|
Head injury and concussion
A guide for patients and carers
What happens in the neurosurgical unit?
The person is again quickly assessed and the scans checked. Some hospitals do not have their own scanner, so the person may be transferred from the A & E department without having a scan, and this will then be performed in the neurosurgical unit. The neurosurgeon then will decide whether an operation is needed and what other types of treatment may be used.
Will they need an operation?
Surgery is only performed in the most serious situations. If there is bleeding within the head this must be stopped and the blood clot removed before the brain becomes compressed, leading to brain damage or even death. There may not be time for the doctor to fully discuss the surgery before it takes place as time is of the essence. The neurosurgeon will explain everything to you afterwards.
How is the surgery performed?
The operation, called a craniotomy, is done under a general anaesthetic, so that the patient is asleep and comfortable. The hair may need to be shaved. The surgeon makes a cut, usually at the side of the head, to lift a flap of scalp off the skull (see Figure 3 on page 10 of the printed bound booklet or the pdf). They then cut a window of bone out of the skull to allow access into the head. The bleeding can then usually be seen and stopped and the blood clot removed. Once that has been done, the bone is usually put back into place and the wound stitched or stapled. If the brain is too swollen, the bone may be left out to make some extra room for the swelling. It will then be replaced later at a second operation.
What can go wrong?
The surgery itself is quite straightforward, but like any brain operation it does carry risks. However, there really is no option, as without surgery the bleeding will continue and cause irreversible damage. If the bleeding is severe or the brain is very badly damaged, surgery may not help. This can sometimes be determined from the CT scan.
What will they be like after the operation?
People are usually nursed on the intensive care unit after this sort of operation and may need to be kept on a breathing machine (ventilator) for one or more days. This may appear alarming, but it has huge advantages, as it helps the body to recover without it having to cope with anything else - even breathing. The ventilation also helps to control the brain swelling. The person may have a bandage on their head, and they will be connected to various machines that monitor all of their body functions and allow the doctors and nurses to detect instantly any changes in their condition.
Surgery is only performed in the most serious situations. If there is bleeding within the head this must be stopped and the blood clot removed before the brain becomes compressed, leading to brain damage or even death. There may not be time for the doctor to fully discuss the surgery before it takes place as time is of the essence. The neurosurgeon will explain everything to you afterwards.
How is the surgery performed?
The operation, called a craniotomy, is done under a general anaesthetic, so that the patient is asleep and comfortable. The hair may need to be shaved. The surgeon makes a cut, usually at the side of the head, to lift a flap of scalp off the skull (see Figure 3 on page 10 of the printed bound booklet or the pdf). They then cut a window of bone out of the skull to allow access into the head. The bleeding can then usually be seen and stopped and the blood clot removed. Once that has been done, the bone is usually put back into place and the wound stitched or stapled. If the brain is too swollen, the bone may be left out to make some extra room for the swelling. It will then be replaced later at a second operation.
What can go wrong?
The surgery itself is quite straightforward, but like any brain operation it does carry risks. However, there really is no option, as without surgery the bleeding will continue and cause irreversible damage. If the bleeding is severe or the brain is very badly damaged, surgery may not help. This can sometimes be determined from the CT scan.
What will they be like after the operation?
People are usually nursed on the intensive care unit after this sort of operation and may need to be kept on a breathing machine (ventilator) for one or more days. This may appear alarming, but it has huge advantages, as it helps the body to recover without it having to cope with anything else - even breathing. The ventilation also helps to control the brain swelling. The person may have a bandage on their head, and they will be connected to various machines that monitor all of their body functions and allow the doctors and nurses to detect instantly any changes in their condition.
|
Page 9 of 14
Contents
- Introduction
- What are the main causes of head injury?
- What are the signs of a serious injury?
- What will happen at the hospital?
- Who gets admitted to hospital?
- What if the skull is fractured?
- What is concussion?
- What will happen if there is internal bleeding?
- What happens in the neurosurgical unit?
- The intensive care unit
- Coma and level of consciousness
- Recovery from a severe head injury
- Summary
- Other organisations that may be able to help
