Don’t dismiss head injuries

The death of 45-year-old Natasha Richardson last week from what had been labelled a “mild brain injury” after a skiing accident...

Written by The Baltimore Sun | Published: March 28, 2009 10:51 pm

The death of 45-year-old Natasha Richardson last week from what had been labelled a “mild brain injury” after a skiing accident,has experts in trauma warning the public to take a blow to the head seriously.

Any blow to the head that causes an ache that gets worse requires immediate medical attention.

“There is no such thing as a mild head injury. It’s a misnomer,” said Vani Rao,director of the Brain Injury Programme at Johns Hopkins Bayview Medical Center and a neuropsychiatrist. “Go to the emergency room immediately and get a complete evaluation.”

Rao estimates that up to 75 per cent of head injuries are labelled mild,but in up to a quarter of those cases,there are significant problems,including sleep and memory troubles,loss of cognitive abilities and changes in motivation and attitude. Many people or their families notice changes in behaviour hours,days or even weeks after a person has hit his head,she said.

In many cases,bleeding is usually revealed by a timely CT scan,which is a more sophisticated X-ray of the body that shows cross-section images,said Dr Howard Eisenberg,chairman of neurosurgery at the University of Maryland School of Medicine.

An epidural haematoma,which is what an autopsy determined killed Richardson,is usually treatable. Doctors drain the blood that is pooling and clotting and causing pressure on the brain. Small ones can heal without surgery.

Because Richardson was conscious and talking immediately after the accident,she may not have believed the problem was serious. It was reported that she developed a headache about an hour after the accident. Eisenberg said that just meant the initial bleeding was slow.

He said a headache that gets worse is the key symptom of a problem. Others who likely need medical attention after a blow to the head are also increasingly dazed,exhibit vomiting or other behaviour changes. They don’t need to have lost consciousness.

“We all hit our heads and don’t go to the hospital,” he said. “But if you’re skiing and you hit a tree,if you fall off your roof or get in an auto accident and hit your head,obviously you need medical attention. If you stand up and hit your head on a shelf,probably not. Consider the force.”

Everyone should be aware if you get struck on the head and it’s a moderate blow,(and) there’s pain that gets worse,even a little bit,that’s a clue to stop what you’re doing and get to the hospital.

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