How is it Diagnosed?
Diagnosis of a head injury involves a combination of clinical evaluation, neurological
assessment, and imaging studies. The Glasgow Coma Scale (GCS) is used initially to
assess the level of consciousness, with scores ranging from 3 (deep coma) to 15 (fully
alert).
A thorough neurological exam evaluates pupils, limb movement, reflexes, and signs of
increased intracranial pressure. The patient's history is essential, especially regarding
the mechanism of injury, presence of loss of consciousness, vomiting, or amnesia.
Computed Tomography (CT) scan of the head is the imaging modality of choice in acute
settings. It can detect fractures, hemorrhages (epidural, subdural, intracerebral), brain
swelling, and midline shift. MRI may follow in subacute or chronic cases or if the CT is
inconclusive and clinical suspicion remains high.
X-rays may be used to evaluate skull fractures, although CT is preferred for detailed
visualization. In moderate to severe head injuries, intracranial pressure (ICP) monitoring
may be necessary. Blood tests are used to assess for metabolic abnormalities or
coagulopathies that may exacerbate injury.
Accurate diagnosis helps determine the severity (mild, moderate, or severe traumatic
brain injury) and guides subsequent treatment and monitoring.