Head Injury-Overview

Head injuries are a major cause of morbidity and mortality in all communities. Trauma is the third most common cause of death in the United States, exceeded only by cerebrovascular disease and cancer. Trauma is the leading cause of death in youth and early middle age and the death is often associated with major head trauma. Head injury contributes significantly to the outcome in over half of trauma-related deaths.

There are approximately 2.5 deaths from head injury per 10 000 population in Australia and neurotrauma causes approximately 3.5% of all deaths. Road traffic injuries (RTI) are responsible for about 65% of all fatal head injuries in Australia. In developing economies, trauma is the leading cause of death with many of them resulting from road traffic injuries (motor vehicles or motor cycles {AKA Okada in Nigeria}).Other causes include fall from heights (particularly in children), sports injuries and assault.

There is a wide spectrum of head injury from mild concussion to severe brain injury resulting in death. The management of the patient following a head injury requires the identification of the pathological processes that have occurred. Adequate attention must be paid to associated injuries whose management may sometimes take precedence over the head injury management.

CLASSIFICATION
The various ways of classifying head injury are:
1. According to aetiology e.g RTI, fall, sports

2. According to mode of injury:
a. Blunt
b. Penetrating

3. According to the state of the scalp and skull
a. Closed: in which scalp and skull are intact
b. Open: in which both are breached

4. According to the Glasgow Coma Score (GCS)
a. Mild: GCS 13-15
b. Moderate: GCS 9-12
c. Severe: GCS 3-8

NB: a. Coma is GCS < 8
b. Some workers classify GCS 3 - 4 as critical head injury