Complications and Sequelae of Head Trauma

, Jeong-Wha Chu

Original Article

Korean Journal of Legal Medicine 1980;4(1):73-77.

Department of Neurosurgery, College of Medicine, Korea University, Seoul, Korea

Abstract

Complications and sequelae of head trauma are described. The neurologic consequence of craniocerebral trauma is dependent on the mode of injury, the site and extent of brain damage, and the subsequent reactions to this damage. Most patients make a rapid recovery if properly managed, and few suffer from persisting sequelae or complications. Infections within the intracranial cavity following injury to the head may be extradural, subdural, subarachnoid(meningitis) or intracerebral (abscess). Cerebrospinal fluid may drain from the nose or the ear when there has been a fracture of the cribriform plate or of temporal bone. Drainage of it is not of itself of great importance, but meningitis will almost invariably result unless the fistula closes spontaneously or is closed by an operation. Injury to the cranial nerve is a frequent complication of fracture at the base of the skull. Hemiplegia and speech disturbances are the common symptoms of focal brain damage in both civil and war injuries. A proportion of head-injured patients will develop seizures. The incidence of post-traumatic epilepsy varies markedly with the mode of injury, i.e. whether the injury was penetrating or blunt. Intracranial hematomas, cerebral thrombosis and arteriovenous aneurysm or fistula are also complicated by head injuries. Transient psychotic episodes and some permanent impairment of the mental faculties are not uncommon after injuries to the head but long continued psychotic episodes are rare. Post-concussional state and post-traumatic neurosis are observed in patients who sustain minor or severe injuries to the head. There is no direct correlation between the severity of the injury and the development of post-traumatic symptoms.