Neurosurgeons are involved in the management of all kinds of head injury, both minor and major. Surgical involvement is usually directed more towards the major head injuries.
Major Head Injuries
A major head injury can result in a variety of insults to the brain and skull. These include various types of skull fracture, large blood clots (haematomata) which may press on the underlying brain and damage it, contusions and lacerations to the brain itself, and diffuse bruising (swelling) of the entire brain. These major injuries are often managed by emergency referral to a neurosurgical unit where life saving surgery may be needed to remove an intracranial blood clot (subdural or extradual haematoma), or to elevate and repair major skull fractures. Patients with major head injuries may require time on intensive care and may also have their intracranial pressure monitored with a surgically implanted probe.
Minor Head Injuries
Neurosurgical involvement often consists of careful observation and/or CT scanning in order to exclude any of the more major injuries outlined above, and to be in a position to respond rapidly should any of these occur.
Post Concussional Syndrome
After a head injury patients often suffer with problems relating to memory, concentration and persistent headaches, as well as any more major deficits. Such patients may therefore need an extensive period of rehabilitation and follow up.
