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Primary Surgery Vol.2 – Trauma : Head injuries : More difficulties with a head injury

63.15 More difficulties with a head injury

We have described most of the difficulties you are likely to meet, but here are a few more. They are not common.

MORE DIFFICULTIES WITH A HEAD INJURY

If a patient has CRANIAL NERVE PALSIES, they are usually the result of fractures of the base of his skull. There is no specific treatment for them.

If he CAN MOVE HIS HEAD AFTER A HEAD INJURY, BUT NOT THE REST OF HIS BODY, he is quadriplegic as the result of a fracture of his cervical spine. When a patient’s head is injured, his broken neck is often missed.

If he STARTS TO SNEEZE he almost certainly has a pneumatococle. This is the slow development of an air filled cavity in his brain connecting with one of his sinuses, usually his frontal sinus. His skull may be resonant to percussion, and an X–ray may show an air filled cavity. He is in great danger of meningitis. Refer him for neurosurgery immediately.

FEW HEAD INJURIES ARE SO SEVERE AS TO BE HOPELESS
NO HEAD INJURY IS SO TRIVIAL AS TO BE TAKEN LIGHTLY
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