Closed head injuries are very serious and can appear well after a car wreck. If you have any symptoms that appear even weeks after the accident, you should go to an emergency room immediately. Most closed head injuries will require the care of a neurosurgeon, although not all such victims need to be operated upon. Some common closed head injuries include:
- Contusion: This is a bruise to the brain. It typically causes pain and minor nervous symptoms that resolve over 24 hours. It can cause swelling of the brain that may not be seen with a CT scan but may be seen a day or two later by an MRI scan.
- Concussion: A concussion is a temporary and brief interruption of nervous function after minor head trauma, which may or may not cause loss of consciousness. The symptoms may last several days and may include confusion, amnesia, nausea, dizziness and “seeing stars.” In children acute symptoms may differ from adults and may include restlessness, confusion, lethargy or irritability. Directly after the wreck a child may be nauseous, have a high pulse rate or appear pale. These symptoms usually resolve within six hours. Many victims of head trauma may develop a variety of vague and persistent problems. This post concussive syndrome can be debilitating and some individuals are not able to return to work or other normal activities for weeks to months after what appeared to be a minor head injury. Common complaints are memory loss, headache and problems with concentration. Imaging studies are usually normal but an MRI may pick small hemorrhages or brain swelling.
- Subarachnoid hemorrhage: This bleeding results from tearing small vessels between the brain and its overlying tissues. The bleeding enters the cerebrospinal fluid and can be diagnosed with a spinal tap or CT scan. Accident victims will typically complain of headache and photophobia (irritation from light). It can cause blood vessels in the brain to constrict and decrease oxygen supply to the brain. This typically happens 48 hours after injury and can persist for two weeks. In the absence of other injuries it generally does not carry a poor prognosis.
- Epidural hematoma: This refers to bleeding between the skull and the tough outer covering of the brain (dura matter). It can occur from injuries such as fractures that deform the skull. The incidence of skull fracture in children is less than adults because of the elasticity of the growing skull. This injury develops rapidly, especially in children, and symptoms appear within hours. The classic presentation is a decreased level of consciousness, followed by a symptom-free interval and then rapid deterioration. Wreck victims will complain of headache, sleepiness, dizziness and nausea. This type of injury is almost always diagnosed with a CT scan.
- Subdural hematoma: This refers to a blood clot that forms between the dura and the brain tissue. It usually is caused by the brain shifting inside the skull in response to a rapid acceleration or deceleration. Subdural bleeds are more common than epidural bleeds and occur in 30% of victims of severe head injury. Acute subdural hemorrhages become symptomatic between 24 hours and two weeks after injury. Victims may complain of headache, altered mental status, muscle weakness or frank paralysis. Chronic subdural hemorrhage may not be apparent until two weeks after injury. The signs may be very subtle but 45% of victims will complain of weakness in an extremity.
- Intracerebral hemorrhage: These are hemorrhages deep within the tissue of the brain. They may appear right after an injury but some may not be seen by CT Scans for hours or days. They can cause pressure within the brain and often require emergency surgical intervention.
If you have suffered a closed head injury in a car wreck, you should consult with an experienced Alpharetta accident attorney to protect your rights.