MYTHS ABOUT HEAD INJURIES
Dr Arvind Bhateja
Consultant Neurosurgeon and Spine Surgeon, Bangalore
Medical Director, Sita Bhateja's Nursing Home
abhateja@gmail.com
Mobile: 98452-94701

Myth 1:
Head injuries need expert treatment and intensive care to ensure a good outcome in victims.
Fact:
Although it is true that once a head injury has occurred, especially if the head injury is a severe one, it is best managed by expert neurosurgical and intensive care- it is also true that the best way to manage head injuries by and large is PREVENTION. Once a severe head injury has occurred, many of its effects are immediate and at times, permanent. Prevention in the form of enforcing safe driving habits, use of helmets, use of safety equipment and just being prudent and careful are the best ways to prevent a head injury from occurring at all.

Myth 2:
Once a head injury has occurred it is vitally important to shift the patient to a neurosurgical setup to mange the head injury, no matter how far it is.
Fact:
Not true. The first steps in managing a head injury are much the same as for any other injury. Of primary concern are ensuring that the patient has a clear air passage, good breathing and is maintaining adequate circulation of blood. This is often called the ABC of resuscitation (A=airway, B=breathing, C=circulation). Ensuring the ABC prevents some of the most common secondary complications such as low oxygen levels in the blood and low blood pressure, which can be more damaging to the brain than the head injury itself.
Once the patient is stabilized with respect to the ABC’s, it is important to transport the patient to the nearest trauma facility with multi-speciality involvement, so that the patient can be managed for all his injuries, under one roof.

Myth 3:
A CT scan is mandatory in all head injured patients.
Fact:
Most minor head injuries, even ones in which the patient has lost consciousness for a short while or does not remember the circumstances of the injury, do not need a CT scan. However, if the patient continues to remain drowsy or has certain other features, a CT scan may be needed. Remember too that a CT scan means exposure to radiation and is not recommended unless it is truly indicated. Also, a CT scan done very early after a head injury may not fully reveal the true extent of the brain injury. Moreover, some injuries may evolve over a period of 1-2 days and a scan done early may give a false sense of security. CT scans are definitely recommended in moderate and severe head injuries.

Myth 4:
If a patient regains consciousness after a head injury, it usually means that he is alright, and does not need hospitalization.
Fact:
While it is true, in most instances, that patients who regain consciousness after a head injury are usually out of danger, it is also true that a small minority of patients can again lose consciousness after a few hours. For this reason, it is recommended that even patients with minor head injuries should be admitted for observation for a period of 18-24 hours after the injury.