The world was deeply saddened by the news of Bob Saget’s death last month. The actor and comedian was found unresponsive at the Ritz-Carlton Orlando, and the cause of death wasn’t immediately clear. However, Saget’s recent autopsy report has revealed something shocking: he experienced severe skull fractures, indicating his death was caused by head trauma. “They have concluded that he accidentally hit the back of his head on something, thought nothing of it and went to sleep. No drugs or alcohol were involved,” the family said in a statement. Since we all bump our heads once in a while, this raises several important questions: How can you tell the difference between a minor head knock and a serious head injury? What are the signs you should see a doctor? Here’s everything you need to know.
Symptoms of a head injury
Most people can easily self-diagnose a head injury, which is defined as an injury to your brain, skull, or scalp. The injury can be a closed wound (such as a bump on your head) that doesn’t break the skull, Dr. Joey Gee, a neurologist with Providence Mission Hospital in Southern California, explains. An open, or penetrating, head wound can consist of a gash along your hairline or on the back of your head. It’s important that you visit a doctor immediately if you have an open head wound because your injury could extend to your brain. Symptoms for a minor head injury may include a bump or pain in the general area where you hit your head or headache. “More severe symptoms include confusion, loss of consciousness, lack of coordination, memory loss, nausea, vomiting, dizziness, ringing in the ears, sleepiness and excessive fatigue,” Dr. Gee adds. It’s also important to note that head trauma can occur without a direct blow to the head. If you or a loved one has an open head wound or is experiencing more severe symptoms, get immediate medical attention.
Different types of head injuries
There are several different types of head injuries to know about. They include:
Concussion
A concussion is one of the most common head injuries and is caused when the impact to the head is hard and severe enough to cause a brain injury. “A hit to the head, along with a sudden acceleration or deceleration, can cause your brain to hit the walls of your skull,” Dr. Gee states. “It’s important to remember that while concussion symptoms might be temporary (such as mild confusion, ringing in the ears), repeated injuries can lead to permanent brain damage.” An official concussion diagnosis can only come from a thorough neurological evaluation. Depending on the extent of the injury, your physician might conduct tests to evaluate thinking and mental processing skills such as recall and memory, as well as your ability to concentrate, Dr. Vernon Williams, MD, sports neurologist and founding director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, CA, explains. Once your physician asks detailed questions about the injury that was sustained, he or she will check the following for signs:
BalanceCoordinationHearingReflexesStrength and sensory processingVision
“For people who have sustained possibly severe concussion injuries, brain imaging examination might be necessary. These types of tests can help determine whether there is any swelling or bleeding on or near the brain,” Dr. Williams adds. “A CT (Computerized Tomography) scan is the examination that is typically selected to assess the brain immediately after an injury has occurred. An MRI (Magnetic Resonance Imaging) may also be indicated to view any suspected bleeding in the brain or to diagnose injuries that are the result of a previous concussion.”
Hematoma
A hematoma, another type of head injury, is when blood clots outside of the blood vessels. This is especially serious (and dangerous) if it occurs inside the brain because this type of injury increases skull pressure. It can cause loss of consciousness and potentially permanent brain damage, Dr. Gee explains.
Hemorrhage
This is uncontrolled bleeding in the brain. “It can occur in the space surrounding your brain (called a subarachnoid hemorrhage) or within your brain issue (called a intracerebral hemorrhage),” says Dr. Gee. Symptoms to look for: headaches, vomiting, and over time, a buildup of pressure in the brain. Older adults may be more prone to hemorrhage or hematoma, especially if they are taking anticoagulants or antiplatelet medications. “If you are taking these medications and have a head injury, it’s important to get immediate medical attention, including brain imaging, to make sure that you are safe," Dr. Gee explains. “There can be a delay in when a hemorrhage can develop, so close observation by a doctor is key.” It is possible to also fracture your skull—the danger here is that if your skull is fractured, it is unable to absorb the impact of a blow to the head, Dr. Gee adds. It’s likely that people who experience a skull fracture could also have brain damage. This is another reminder why it’s important to see your doctor immediately after a head injury. Any type of head injury can also lead to edema, or swelling of the brain tissues. “Because your skull is so tough, it can’t stretch to accommodate the swelling. This can lead to increased pressure in the skull cavity, pressing the brain against the skull, which can be extremely dangerous,” says Dr. Gee.
Traumatic brain injury
Head trauma and concussions are also known as a traumatic brain injury (TBI). If your injury isn’t diagnosed by your doctor as being serious, it is important to rest your brain help recover from a TBI. And, the recovery time among patients will vary. It’s important to recognize that performing normal activities following a TBI may increase your concussion symptoms or prolong your overall recovery, Dr. Gee explains. If your symptoms do not improve, contact your doctor.
What causes bruising and internal damage to the brain?
Your brain can become bruised if you receive a direct hit to the head, a severe shaking of the head in a child (typically, in abuse situations) or experience whiplash in a car accident. Brain tissue and blood vessels can also become damaged. When your brain hits the sides of your skull, it can cause a tear of the internal lining, tissues and blood vessels can also occur. And, this can cause internal bleeding, bruising and swelling of the brain, Dr. Gee states. You may also develop a bruise where you hit your head—it is directly related to the trauma you experienced and occurs when the brain is jolted backward.
How to tell the difference between a minor or more severe head injury
“Progressive or more severe symptoms including memory changes, loss of consciousness, nausea/vomiting, or other concerning features may be a red flag for a more severe injury,” says Dr. Gabriel Zada, MD, Professor of Neurological Surgery (Clinical Scholar) and Director, USC Brain Tumor Center. “If there is any concern, it is always safer to be evaluated by an emergency room or other expert in order to rule out any severe injury.” The most common causes of head injuries in adults and kids are car and motorcycle accidents or being struck by a car while on a walk. Head injuries can also happen when you accidentally fall. And, getting in fights with others, especially when punches are thrown at your head, can also cause an injury, Dr. Gee explains. More specifically, mild head injuries are when symptoms last less than 15 minutes and the person doesn’t lose consciousness. A moderate head injury is when symptoms last longer than 15 minutes and the person still doesn’t lose consciousness. A severe injury is when a person loses consciousness, even just for a couple of seconds. Symptoms also tend to last longer than 15 minutes. It’s important that those who lose consciousness after a head injury seeks immediate medical attention, Dr. Gee states.
Why it’s important to seek medical care when you have a severe head injury
Severe head injuries are very scary for the person injured and their loved ones. Symptoms of untreated severe head injuries can also include seizures, difficulty speaking or staying aware, blood or clear fluid coming from the ears and nose, sudden swelling or bruising around both eyes or behind the ear, difficulty walking or coordination, Dr. Gee explains. It’s important to immediately see a doctor for treatment so that symptoms don’t get worse. Severe head injuries typically require hospitalization—you’ll likely be monitored by your doctor for any changes in your health while other injuries are treated. And, your doctor will be able to assess if you need surgery or any further treatment, Dr. Gee adds. Next up: Always Waking Up with a Headache? Here Are 9 Possible Causes
Sources
Dr. Joey Gee, a neurologist with Providence Mission Hospital in Southern CaliforniaGabriel Zada, Professor of Neurological Surgery (Clinical Scholar) and Director, USC Brain Tumor CenterVernon Williams, MD, sports neurologist and founding director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, CA
