axonalinjury: Diffuse axonal injury, or DAI, usually occurs as the result of an acceleration or deceleration motion, not necessarily an impact.
Immediate, seen within seconds or minutes
Loss of consciousness (In some instances, persons with head injury may remain conscious as well)
Impaired attention, poor response to commands, speech without coherence
Headache, confusion
Disorientation and lack of co-ordination
After several hours or weeks
Nausea/ Vomiting
Vision problems
Ringing in the ears (Tinnitus)
Fatigue, irritability, anxiety or depression
Memory retention problems
Lack of attention and concentration
Sleep Disturbances
Convulsions / Seizures
Coma
Loss of sensation in the extremities.
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1 |
2 |
3 |
4 |
5 |
6 |
| Eyes |
Does not open eyes |
Opens eyes in response to painful stimuli |
Opens eyes in response to voice |
Opens eyes spontaneously |
N/A |
N/A |
| Verbal |
Makes no sounds |
Incomprehensible sounds |
Utters inappropriate words |
Confused, disoriented |
Oriented, converses normally |
N/A |
| Motor |
Makes no movements |
Extension to painful stimuli |
Abnormal flexion to painful stimuli |
Flexion / Withdrawal to painful stimuli |
Localizes painful stimuli |
Obeys commands |
The scale comprises three tests: eye,verbal and motor responses. The three values separately as well as their sum are considered. The lowest possible GCS (the sum) is 3 (deep coma or death, while the highest is 15 (fully awake person).
• stretches to increase muscle length as shortened muscles can lead to tension and movement problems
• help to facilitate movement
• work on muscle strengthening
• balance re-education, providing a series of exercises to help patients improve their balance
• Work on improving functional ability e.g. transfers
• gait re-education, to help make walking as efficient as possible
• sensory stimulation, to help patients with lack of sensation in any part of their body
• Wheel chair management
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