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	Head Injury
	Head injury, especially from car and motorcycle accidents, is one of the most common causes of accidental injury and death.
	Definition
	Head injuries can be divided into 3 major categories: Closed Head Injury. The skull does not fracture. Brain damage results from bruising or swelling of brain tissue (called contusion), or internal hemorrhage. Injury to the brain is usually less severe than after obvious skull fractures. The mildest form of closed head injuries is a concussion, in which there is brief loss of consciousness at the time of trauma, but no permanent effects. Depressed Skull Fractures. The outer skull may remain intact, but fragments of underlying bone are pushed down and can compress or lacerate the brain beneath. The degree of damage to the brain can vary greatly. Compound Fractures. The outer tissues are torn, the skull opened, and the brain tissue exposed. Brain damage is likely.
	Diagnosis
	The symptoms of a brain injury vary and are directly related to the location and severity of damage. Concussion may be followed by headache, dizziness, and amnesia about events immediately before and after the injury. More serious head injuries may cause speech difficulty, bleeding from the nose or ears, muscular weakness, paralysis, and long periods of altered awareness or coma. Serious injury may also cause convulsive seizures. Sometimes the effects of head injury are completely reversible; in other cases, some degree of neurological impairment may be permanent. In more than a third of cases, even those with mild head injury, victims suffer a collection of sometimes vague symptoms known as posttraumatic or postconcussive syndrome. These symptoms, which may persist for weeks or longer, include headache, dizziness, insomnia, and such psychological disturbances as irritability, restlessness, inability to concentrate, personality change, and depression. Anyone who loses consciousness following a head injury should be examined by a doctor. Even if the patient appears normal, a period called the "lucid interval" sometimes obscures a potential, fatal intracranial hemorrhage. Even slight bumps on the head that cause severe head or neck pain should be medically evaluated. More serious injuries producing any of the symptoms described above should be viewed as medical emergencies and the victim taken to a hospital emergency service at once. The extent of injury is usually diagnosed by x-rays of the skull and CT scans. Electroencephalograms (EEGs) may also be used to determine the prognosis.
	Treatment
	Treatment depends on the extent of the injury and may range from bed rest and medical observation for 24 to 48 hours, to surgery and extended postoperative care including physical and occupational therapy. Following the immediate treatment, the patient must be observed for late complications, including epilepsy and subdural hematoma (a blood clot between the layers of the tissue surrounding the brain), which may develop weeks or even many months later. Reassurance and support by family members and medical personnel are vital to recovery; psychological counseling may also be necessary.
	Prevention
	Many head injuries would be preventable if automobile drivers observed speed laws and both passengers and drivers wore seat belts. Motorcyclists and bicyclists should obey traffic laws and always wear helmets.
	Male/Female Differences
	Head injuries are most common among young adult males because they have a higher rate of automobile accidents, a leading cause of head injury. Motor vehicle accidents cause an estimated 3 million head injuries annually.