Time is of the essence if one experiences any hard blow to the head, even if there are no immediate symptoms. Seek emergency treatment immediately. The same holds true if the blow is not hard but produces bleeding, loss of consciousness, severe headache, repeated vomiting, confusion, loss of balance, weakness in an arm or leg, unequal pupil size, slurred speech or seizure. You may have sustained a traumatic brain injury (TBI), which is defined as a blow to the head or a penetrating head injury that disrupts the normal function of the brain. In severe cases, one may experience unconsciousness, coma, or even death.
Emergency surgery is called for if neurosurgeons find a hematoma (a blood clot) within the brain or on its surface, or a cerebral contusion (bruising of brain tissue), compressing the brain or increasing pressure within the skill. A blood clot in the brain itself may be removed through surgery if it puts too much pressure on the brain. Since contusions or hematomas may enlarge over the first hours or days after the incident, the injury should be closely monitored and surgery performed at that time.
A traumatic head injury may result in a subarachnoid hemorrhage (SAH), epidural hemorrhage (EDH), or intracerebral hemorrhage (ICH). The size and location of the hemorrhage help determine whether it can be removed surgically.
TBI also can result in hydrocephalus or a condition in which excess cerebrospinal fluid builds up in the brain, causing increased pressure within the head. The pressure is relieved through surgical placement of a shunt to direct the fluid where it will not pressure brain tissue.
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