Head or Spinal Cord Trauma
The brain, the seat of all bodily functions, is greatly protected by membranes, fluid that absorbs shock and a hard-boney skull surrounding it. Despite this, high-intensity trauma such as motor vehicle accidents, sports injuries, falls or assaults can cause trauma to the head, injuring the scalp, skull or brain. Head trauma can be of various types:
- Closed head injury: An injury to the head where the skull remains intact, but causes bruising or swelling of the brain.
- Open head injuries: Head injuries that cause the skull to fracture and penetrate the brain, causing bleeding and damaging of tissues.
- Concussion: A head injury that causes the brain to shake and forcefully strike against the skull. It can happen when the head is struck or shaken violently and can produce a headache or temporary loss of consciousness.
- Scalp injuries: Head injuries may damage the tissues of the scalp and produce a bump, bruise or significant bleeding as it has a rich blood supply.
The common symptoms of minor head trauma include pain, headache, nausea, vomiting, dizziness, confusion, loss of recent memory and an altered mental state. With severe head trauma, symptoms are more intense and may begin with loss of consciousness, which can sometimes last for days. Other symptoms may include blood or fluid leakage through the nose or ears and seizures. Depending on the part of the brain damaged, there may be problems with balance, movement, speech, sight, hearing, thought, memory and emotions.
When you present to the clinic, your doctor will review your symptoms, and medical history and perform a thorough physical examination to determine vital signs, your orientation, ability to respond, basic brain function and the severity of your head injury. If brain injury is suspected, imaging studies such as a CT or MRI are ordered for confirmation.
In cases of minor head trauma, medication is prescribed to control pain. Wounds are closed with sutures if necessary and dressings are placed. You may need to be examined periodically for some time to ensure you have no signs of brain damage. In case of severe head trauma, you are managed intensively by monitoring your blood pressure, oxygen levels, and pressure inside the skull. Your neck is stabilized as there may be an associated spine injury. Seizures and clotting are prevented with medication. You may need surgery to manage bleeding or swelling of the brain.
Spine trauma is damage to the spine caused from a sudden traumatic injury caused by an accidental fall or any other physical injury. Spinal injuries may occur while playing, performing normal activities, operating heavy machines, lifting heavy objects, driving automobiles, or when you suffer a fall. Injury to spine may cause various conditions including fractures, dislocation, partial misalignment (subluxation), disc compression (herniated disc), hematoma (accumulation of blood) and partial or complete tears of ligaments.
The most common symptom of spinal injuries is pain. Spinal injury causes weakness and sensory loss if the spinal nerves are damaged. Symptoms may proceed to paralysis, limited movement, and immobility. Spinal injuries are diagnosed using spine X-rays and a computed tomography (CT) scan or magnetic resonance imaging (MRI) of the spine.
The treatment will depend entirely on the specific type and location of the injury. You may be treated with pain medications, epidural injections (injecting into spine), physiotherapy, and surgery. Surgery is recommended when other treatments are a failure or inappropriate. Surgery for spinal condition depends on the type and severity of injury. Some of the common spinal surgeries include:
- Coccygectomy – Coccygectomy is a surgical procedure which involves removal of part or entire portion of tailbone (coccyx) present at the end of your spine. It is performed in patients who have persistent tailbone pain due to injury, fall or contact sports and when all other conservative treatments are a failure.
- Spinal decompression – Decompression is a procedure of relieving pressure on one or many “pinched nerves” of the backbone. Spinal decompression is performed by two procedures microdiscectomy and laminectomy. Microdiscectomy is a minimally invasive procedure which involves removal of a portion of a slipped disc by a surgical instrument or LASER. Laminectomy is a procedure in which a small portion of the roof of the spinal bone is removed to relieve pressure on pinched nerve.
- Discectomy – It is a surgical procedure performed for the removal of the fragment of slipped disc, also known as bulging disc or herniated disc.
- Transforaminal lumbar interbody fusion – Fusion surgery is a surgical procedure where the damaged disc between two vertebrae in lumbar region of spine is removed in lumbar region of spine and the vertebrae are fused together.
- Decompression fusion – This is a surgical procedure that includes both decompression and fusion. Decompression relieves the pressure from the spinal cord and/or nerve roots and fusion surgery helps in joining the two vertebrae. This procedure is performed to reduce deformity and stabilization, minimizing neurological injury and early rehabilitation of the spine.
Your spine surgeon may recommend rehabilitation program to promote complete and faster healing.