Hitting your head is not fun, but unfortunately, it’s something just about everyone has experienced to some degree throughout their lives. Whether it’s getting hit with a ball playing your favorite sport or bumping your forehead on that open kitchen cabinet, a thump to the head doesn’t feel good and can leave you feeling sick, dizzy, confused, or all the above. But how do we know if we should seek medical attention or just shake it off and continue going about our days? Well, when it comes to head injuries, “better safe than sorry” definitely applies and there are some instances in which you may benefit from being particularly cautious in responding to potential head trauma. The recent tragic death of beloved actor and comedian Bob Saget serves as an unfortunate example of the importance of acting quickly and appropriately after a hit to the head.
What’s the Big Deal?
You might be wondering what’s so important about an injury to the head specifically? The most straightforward answer is the amazing brain! A healthy brain is paramount for humans to be able to function properly and ultimately survive; however, this critical part of our bodies is relatively susceptible to physical trauma in part due to the anatomy of the human skull and other protective layers encompassing the brain. Many people are not aware that despite being encased by strong bones that make up the skull, there really is not much holding our brains in place. There are three layers of protective tissue between the brain and the skull called meninges, which are cushioned by fluid surrounding the brain known as cerebrospinal fluid (CSF). While it’s a little strange to think about fluid resting inside our heads between the brain and the skull, we have CSF to thank for acting as a shock absorber and preventing our soft brains from easily bumping into our bony skulls. However, in the event that you experience blunt or penetrating trauma from a forceful hit to the head, the meninges and CSF may not be sufficient in protecting the brain from making impactful contact with the skull which could result in varying degrees of traumatic brain injury (TBI).
What are the Classifications?
Head trauma can present differently across individuals, but in general there are three main classifications of TBI based on severity and prognosis. Firstly, a mild TBI typically results from a softer bump to the head that may leave the individual briefly feeling dizzy, confused, or disoriented. A key giveaway that a head injury more than likely qualifies as mild is if the person’s eyes remain open and only experiences a loss of consciousness for a few seconds, if at all. An individual may experience a moderate TBI if consciousness is lost for at least 20 seconds, which can persist for up to six hours. The person with moderate head trauma will likely be lethargic and may experience more severe headaches as a result of potential bleeding or swelling on the brain but is still aroused by external stimuli. The most detrimental head injuries are classified as severe, which occur when the individual is unconscious for at least six hours following the impact of the TBI and who’s eyes remain unopened even when exposed to stimulation.
What or who is Coup-Contrecoup?
Coup-contrecoup (pronounced coo contra coo) is a big reason why some head injuries that may appear mild on the surface have significantly more damaging effects than initially anticipated. In some instances of head trauma, the force is so great that the brain moves to the opposite side of the initial injury, causing damage at both the site of the injury and the part of the brain opposing the initial site. As a result, the impacted person is likely to have a more severe prognosis in part simply because a larger portion of the brain is affected oftentimes by bleeding or bruising. In the case of Bob Saget, officials speculate the devastating outcome of his seemingly harmless fall may be attributed to the effects of a coup-contrecoup injury. Based on findings from his autopsy, it is believed Bob Saget likely fell in his hotel room and hit the back of his head before getting back up to go to sleep in his bed where he later passed. After his death, several fractures were found in his skull along with bleeding on both sides of his brain, leaving him with injuries comparable to a hit in the head by a baseball bat. While Bob Saget’s age and list of prescription medications may have made him more susceptible to falls and fractures, some health officials wonder if the outcome could have differed if he had sought prompt treatment and avoided going to sleep immediately after the injury.
How do I Respond to Head Trauma?
When you suspect a possible head injury, the most important takeaway to bear in mind is to err on the side of caution and respond quickly in order to stop potential internal bleeding on the brain. Immediately after a suspected TBI, the impacted individual will want to carefully lay down keeping the head and shoulders slightly elevated while waiting for medical personnel. If there is evident external bleeding, you will want to do your best to minimize the active bleeding by applying firm pressure to the affected area using a sterile cloth or gauze, unless a fracture is suspected. In the moments after a TBI, be aware of the person’s breathing and alertness and continue to monitor for abnormal changes, including in personality, over the weeks following the injury. Getting a head injury can be not only painful, but anxiety-provoking. While addressing a potential TBI can be a daunting or stressful process, seeking care soon after a hit to the head could be the difference in treatment outcomes.
- Ellery Miner