Head Injury: An Evidence-Based Approach

Head injury is any injury that results in trauma to the skull or brain, due to falls, accidents or physical assault. Head injury can be conspicuous or inconspicuous. In an open head injury, the skull may be broken or cracked open, leading to bleeding. Besides the more apparent nature of the injury, it may present itself with symptoms such as sleepiness, abnormal behavior, severe headaches, vomiting, mismatched pupil sizes and localized paralysis in certain parts of the body. Many of these problems may not be immediately apparent and may develop later in life. Sometimes, a head injury can result in the destruction or degeneration of brain cells leading to brain damage. Several imaging techniques can aid in detecting and assessing the extent of brain damage, such as MRI, CT scan, PET, magnetic resonance spectroscopy, single-photon emission tomography, etc. Most head injuries though benign need close monitoring for complications such as intracranial bleeding. Neurosurgical evaluation is useful when the brain sustains severe damage. Treatment strives to control elevated intracranial pressure by using paralytics, sedation and cerebrospinal fluid diversion. The second line of strategy may involve barbiturate coma, decompressive craniectomy, hypertonic saline and hypothermia. This book contains some path-breaking studies in head injuries. It provides an evidence-based approach to the management of head injury. It will serve as a valuable source of reference for graduate and post graduate students.