Why are some head injuries missed?

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Life threatening injuries or those requiring immediate surgery will always be dealt with first of all. The medical notes tend to concentrate on these issues and what are perceived to be the most serious injuries. 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 simply relieved that their loved one is 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 able to work can also 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 to look out for symptoms that persist and to raise concerns with your GP or consultant if you remain under hospital review.

When I am instructed on any case where a head injury is suspected I always ask to see the ambulance notes as well as the hospital records.   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 (GCS) 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. The notes may refer to pre or post traumatic amnesia. This is lost time before and after the accident. What is the last thing you or the injured person 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 effected by medication. 

This is a good indication of how severe a person's head injury will be classified by the medical profession.  It does not mean that just because someone has a mild injury that the consequences are not significant.  I have acted for client's who have suffered a mild head injury, but due to behavioural changes they have had difficulty copying at work,  they are no longer able to multi task, become very rigid in their though processes.  This does not just impact at work, but can cause problems at home, with loss of temper, arguments with partner, intolerance with noise and activity caused by young children. 

Symptoms to look out for are:
mood swings
problems with memory and concentration
difficulty with multi tasking or word finding
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 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.

Claire Howard

Partner - Personal Injury team

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