The recent death of Natasha Richardson shows that even those with the mildest of symptoms should seek emergency care following trauma to the head. While those who are unconscious or who are experiencing severe symptoms will likely be immediately transported to the nearest facility qualified to handle brain injury, it’s up to those with less severe symptoms—symptoms such as dilated pupils, nausea, dizziness, lethargy, vomiting, and confusion—to make a judgment call on their own. As a general rule of thumb, if any of these symptoms are present medical care should be immediately sought. Those who are treated in a timely manner have a better long-term prognosis in general.

Acute Care Phase

What kinds of care can be expected immediately following a brain injury, during what is commonly called the “acute care phase?” That will depend upon the condition of the patient and the severity of the injury. Patients with very severe brain injuries may require life support, while those with minimal injuries may be sent home to recover with little more than instructions to take it easy for several weeks.

In general, the first action the medical team will take will be to ensure that the patient is stable. Any life-threatening injuries will be attended to, and respiration and circulation will be monitored. At this point physicians will attempt to control or minimize intracranial pressure, as excessive swelling can cause further brain damage in addition to that already caused by the accident. In many cases swelling can be controlled with medication, but in some cases surgery to reduce pressure is needed. A monitor to measure intracranial pressure is sometimes implanted under the survivor’s skull to continually monitor pressure.

Physicians will run tests such as X-rays, MRIs, and CT scans to assess the site and severity of the injury, as well as to look for bleeding or blood clots. These tests can also give physicians a better idea of the long-term prognosis of the survivor, as well as the types of issues he or she may face as a result of the injury.

Glasgow Coma Scale

Another tool that will be used to assess the severity of brain injury is the Glasgow Coma Scale. This tool is usually used immediately upon examination as well as throughout the acute care phase to measure the patient’s level of consciousness.

The scale, which ranges from “3” to “15,” assesses consciousness based on the patient’s visual ability, verbal responsiveness, and motor skills. The higher the score, the higher the level of consciousness. Scores from the Glasgow Coma Scale are frequently used as part of the formula that determine long-term prognosis.

Immediate Care is Important

Because timely care can minimize the long-term effects of brain injury, it’s important that even those exhibiting mild symptoms of brain injury are immediately seen. Fully conscious patients will be given a full neurological exam that assesses cognitive and physical function. While most head injuries that appear to be mild are exactly that, a comprehensive neurological exam is the only way to determine whether additional testing—and treatment—is necessary.

Depending upon the severity of the brain injury, patients will either be sent home, or will be sent to a rehabilitation center to recovery.