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November 25, 2009
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Head Injury (cont.)

How is a Head injury treated?

The treatment of a head injury depends upon the type of injury. For patients with minor head injuries, nothing more may be needed other than observation and symptom control. Headache may require pain medication. Nausea and vomiting may require medications to control these symptoms.

Bleeding

Intracerebral bleeding or bleeding in the spaces surrounding the brain are neurosurgical emergencies, although not all bleeding requires an operation. The decision to operate will be individualized based upon the injury and the patient's medical status.

One option may include craniotomy, drilling a hole into the skull or removing part of one of the skull bones to remove or drain a blood clot, and thereby relieve pressure on brain tissue.

Other times, the treatment is supportive, and there may be a need to monitor the pressure within the brain. The neurosurgeon may place a pressure monitor through a drilled hole through the skull to monitor the pressure. The slang term for this procedure is "placing a bolt."

Supportive care is often required for those patients with significant amounts of bleeding in their brain and who are in coma. Many times, the patient requires intubation to help control breathing and to protect them from vomiting and aspirating vomit into the lungs. Medications may be used to sedate the patient for comfort and to prevent injury if the bleeding causes combativeness. Medications may also be used to try to control swelling in the brain if necessary.

What is the prognosis for head injury?

The goal for the treatment of any patient is to return to the level of function that they had prior to the injury. This maybe a challenge with head injury, and the return of function depends upon the severity of the injury to the brain.



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Head Injury

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