What is head injury?
Head injury refers to any external force applied on the head, whose severity can be minor as seen in laceration or lethal as observed during internal bleeding. Therefore, adequate rest and continuous monitoring to avoid deterioration of the symptoms are crucial for head injury patients.
 
Common symptoms: 
  1. Headache, nausea, vomiting, dizziness, troubled walking, sleepiness, memory loss, grumpy or irritable (especially in young children).
  2. Most symptoms go away within minutes to hours. But some people show symptoms for weeks to months.
 
Warning of head injury:
  1. After being discharged from hospital, the patient should be cautious about any new symptoms for at least 3 to 7 days.
  2. Have someone keep the patient company within 24 hours. 
  3. Observe the patient at least once per hour, and wake up the patient every two to four hours.
  4. Do not stay alone at home in the first 48 hours, and make sure the patient is able to stay connected with others. 
  5. Have adequate time for rest and avoid stressful events. When being awake, the patient should avoid strenuous physical activities or any other heavy exercise which will increase heart rate.
  6. Avoid doing activities requiring concentration or a lot of attention.
  7. Avoid taking sleeping pills, sedatives or tranquilizers.
  8. Do not drink alcohol for 2 days after injury.
  9. Pain-killer pills may be taken to relieve headache (but consult the doctor before taking any new medicines).
  10. Avoid driving the car, riding the scooter or bicycle, or operating machine unless the patient is completely recovered.
  11. Avoid playing any competitive sport (such as rugby or football) for at least three weeks.
  12. If any of the symptoms persist, this will require clinical assessment by a neurologist.
 
If you have the following conditions, please go to the emergency department immediately:
  1. Persistent vomiting, dizziness, or worsening headache.
  2. Conscious change of such as confusion, drowsiness and slurred speech.
  3. Seizure/convulsion.
  4. Fever or neck stiffness and pain.
  5. Blurred vision or visual impairment.
  6. Weakness or numbness involving any part of limbs or unsteady gait.
  7. Urinary or bowel incontinence.
 
Reference
  1. Carney, N., Totten, A. M., O'reilly, C., Ullman, J. S., Hawryluk, G. W., Bell, M. J., ... & Rubiano, A. M. (2017). Guidelines for the management of severe traumatic brain injury. fourth edition. Neurosurgery, 80(1), 6-15. doi:10.1277/NEW 0000000000001432
  2. Silverberg, N. D., Duhaime, A. C., & Iaccarino, M. A. (2020). Mild traumatic brain injury in 2019-2020. The Journal of the American Medical Association, 323(2), 177-178. doi:10.1001/jama.2019.18134
  3. UpToDate. (2019, Mar.01). Concussion and mild trauma brain injury. Retrieved from https://www.uptodate.com/contents/concussion-and-mild-traumatic-brain-injurysource=search_result&search=head%20injury&selectedTitle=2~150
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