Blunt head trauma is a type of head injury caused by a blow or impact to the head without penetration of the skull. It can be caused by falls, motor vehicle accidents, physical assault, or sports-related injuries, among other causes.
Blunt head trauma can result in a range of injuries, from mild concussion to more severe traumatic brain injury (TBI). Symptoms of blunt head trauma can include headache, dizziness, confusion, loss of consciousness, memory loss and difficulty speaking or moving.
The severity of blunt head trauma can vary depending on the force of the impact, the location of the impact and the age and overall health of the individual. In combination with the pattern of injury, a patient can be considered to have a serious blunt head injury with or without loss of consciousness / amnesia and
GCS 13 – 15 with any of the following from the five HEDS tool.
5 HEDS Tool
| 5 HEDS | |
| 5 | Any loss of consciousness exceeding 5 minutes |
| H | Has skull fracture (depressed, open or base of skull) |
| E | Emesis – Vomiting more than once |
| D | Neurological deficit |
| S | Seizure activity |
Significant Blunt Head Trauma
Significant blunt head trauma can result in a complex pathophysiological cascade that can lead to a variety of neurologic and systemic consequences. The following is a brief overview of the pathophysiology of significant blunt head trauma:
- Primary injury: The initial impact can cause damage to the brain tissue, blood vessels, and meninges. This can result in focal or diffuse injuries such as contusions, haemorrhages and diffuse axonal injury.
- Secondary injury: The primary injury can initiate a cascade of biochemical and metabolic events that lead to secondary injury. These include:
- Cerebral oedema: Increased intracranial pressure can result from swelling of the brain tissue or accumulation of cerebrospinal fluid.
- Ischaemia and hypoxia: Blood flow to the brain may be impaired by compression of blood vessels, leading to decreased oxygen delivery and cellular damage.
- Excitotoxicity: The release of neurotransmitters, such as glutamate, can lead to an excessive influx of calcium ions and subsequent cell death.
- Inflammation: The immune response to injury can lead to inflammation, which can further damage brain tissue.
- Impaired cerebral autoregulation: Blunt head trauma can disrupt the brain’s ability to regulate blood flow, leading to hypotension or hypertension.
- Systemic consequences: Significant blunt head trauma can also affect other organ systems. For example, trauma-induced coagulopathy can lead to bleeding in other parts of the body. Hypoxaemia, hypoventilation, and respiratory failure can occur due to brainstem injury or sedation.
Symptoms
Significant blunt head trauma can result in a wide range of symptoms depending on the severity of the injury. The following are some common symptoms associated with significant blunt head trauma:
- Loss of consciousness: This is a common symptom of significant blunt head trauma, and can occur immediately after the injury or after a period of time.
- Headache: A severe or persistent headache is a common symptom of significant blunt head trauma.
- Confusion: Confusion or disorientation is common after a head injury, and may be a sign of significant blunt head trauma.
- Dizziness: Dizziness or vertigo can occur after a head injury and may be a sign of significant blunt head trauma.
- Nausea and vomiting: Nausea and vomiting may occur after a head injury, especially if there is a significant blunt force to the head.
- Seizures: Seizures may occur after a significant blunt head trauma, especially in severe cases.
- Weakness or numbness: Weakness or numbness in the arms or legs may occur after a significant blunt head trauma, and may be a sign of spinal cord injury.
- Cognitive or behavioural changes: Significant blunt head trauma can cause changes in cognitive function, including memory loss, difficulty concentrating, and behavioural changes.
- Vision or hearing changes: Blurry vision, double vision, or changes in hearing may occur after significant blunt head trauma.
Significant blunt head trauma can result in a complex pathophysiological cascade that can lead to a variety of neurologic and systemic consequences. The severity and type of injury depend on factors such as the force of impact, location of impact, and individual patient factors.