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Head injury definition, classification, etiology, clinical features, sign and-- signs and symptoms, investigation, differential diagnosis, management, medical and surgical complication. Exam based answer, अ,

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Head injury (traumatic brain injury) is a broad exam topic covering many subsections. Rather than cramming everything into one long note, here's the map of the topic and a brief overview - then tell me which part you want in full exam depth.

Topic Breakdown

  1. Definition - head injury vs traumatic brain injury (TBI)
  2. Classification - mechanism (blunt/penetrating), severity (GCS-based: mild/moderate/severe), pathology (primary vs secondary; focal vs diffuse - EDH, SDH, SAH, contusion, diffuse axonal injury), and skull fracture types
  3. Etiology - RTA, falls, assault, sports, occupational
  4. Clinical features / Signs & symptoms - level of consciousness (GCS), pupillary signs, lateralizing signs, signs of raised ICP, basal skull fracture signs (Battle's sign, raccoon eyes, CSF rhinorrhea/otorrhea), Cushing's triad
  5. Investigations - CT head (gold standard), X-ray skull, MRI, labs, ICP monitoring
  6. Differential diagnosis - stroke, hypoglycemia, drug/alcohol intoxication, meningitis, post-ictal state
  7. Management - primary survey (ABCDE), GCS-based triage, medical management (ICP control, osmotherapy, anticonvulsants), surgical management (burr hole, craniotomy, decompressive craniectomy), indications for surgery
  8. Complications - medical (seizures, infection, SIADH/DI, DVT/PE, respiratory) and surgical (hydrocephalus, CSF leak, infection, re-bleed, herniation)

Brief Overview

A head injury is any traumatic insult to the scalp, skull, or brain that alters brain function or structure. Injuries are broadly classed as primary (occurring at the moment of impact - contusion, laceration, diffuse axonal injury, skull fracture) and secondary (evolving afterward - hypoxia, ischemia, raised ICP, edema, hematoma expansion). Severity is graded by the Glasgow Coma Scale: mild (13-15), moderate (9-12), severe (≤8, defines coma).
Common causes are road traffic accidents, falls, assaults, and sports injuries. Clinical presentation ranges from brief loss of consciousness and headache to deep coma, with key red flags being a deteriorating GCS, unequal/non-reactive pupils, lateralizing weakness, and signs of a basal skull fracture (Battle's sign, raccoon eyes, CSF otorrhea/rhinorrhea). Cushing's triad (hypertension, bradycardia, irregular respiration) signals critically raised intracranial pressure.
CT head is the primary investigation to detect fractures, hematomas (extradural, subdural, subarachnoid), contusions, and midline shift. Management follows ATLS principles - airway/C-spine protection, breathing, circulation - then neurological assessment and CT-guided decision-making. Mild cases need observation; surgical evacuation (burr hole/craniotomy/decompressive craniectomy) is indicated for significant mass lesions, midline shift, or refractory raised ICP. Complications range from seizures and infections to hydrocephalus, CSF leaks, and long-term neurocognitive deficits.
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