Medical Moment: Head Injury?

Dr. Simon Kotylar, Board certified in Emergency Medicine

Our community engages in a number of high-speed recreational activities and unfortunately, people that play hard also fall hard. Often times head injuries are a significant component of the trauma that ensues. While bones and skin heal well and are able to regenerate, injury to the brain poses a more serious threat and may leave an individual with permanent disability. Fortunately, the majority of head injuries are minor and as such, most people will present with signs and symptoms of a concussion.

While most of the concussion hype revolves around professional athletes, the largest segment of the population affected by concussions is children and young adults. The focus of this week’s medical moment will be this common condition.

What are the signs and symptoms of a concussion?

A concussion is a type of traumatic brain injury caused by a blow or jolt to the head, usually associated with a movement that causes the brain to move back and forth quickly within the skull.

The diagnosis of a concussion relies on the presence of symptoms following a blow to the head and while the list of symptoms is long and quite diverse, most individuals have some combination of difficulty in concentrating, nausea, headache, light sensitivity and/or poor energy. Some of these symptoms may appear right away, while others may not be noticed for a few days.

In rare cases, individuals sustaining trauma to the head can develop bleeding within the brain which can cause swelling and become life threatening. Fortunately this is very rare and we have good scientific data that can help us decide when a CT scan in necessary to look for blood and more serious brain injury. It is important to remember that a concussion is not diagnosed with a CT scan.

What should I do if a head injury occurs?

Most minor head injuries cause mild symptoms and can be managed at home. If you suspect that you or someone you know has a concussion, contact your health care provider as even seemingly minor concussions may benefit from early referral and care. If you, or a friend or family member sustained a blow to the head, emergency care should be sought promptly if any of the following symptoms develop:

• Headache that gets worse and does not go away
• Repeated vomiting
• Poor coordination or weakness
• Unusual behavior or confusion
• Drowsiness
• Convulsions or seizures
• Loss of consciousness following the injury

Young children who will not stop crying or will not nurse or eat following a head injury should also be cared for urgently. Athletes with concussions that occur during sanctioned sports should adhere to the same initial principles followed by a structured return to play assessment.

What can you do to recover after a concussion?

How quickly one improves following a concussion depends on several factors including age, prior concussions, and how one takes care of oneself after the injury. The road to recovery should be coordinated with your health care provider. However these general rules are helpful to remember:

• One should get plenty of sleep and rest
• Alcohol and drugs should be avoided
• Contact sports and demanding physical activity should be avoided until you are symptom free and you get the green light from your doctor
• Consider minimizing work and or school related activities during the initial recovery period
• Avoid prolonged computer and TV exposure

What are the best ways to prevent a concussion?

As long as we continue to play hard and fast, falls and injuries are bound to happen, and as such, I cannot over-emphasize the importance of helmet use. We see quite a lot of head injuries in our emergency department and fortunately very few of these result in serious injury or long-term damage. This is due to the fact that the majority of our athletes wear appropriate protective gear. Brain injuries can be devastating. Please wear those helmets, make sure they fit properly and stay safe.

Editor’s note: The Telluride Medical Center is the only 24-hour emergency facility within 65 miles. As a mountain town in a challenging, remote environment, a thriving medical center is vital to our community’s health.