Head injuries are one of the most common causes of disability and death in humans. The injury can be as mild as a bump, bruise (contusion), or cut on the head, or can be moderate to severe in nature due to a concussion, deep cut or open wound, fractured skull bones, or from internal bleeding and damage to the brain.
There are many causes of head injury in children and adults. The most common traumatic injuries are from motor vehicle accidents (automobiles, motorcycles, or struck as a pedestrian), from violence, from falls, or as a result of child abuse. Subdural hematomas and brain hemorrhages (called intraparenchymal hemorrhages) can sometimes happen spontaneously.
When there is a direct blow to the head, the bruising of the brain and the damage to the internal tissue and blood vessels is due to a mechanism called coup-countercoup. A bruise directly related to trauma, at the site of impact, is called a coup (pronounced COO) lesion. As the brain jolts backward, it can hit the skull on the opposite side and cause a bruise called a counter coup lesion. The jarring of the brain against the sides of the skull can cause shearing (tearing) of the internal lining, tissues, and blood vessels that may cause internal bleeding, bruising, or swelling of the brain.
The patient was rushed in Emergency at Chandan Hospital, Lucknow; he was bleeding from his forehead and was in an unconscious state. The emergency staff responded quickly and discovered head injury with exposed RT frontal brain and communicated frontal bone fracture. They also did some further investigation and figured out that the patient’s right pupil dilated & non-reactive and left pupil was pinpoint non-reactive.
Further, test like CT scan was performed on the patient to determine the extent of his head injuries. Following were the findings:
• Comminuted fracture frontoparietal bone with anterior body defect.
• Multiple hyperdense areas with hypodensities are seen in bilateral frontal and right parietal.
• Gangliocapsular region was suggestive of hemorrhagic contusions.
• Multiple air pockets are also seen, sulci and fissures effaced with midline ship of approx 2.5mm.
• Both cerebral hemisphere and brain stem are normal in position and appearance.
The patient underwent surgery, under general anesthesia with bicoronal incision, removal of all contused and exposed RT frontal lobe was done with the elevation of depressed fracture and removal of exposed bone chips. Dr. Mohd Iqbal did fixation of multiple fractured segments of skull bone with miniplate and screws. Alignment of the right upper orbital rim was also performed. Fractures involving frontal bone are rather uncommon. Injuries to this bone are rather critical because of its proximity to the brain. Due to excellent treatment, timely visits, and regular monitoring, the patient recovered successfully without any further complications.
“He was unconscious and his forehead was bleeding very badly. We were dismantled by this situation and got worried, so we rushed immediately to Chandan Hospital where emergency staff quickly responded and made his condition stable. He has undergone surgery and by God’s grace, he has recovered back. It is not less than a miracle. We thank Dr. Mohd Iqbal for his excellent treatment. His timely visits and regular monitoring really helped us to take him back home. We wish Chandan Hospital continues rendering such good quality of treatment.” Best Hospital in Lucknow
~ Patient’s Family Member