Open Head Injuries

Open or penetrating head injuries are more severe than closed head injuries. Open head injuries involve the skull and the brain being penetrated due to trauma. This sort of trauma can cause a wide range of brain injuries.

Causes

• All causes of open head injuries involve being hit in the head with a hard object either by propelling into it or by having it hurled toward you. In order to cause the skull to open it is usually necessary for the impact to come at high speed. Vehicle accidents and gunshot wounds are among the leading causes of open head injuries.

Brain Injuries

• In the severe trauma of a penetrating head wound, brain injuries are likely to occur. There are numerous types of such injuries, ranging in severity. These include subarachnoid hemorrhaging, or bleeding occurring in the subarachnoid area, the space between brain and the tissue surrounding it; and subdural hemorrhaging, a collection of blood on the brain's surface.

Potential Risks

• When brain damage occurs due to an open head wound, a myriad of other risky injuries may be the result. Many of these conditions, occurring mostly within the brain, can be life-threatening or, at the very least, life-altering. Secondary conditions caused by penetrating head injuries include aneurysms, seizures and paralysis.

Signs and Symptoms

• Symptoms of open head injuries can be both outwardly noticeable and inwardly felt. The signs that may be obvious to others include distorted facial features, fluid draining from the ears, nose and mouth, convulsions, slurred speech and unequal pupil size. Inward signs can range from loss of consciousness, inability to move or restrained movement, pain in the shoulders, neck and head, and blurred vision. These symptoms may appear and disappear sporadically.

Treatment

• There are some important steps in treating an open head injury. For bystanders, these steps include: contacting emergency medical assistance, stabilizing the patient's head so that it is aligned with the spine, checking the patient's pulse and breathing (if irregular, either start rescue breathing or CPR), and placing sterile gauze lightly over a penetrating wound in order to minimize the outward bleeding. Stabilization of the head is necessary because it must always be assumed that when the head is injured, so to is the spine. In cases of brain damage, surgical procedures may be needed to relieve pressure on the brain or to remove foreign objects and repair broken blood vessels and nerve connections.

Things Not to be Done

• Equally important to providing the proper assistance to someone who has sustained an open head wound is remembering that there are some things that you should never do to or for the injured person. Most of these activities may cause infection or further the damage the patient will suffer. Never apply direct pressure to a penetrating wound; resist cleaning the wound or removing any foreign objects from it; do not remove a helmet; refrain from moving the injured person unless absolutely unavoidable; and do not allow someone who has sustained any type of head injury to drink alcohol within 48 hours of its occurrence. These warnings must be adhered to in order to enhance a person's chance of recovery and minimize his injuries from an open head wound.