Head Traumas
Human beings are exposed to mild or severe head trauma throughout their life, especially in childhood. Every year, thousands of people die or become disabled due to head trauma in our country, where traffic and work accidents occur in large numbers. The brain is contained within the skull, which is a rigid box. With the impact of the impact, various degrees of damage occur, from mild swelling (edema) to ruptures and hemorrhages in the brain tissue by shaking inside the skull.
The brain is not damaged only in the direction of the impact. With the force of the impact, it is damaged by hitting different directions within the skull like a rubber ball bouncing on the concrete floor. When exposed to a serious head injury, at least an edema and hyperemia (redness) occur in the brain. The brain, which swells in the skull, which is a fixed closed box, can become more and more compressed, leading to unconsciousness of the patient, coma and even death.
In mild traumas, the patient may even lose consciousness after trauma. Headache vomiting occurs. Since vomiting is thought to be the most important sign of cerebral hemorrhage among the public, unnecessary panic and anxiety may occur. Especially young children may vomit without any damage or bleeding in the brain after mild head trauma. Fractures and cracks in the skull in head traumas are an indication that the trauma is severe, and there is a possibility that a vessel under the fracture may rupture and cause bleeding. Therefore, when a fracture is detected, the patient should be kept under observation in the hospital.
Again, after severe trauma, intracranial vessels rupture and hemorrhages occur outside the brain or inside the brain. These hemorrhages are named differently according to the bleeding sites and different clinical and radiological findings occur in each of them.
1-Epidural Hemorrhages: These are hemorrhages between the skull and the cerebral cortex. It is usually seen in traumas in which the skull is fractured. Between the cerebral cortex and the skull, the ruptured arterial blood accumulates and begins to compress the brain. When the patient is conscious after trauma, it closes within minutes or hours and a coma develops. Draining the blood with the intervention before the deep coma state occurs will save the patient’s life.
2-Subdural Hemorrhages: They are hemorrhages just below the cerebral cortex, that is, between the outer surface of the brain and the cerebral cortex. Again, it must be surgically drained. The earlier the interventions are, the better the results.
3-Subarachnoid hemorrhages: These are hemorrhages in the brain cavities. No surgical treatment is required. The blood is destroyed by the body over time.
4-Intra-Cerebral Hemorrhages: (Intracerebral hemorrhages): It occurs with the rupture of vessels during ruptures in the brain tissue due to the severity of trauma. When the bleeding reaches a certain size and threatens the patient’s life, it is drained by surgical intervention. Otherwise, small hemorrhages will not be operated on because they will be destroyed by the body over time. After severe head trauma, the patient may experience headaches, dizziness, instability, epileptic seizures, which can last for days or months and even rarely be permanent. Medication is possible. Rarely, cerebrospinal fluid (CSF) leakage may occur from fractures in the skull base bones after head trauma. The patient states that a liquid is constantly flowing from his nose. This is a very important situation. Since bacteria may reach the brain and cause meningitis through CSF leakage, this leakage must be treated and eliminated.
