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One of the most common complications of head injury is subdural hematoma, resulting from the oozing of blood from the cortical veins and the small blood vessels that lie between the arachnoid and the dura mater. A less common but more serious complication that constitutes an extreme surgical emergency is epidural hematoma, a collection of blood in the space between the skull and the dura mater. The leaking of blood into the epidural space is the result of the rupture of a large meningeal artery. It progresses rapidly and therefore requires immediate treatment. A third complication that may occur following head injury is herniation of either the brainstem or a part of the cerebellum through the tentorial hiatus (transtentorial herniation). This is an extreme emergency demanding immediate relief of pressure against the blood vessels serving the brain stem and cerebellum.
Long-term effects of head injury include chronic headache, disturbances in mental and motor function, diabetes insipidus, and a host of other symptoms that may or may not be psychogenic. Organic brain damage and posttraumatic epilepsy resulting from scar formation are possible sequels to head injury.
Any one of the following symptoms should be reported to the physician: (1) changes in the patient's blood pressure, pulse, or respiratory rate, especially slowing of the pulse with a rising blood pressure; (2) extreme restlessness or excitability following a period of comparative calm; (3) changes in the level of consciousness; (4) headache that increases in intensity; (5) vomiting, especially persistent, projectile vomiting; (6) unequal size of pupils; (7) inability to move one of the extremities; (8) leakage of spinal fluid (clear yellow or pink-tinged) from the nose or ear.
When leakage of spinal fluid is suspected, this can be verified by using a Clinistix test for sugar. If it is positive, the leaking fluid is spinal fluid rather than mucus. When there is leakage of spinal fluid through the nose, the patient must be warned not to blow the nose. Leakage of spinal fluid from the nose or the ear demands absolute bed rest with the head elevated 30 degrees to maintain neutral intracranial pressure and promote healing.
Patients who are unconscious must be watched closely for respiratory difficulty or inability to swallow. If the patient cannot swallow, the head must be turned to the side and the mouth and trachea suctioned as necessary to prevent aspiration of mucus into the lungs. A tracheostomy set and ventilator should be readily at hand in case severe respiratory embarrassment occurs.
Side rails are applied and the headboard of the bed is padded with pillows or a blanket if the patient is delirious or if convulsions are anticipated. An accurate record of the patient's intake and output is kept and the patient is observed for signs of retention of urine, incontinence, or abdominal distention.
An abnormal fixation of the head may be caused by postpharyngeal abscess, arthritis deformans, swollen cervical glands, rheumatism, traumatism of the neck, sprains of cervical muscles, congenital spasmodic torticollis, caries of a molar tooth, burn scars, or eye muscle imbalance (hyperphoria). An inability to move the head may be due to caries of the cervical vertebrae and diseases of articulation between the occiput and atlas or paralysis of neck muscles.
Abnormal movements of the head include habit spasms such as nodding. Rhythmical nodding is seen in aortic regurgitation, chorea, and torticollis. A retracted head is seen in acute meningitis, cerebral abscess, tumor, thrombosis of the superior longitudinal sinus, acute encephalitis, laryngeal obstruction, tetanus, hydrophobia, epilepsy, spasmodic torticollis, strychnine poisoning, hysteria, rachitic conditions, and painful neck lesions at the back.
- the upper or front part of the body in vertebrates, that contains and protects the BRAIN, eyes, mouth, nose and ears when present. There is usually a concentration of sense organs in the head, such as eyes, tentacles, antennae and mouth parts. The head has probably developed because of forward locomotion, as a well-developed head is absent in organisms lacking unidirectional movement (e.g. sea urchin).
- the corresponding part of an invertebrate animal. See also CEPHALIZATION.
- the foremost part of a sperm cell containing the ACROSOME.
Patient discussion about head
Q. What is the cause of my head rash? I have a rash on my head. It is red and itchy, what could it be from?
Q. Head aches terrible I am suffering with bad headaches everyday for the past week, so i thought i would check up on it from you guys. When the day nears the noon, my head ache becomes worse. No common cold. Kindly give me a solution.
Q. Why do they think that the pain is all in my head? Is there any chance which may wrongfully lead doctor to conclude that our symptoms are of a psychological nature? Why do they think that the pain is all in my head?