When head trauma is life threatening

In light of news that comedian Bob Saget died of an accidental head trauma in his Florida hotel room, a Northwestern Medicine expert tells what you need to know about the risks of head trauma and when to seek emergency care.

The expert: 

Dr. George Chiampas is an assistant professor of emergency medicine and orthopaedic surgery at Northwestern University Feinberg School of Medicine. For an interview with him contact marla-paul@northwestern.edu. 

Quotes from George Chiampas:
“Head injuries are serious injuries, and because you may not see anything and it’s not a visualized injury, these can be missed. There is a continuum of type of injuries you can have from something as mild as a headache to potentially physiologic changes in your brain such as a concussion to bleeding in the brain that can lead to much more serious injuries. 

“The reason those are serious and timely injuries is that the brain sits in a very enclosed space. If there is an injury, that can put the brain tissue at risk.”

Who is at highest risk?
“Those individuals who are immediately at high risk are the elderly population, because as you get older your brain atrophies and becomes smaller. As a result, the veins and blood vessels in your brain are stretched and more fragile, so a jarring injury to your head can cause an injury to your blood vessel that can cause bleeding in your brain. People who are taking blood thinners are at increased risk for these types of injuries as well as a population that can’t state if they have any symptoms such as people with Alzheimer’s disease or dementia.

What are the danger symptoms to watch for? 
“Individuals should monitor their symptoms after the injury happens. Are you having trouble finding words, do you have slurred speech, is a headache worsening, are you nauseous, do you have any visual disturbances? Those are immediate symptoms you should urgently be seen. It’s not something that can wait. 

“Sometimes people have a head injury and feel ok, but progressively get worse. This is an epidermal hematoma, which is when you strike an artery in your brain. In this circumstance, Bob Saget probably went to sleep, and those symptoms rapidly came on.

Where is the most dangerous place to hit your head?
“The side of the brain or over the temple are the injuries where we see epidermal hematomas, because there is less protection from your skull, and the artery sits across on that side. That’s a more dangerous area of your brain to hit.

“You should make sure before you go to sleep or before you are not supervised that your symptoms are not worsening, or that you are not developing new symptoms. Any new or increasing symptoms are red flags that you should be seen immediately in an emergency room. 

Also watch for numbness or tingling in arms or legs

“Something else to look out for are secondary injuries to your neck. Sometimes individuals can also have a spine injury so any numbness or tingling in arm or legs are additional things to consider. In those injuries you can have a hematoma, bleeding that needs immediate attention.”