Why bumps to the head can have a sinister side

A doctor looking at brain scans.
A doctor looking at brain scans.
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A bump to the head is something everyone has experienced at some stage, and most of the time it’s nothing to worry about.

But sometimes knocks are a cause for concern, with serious head injuries being the most common cause of death and disability in British people aged under 40.

And the festive season is an especially risky time for South Yorkshire residents.

According to the Royal Society for the Prevention of Accidents, nationally more than 6,000 people will have ended up in hospital on Christmas Day alone, and over the Christmas period more than 80,000 people visit accident and emergency wards.

Over recent years, there has been a particular increase in injuries, many to the head, involving falls from ladders while stringing lights.

When head injuries are serious, early detection and prompt treatment is vital, warns the National Institute for Health and Care Excellence, or NICE, which is in the process of revising its guidelines for the treatment of head injuries.

Emergency medicine consultant Professor Fiona Lecky, from Sheffield University’s School of Health and Related Research, who chaired the NICE committee revising the guidelines, said: “It’s really important to spot the signs of what could be a serious head injury, and if there’s any doubt whatsoever, to get the patient to hospital.”

Signs that it’s serious include loss of consciousness, having a seizure, a serious scalp wound - possibly with a lot of blood and being able to see the skull - severe headache and vomiting.

The updated draft guidance recommends that people who show such symptoms should be given a brain scan within an hour.

Others should be scanned within four to eight hours of their injury, depending on its severity.

However, many people seek no medical help at all after a bad bang, even if they’re experiencing worrying symptoms - and this can lead to serious consequences.

After a head injury, over time the brain can swell, potentially cutting off its blood supply.

“If there’s an injury to the brain that’s causing swelling or bleeding, the sooner a patient gets to hospital, the sooner such problems can be diagnosed and treatment can be started,” said Prof Lecky.

She points out that spotting warning signs can be particularly difficult with young children and elderly people with dementia.

She advises parents and carers to take them to hospital as soon as possible if they have any concerns at all - for example, if a child’s abnormally drowsy, or falling asleep at a time other than their normal sleep time.

Lecky notes that most people who go to A&E with a head injury have concussion, caused after the blow shakes the brain.

“There isn’t any particular treatment for concussion, other than reassurance and an explanation of what the condition involves,” says Lecky.

“Most of the time you’re better after 48 hours, but some people are unlucky.”

Included in the updated NICE draft guidance - set to be published in its final form in January - is the recommendation that medical staff give verbal and printed advice to patients with any type of head injury when they are discharged from A&E.

Prof Lecky said: “NICE guidance has been really important in raising the standard of care for head injuries, and making sure more people get a scan early. We’ve seen a big improvement in survival as a result, so we’re updating it in the hope that we’ll continue to improve patient care.”

Call the Headway charity on 0808 800 2244 or visit www.headway.org.uk for more information and support after a head injury.