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The Hidden Impact of Head Injuries
Trauma to the head, whether through direct impact or shaking, can result in varying degrees of brain injury. Although the brain is protected by the skull, accidents in daily life, such as those occurring during sports like basketball or football, or in road traffic collisions, can still cause significant neurological damage and long-term sequelae.
There are multiple forms of brain injury. These include concussions, cerebral contusions, and epidural haematomas, more common in younger individuals, as well as subdural haematomas, which are frequently seen in the elderly. Symptoms depend on the severity and location of the injury and may include dizziness, headache, nausea, and impaired memory or concentration, and it is important to note that symptoms may not always appear immediately after the trauma.
Diagnosis Through Comprehensive Neuroimaging
Accurate diagnosis is fundamental to the management of brain injury. A thorough medical history, mechanism of injury, and symptom assessment are critical. However, clinical evaluation alone may be insufficient. Objective neuroimaging, such as computed tomography (CT) or magnetic resonance imaging (MRI), is essential to determine the presence and extent of intracranial injury.
Epidural Haematoma May Require Repeat Imaging
In one case, a patient presented to the emergency department with no abnormalities detected on the initial CT scan. However, the patient subsequently developed limb weakness and a decreased level of consciousness. A repeat scan revealed an epidural haematoma, prompting emergency craniotomy. The patient eventually made a full recovery. This case illustrates the importance of follow-up imaging, as bleeding may not be immediately visible. Generally, patients with head trauma are observed in hospital for 48 to 72 hours to ensure stability before discharge.
Delayed Symptoms in Concussion and Subdural Haematoma
Subdural haematomas are more frequently seen in older adults. Most mild subdural bleeds are reabsorbed over 3 to 12 weeks. Should symptoms of neural compression arise during this period, minimally invasive surgery can be performed to evacuate the accumulated blood.
Concussion symptoms vary with the severity of trauma and may include dizziness, headache, nausea, and impaired memory. These symptoms can be delayed, often appearing one to two weeks post-injury. It is advised that concussion should ideally be treated within three months of onset, neglecting treatment may result in prolonged or worsening symptoms, whereas timely intervention typically leads to favourable recovery.
Citicoline Supports Neurological Recovery
During concussion recovery, patients are advised to abstain from alcohol and smoking and to prioritise adequate rest. A minimum of 7 to 8 hours of uninterrupted sleep per night is recommended to support neurological healing. Supplementation with vitamins and citicoline may aid recovery, with many patients experiencing noticeable improvement within one to three months.
Avoiding tobacco and alcohol and getting enough sleep are the keys to brain recovery.
Returning to Work After Cerebral Contusion
A 38-year-old male accountant sustained a skull fracture and brain injury following a road traffic accident while travelling in the Philippines. CT and MRI scans revealed multiple cerebral contusions, though bleeding had ceased spontaneously, eliminating the need for emergency craniotomy. Upon returning to Hong Kong, he experienced typical post-concussive symptoms including dizziness, headache, nausea, and memory impairment. After a three-month course of medication, neurological supplements, and adherence to healthy sleep and lifestyle habits, his symptoms gradually resolved, allowing him to return to work.
There are many types of brain injuries, and diagnosis requires clinical interviews and imaging examinations.