Brain Injury Symptoms and Early Diagnosis

Brain Injury Symptoms and Early Diagnosis

The reporting of head injuries is certainly more common than it was a generation ago. The main reason for this is probably due to a greater awareness and understanding of the symptoms. It remains vital though that all those attending hospitals are given appropriate treatment to identify the full extent of the injury and to maximise their recovery.

The recovery may be swift for many, with no lasting effects, but there are many cases where individuals never fully recover and require long term support. In either case, to optimise the outcome, good management of the patient is important.

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Head Injury Statistics

In 2015, Headway, the brain injury association, published its latest findings on the prevalence of brain injury across the UK.  “Acquired Brain Injury: The numbers behind the hidden disability” which revealed that in a 12 month period during 2013 – 2014, there were 348,934 admissions for traumatic brain injury. This research reveals a 10% increase in acquired brain injury admissions since 2005 -2006.  There has also been increase in admissions with a diagnosis of stroke in the same period.

It is also reported by the National Institute for Health and Care Excellence that head injury is the most common cause of death and disability in people aged up to 40 years of age. Men are 1.6 times more likely to be admitted to hospital with a head injury although recent statistics reveal a sharper rise in admissions for women than men.

Assessment and Investigation of Head Injury

The National Institute for Health and Care Excellence (“NICE”) provides national guidance and advice to improve health and social care. They deliver guidance, advice, quality standards and information services for health and social care.  The issued guidance covers a wide range of health issues, including the management of those experiencing a head injury. From time to time that guidance is reviewed and in 2014, NICE updated the guidelines for Head Injury, in the “Triage, assessment, investigation and early management of head injury in children, young people and adults.” 

Immediate medical action

Beyond the guidance to the health professionals, there is also assistance to others, such as police, to encourage those who have sustained a head injury or know of others who have, to seek immediate medical advice.  This is a long-standing recommendation and possibly reflects the greater awareness across society of the importance of reporting head injury. Such injuries are talked about openly, to examples being sportsmen George North and Luke Shaw.

Identifying the symptoms of head or brain injury

The first port of call for most people will be a call to the 999 emergency services. Those services are advised to refer patients to hospital if the injured person has experienced any of the following symptoms:

  • Loss of consciousness
  • Suspicion of skull fracture or penetrating head injury
  • Seizure
  • Amnesia
  • Persistent headaches
  • Vomiting
  • Altered behaviour

The Glasgow Coma Score (GCS) is a diagnostic tool to determine the level of impairment following head injury. Three measurements are taken and appropriately scored, depending on the level of response from the patient.   The observed responses are eye opening, verbal response and motor response. The maximum score is 15 for the 3 responses, so the recommendation from NICE is that patients should be referred to a hospital emergency department where the GCS score is less than 15 on the initial assessment.

NICE instruct health professionals to manage patients according to clear principles set out in other guidance notes, with the requirement that they treat the greatest risk to life in the first instance.

Assessment in the Emergency Department

On arrival at the emergency department, the priority is the stabilisation of the airway, breathing and circulation, before attention to other injuries. Skilled clinicians who note a patient arrive with a GCS score of less than 15 should assess the severity of injury immediately.  There should also be trained personnel present to determine the presence or absence of risk factors for a CT scan. 

There is an overriding direction that all patients presenting in the department with a head injury should be seen within 15 minutes of arrival. Depending on the findings in those early observations, a number of routes will be available for the treating staff to follow, to diagnose and treat the patient appropriately. This may include further scans and consideration of other injuries, including those to the spine.

NICE provided separate guidance for treating children with head injuries as, for example, the GCS scoring has to be adapted to recognise a different response level.

Information to the Family

A head injury can be very serious and will cause family members to become anxious. Therefore, whilst the clinicians are focused on the needs of the patient, NICE also requires staff caring for head injury patients to introduce themselves to family members and carers, to explain the actions being taken and to provide information sheets.  

Treatment and rehabilitation for head injury patients

The care, treatment and rehabilitation for head injury patients has improved markedly. That is due to the quality of care provided by all health professionals. 

Unfortunately there will be some patients who sustain such a severe brain injury that their recovery will be limited.   In those cases, long-term care will be required. It is therefore important that the Government understands the value of long-term rehabilitation and care, so they do not make short term political decisions, which adversely impacts on individual head injury patients and on society as a whole, in terms of long term costly welfare support. Matching the resource applied to early management and treatment with good rehabilitation will reduce the cost to the public purse.

Making a compensation claim for a head or brain injury

If you want to enquire about making a head or brain injury claim following a car accident, fall, sporting injury or other incident, please contact one of our experienced brain injury solicitors such as Malcolm Underhill on 0333 123 9099. Alternatively, you can send an email with your name and contact information and brief details as to the nature of the accident/clinical negligence and the injuries sustained to and one of our team will be able to help you.

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