Why a bump on the head is never trivial

April 4, 2009


I am indebted to Dr Ben Kim for the following information, as it serves as a timely reminder never to shrug off any injury to the head as trivial and to alert you to what to look out for. It has been prompted by the death of the actress Natasha Richardson, on the 18th of March from what initially seemed like a minor bump when on a nursery ski slope in Quebec. She laughed off the incident, felt fine with no symptoms, and refused any medical treatment, but that minor blow to her head had caused internal bleeding which formed a clot (an epidural haematoma) which in turn placed pressure on her brain and within a short period of time caused her death.

Along the sides of your head in the area around your temples, your epidural space houses an artery called your middle meningeal artery, whose job is to provide steady blood supply to your meninges. The portion of skull that protects this area is quite thin and weak compared to the rest of your skull which is why even a low force blow to this area could lead to a fracture and tearing of your middle meningeal artery. If this happens then blood can quickly begin to pool in your epidural space and because your heart would continue to send blood to the area, and this blood wouldn’t be drained by your veins, the result is increased pressure on your brain tissues, which could lead to death of brain cells from oxygen deprivation.

What to look out for: A fall, a casual blow to the head, that may seem unimportant can be fatal and it always pays to be checked out. About 50% of people who experience epidural hematomas briefly lose consciousness, but appear to be just fine when they come to. If pressure in the head continues to build, then over a period of just a few hours, a searing headache tends to develop as increased intracranial pressure causes the dura mater to tear away from the skull. Other signs and symptoms that may develop include:

* Lethargy
* Nausea
* Dizziness
* Drowsiness
* Weakness on one side of the body

Vigilance is the only safeguard; you need to be carefully monitored after any blow to the head and be prepared to seek immediate medical help. However fine you feel, don’t ignore it.


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