staying ahead
Sometimes head injuries sustained in accidents can be missed by
both the medical and legal professions. This means they are not
properly investigated, treated or compensated. A closed head injury
can sometimes be difficult to spot. By this we mean a head injury
that has no physical outward signs such as fractures, loss of
consciousness cuts or bruising.
This can happen for a number of reasons. An individual may have
been knocked out but no one is there to witness it. It will always
take time for the emergency services to arrive on any accident
scene. If the individual sustained other serious injuries such as a
broken pelvis, multiple fractures to a leg or internal injuries
then these will be dealt with first and any symptoms or signs of a
head injury can be overlooked. Life threatening injuries or those
requiring immediate surgery are always dealt with first. The
clinical notes tend to concentrate on these issues. The injured
person may also be placed on an orthopaedic or general ward where
the signs or symptoms of a head injury are not picked up or
recorded.
Then when an individual is released from hospital family members
are not warned of signs to look out for. They are relieved that
loved ones are on the mend and just happy to have them home. They
put problems of poor memory, concentration, mood swings, anger and
headaches down to a side effect of medication, pain, the
frustration of being at home and not at work or being incapacitated
by a physical injury that can be seen such as a broken leg in
plaster. The financial stress of not being at work can cause
significant worry that manifests itself with physical signs.
The signs of a traumatic head injury can be very subtle and
therefore easily missed or put down to some other cause. It is
therefore very important for medical records to be reviewed and a
detailed history taken from the injured party, their friends and
family. You need to obtain and review all medical records which
will include ambulance records, the hospital admission records
which are usually via accident and emergency as well as the nursing
and clinical records from the ward where an individual was
recovering.
Details to look out for are:
- reference to loss of consciousness and an estimate of the
period of time. There will be reference in the notes to Glasgow
Coma Score and is scored out of 15. A fully conscious patient will
be recorded as GCS 15/15. A non responsive unconscious individual
as GCS 4/15. They may refer to pre or post traumatic amnesia. This
is lost time before and after the accident. What is the last thing
the injured party remembers? For example, do they recall the
accident, the paramedics and police being at the scene or the ride
to hospital in an ambulance? What is the first thing they remember
after the accident? This can be deceptive because if an individual
has had surgery their memory will be affected by medication.
- when an individual is recovering from surgery or has been
assessed in accident and emergency and discharged other signs to
look out for are headaches, mood swings, problems with memory and
concentration, difficulty with multi tasking or word finding,
dizziness, altered personality, being short tempered or less
tolerant of others and their views. These are just a few of the
possible symptoms of head injury. They could also just be a
reaction to the accident, pain or immediate financial hardship.
Therefore these symptoms need to be kept under review and
monitored.
It can be useful for the injured party or family members to keep
a diary so that these symptoms can be logged. These documents are
then available to help diagnose the cause as well as access
recovery.
If some of these symptoms persist mention them to your GP,
physiotherapist or hospital consultant.
You can also contact Headway which is a national
charity with regional branches throughout the country to help
individuals and their families who have suffered traumatic brain
injury.
