The Uncertainity We Face With Head Injuries

Every year in America, almost one and a half million people suffer traumatic brain injury. This refers to an injury to the brain usually as a result of an accident, or sometimes an assault.

Often the injury results from a blow to the head such as may be suffered in an automobile accident, a fall or a gunshot wound. The injury may also occur as a result of lack of oxygen or as a result of lack of blood supply to the brain for example following a heart attack.

People with multiple injuries like in serious auto mobile accidents often suffer brain injury by more than one of these mechanisms. The term head injury is preferable to the term brain damage because the brain has tremendous powers of recovery.

Furthermore, shortly after a head injury, it is usually impossible. One may never know the exact cause of the accident or injury, and chances are the head injured person will never remember what happened. No one can tell when the person will wake up. The usual policy is to wait and see.

Furthermore, head injured persons rarely wake up all at once. Rather the process of full recovery of consciousness is gradual and takes hours in the mildest cases, and may take months or even years in the worst cases. Some people improve only to a point and never fully regain awareness of their surroundings. In contrast to the short time it takes to injure the brain, recovery is measured in weeks, months and even years.

Recovery is most rapid shortly after the injury and slows down with the passage of time. Many people with severe head injuries end up with almost no noticeable problems, but others require constant care for the rest of their life. Most people who survive a serious head injury eventually wake up from coma, that is, they begin to open their eyes. In the best cases recovery proceeds from this point to nearly complete recovery.

In worst cases there is no recovery beyond opening their eyes. People who wake and sleep but have no meaningful interaction with the world around them are said to be in persistent vegetative state. This is probably the worst possible outcome. In between these extremes is a very wide range of outcomes, some fortunate, and some tragic.

It is very important to know that the outcome may remain unknown for many months. It may seem cruel and uncaring when the doctor says that only time can tell about the extent of injury, but this is the accurate answer. In general terms, the longer a person remains in coma, the less likely he or she is to recover completely.

The process of recovery almost always takes much longer than the family and friends expect. A few people may eventually become essentially normal after several months in coma, whereas others may suffer devastating permanent injury after only a brief period of coma.

As would be expected, people with head injuries generally do better if just their head is injured and they do not also have serious injuries to other parts of their bodies.

No one can accurately predict whether a head injured person will die. Head injuries are often serious enough themselves to cause death. There are two critical periods in the immediate recovery of a head injured person. The first is in the first day or two after the injury when the injuries may be so overwhelming as to cause death in the face of the most intensive treatments.

Those who survive this period face another critical period beginning a few days later and continuing for two weeks or more. This critical period results from swelling of the injured brain. After head injuries patients and their care takers are advised to take notice of certain key pointers towards late manifestations of head injuries.

These include any symptom that is getting worse, such as headaches, nausea or sleepiness, nausea that doesn't go away, changes in behavior, such as irritability or confusion, dilated pupils (pupils that are bigger than normal) or pupils of different sizes, trouble walking or speaking, drainage of bloody or clear fluids from ears or nose, vomiting, seizures or weakness or numbness in the arms or legs.

Patients are advised that if any of these symptoms appear then they should consult the doctor, or get someone to take them to the nearest hospital accident and emergency department as soon as possible.

In most patients recovery is rapid and no long-term problems are encountered however as there is a chance of having late problems, patients are strongly advised to have regular checkups with their doctors.