Head contusion

A head contusion is an injury to the soft tissues of the skull, most often closed. Damage of this nature is divided into the following types:

• Minor head injuries;
• Contusion with damage to the skin;
• Jaw injury;
• Traumatic brain injury.

If the head is subjected to a bruise, as a rule, the skin and the subcutaneous tissue located under it are damaged. The subcutaneous tissue, due to its structure, does not allow blood from torn vessels and capillaries to spread, thus, the blood is localized in the bruise area. A characteristic lump or hematoma (bruise) appears. Bruises tend to change color depending on the time period.

The first stage is a crimson-reddish hue due to the gushing blood and the hemoglobin it contains. Then the hemoglobin begins to disintegrate, which is carried out by leukocytes. Thus, the erythrocytes gradually change their hue - from crimson to bluish-green and yellow. The green hue is due to the hemoglobin breakdown product - biliverdin, the yellow hue is brought by bilirubin. It is necessary to take into account the characteristic features of bruises, especially if they appear in the orbital area. The so-called glasses symptom may indicate serious damage - a fracture of the base of the skull.

Clinically, head contusions, depending on the severity, are divided into the following:

• Subcutaneous (the bruise itself);
• Subgaleal hematoma – formed under the galea aponeurotica (aponeurosis). May cause significant blood loss due to the large area of effusion (sometimes from the frontal bone to the back of the head) and indicate trauma to the cranial vault;
• Cephalohematoma - periosteal, which is characterized by the presence of blood between the periosteum and the bone. It is fraught with suppuration and may require local surgical intervention.

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How does a head injury manifest itself?

A head injury is often accompanied by damage to the skin. Heavy bleeding can be explained by increased blood supply to these tissues. The wounds swell very quickly, and when the aponeurosis is cut, the wound seems very deep. Early ones in the lip area, as a rule, also affect the internal cavity of the mouth, its mucous membrane. Such injuries are dangerous due to damage to the facial nerves, parotid glands, and bridge of the nose. The most complex wounds can develop into suppuration and abscesses.

Most often, a head injury is not a life-threatening phenomenon, but it is necessary to exclude all risks of more serious TBI - traumatic brain injury and pay attention to the following alarming symptoms:

• Heavy bleeding - anywhere on the head or face;
• Blood from the nose, ears;
• Headache that gets worse;
• Loss or impairment of consciousness for more than 30 seconds;
• Glasses symptom, bruises behind the ears;
• Disturbed balance, dizziness;
• Difficulty breathing, breathing stops;
• Impaired coordination, inability to move limbs;
• Vomit;
• Asymmetry of the eyes, different pupil widths,
• Speech impairment;
• Loss or decrease of pulse, blood pressure;
• Convulsive syndrome;
• Lack of sensitivity to odors.

How to recognize a head injury?

Even a slight head injury can be a serious injury, so the primary diagnosis sometimes depends on where the injury is localized and how the injury and swelling change. The dynamics of swelling increase and buildup, expanding hematomas may indicate complex closed skull injuries. Any head injury in an adult or child requires a thorough examination and correct diagnosis, so as not to miss hidden fractures and serious internal hemorrhages in the brain. To specify and clarify the localization of internal damage, an X-ray and CT (computer tomography) are required, a neurological examination is mandatory.

A head contusion may be localized in the face area. Such injuries are characterized by edema and rapid blood saturation of the tissue (imbibition). Hematomas are rare, mainly the forehead, upper eyelids and superciliary arches are prone to them. The area of the contusion should be carefully and delicately palpated to exclude damage to the paranasal sinuses. When palpating the subcutaneous tissue, air is felt, which may indicate an injury to an important and fragile bone - the ethmoid bone (the bone separating the nasal cavity from the cranial cavity). You should also carefully examine the damage in the eye sockets to exclude a fracture in the anterior fossa of the base of the skull. A symptom of such a severe injury is characteristic bruises in the form of glasses, in addition, a fracture of the base of the skull may be indicated by the accumulation of cerebrospinal fluid in the nasopharynx and the lack of sensitivity to odors (anosomia). A cheekbone fracture may be accompanied by extensive swelling in the area of the injury, which also needs to be diagnosed using an X-ray, otherwise, after the swelling resolves, the entire face will become deformed.

What to do if you have a head injury?

If any of the listed symptoms are noticeable, it is necessary to seek medical help immediately. Before the doctors arrive, the patient should be placed in a dark place in a horizontal position, preferably, with the head gently slightly raised, without turning or turning. If there is bleeding, it is necessary to stop it, without squeezing the wound, apply a sterile or simply clean cloth, bandage. You should pay attention to the victim's tongue and do everything possible so that it does not fall back.

It is better not to allow a head injury, since such injuries, while seemingly commonplace and curable, can result in increased intracranial pressure, visual impairment, and other equally serious problems many years later. And if the injury causes concern after a few days, you should not take risks - it is better to consult a doctor in a timely manner to receive qualified help.