Head Injury

Key points

• • Head injury can damage the brain directly at the moment of impact, and again from later swelling or bleeding inside the closed skull.
• • An extradural haemorrhage, often from a torn artery after a skull fracture, classically gives a lucid interval before the person deteriorates.
• • A subdural haemorrhage, from torn bridging veins, may develop more slowly, especially in the elderly and in alcohol misuse.
• • Warning signs of a serious injury include worsening consciousness, a severe headache, repeated vomiting and unequal pupils.
• • The level of consciousness is tracked with the Glasgow Coma Scale, and a CT scan shows bleeding and swelling.