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Signs and symptoms of a head injury

A head injury is sometimes difficult to diagnose because patients who are hurt very badly in their brain may not exhibit very many signs of external damage. For this reason, the Glasgow Coma Scale has become the primary way of rapidly assessing the extent of a head injury.

The GCS provides a score based on various external signs of head trauma. The list of symptoms that the GCS looks for include:

-- Bleeding or bruising of the scalp and head, and blood behind the tympanic membranes or blood in the ear canal

-- Anosmia, which is the inability to perceive smells

-- Abnormal post-resuscitation pupillary reactivity, which has to do with the size of the patient's pupils

-- Isolated internuclear ophthalmoplegia, which has to do with abnormal eye movements

-- Cranial nerve palsy, which affects the patient's ability to control the eyes and other parts of the head

-- Hearing loss

-- Dysphagia, which is difficulty swallowing

-- Local motor problems such as weakness or paralysis in different limbs.

In addition to the above, doctors will also look for problems relating to cognitive deficiencies, and issues with consciousness, orientation and attention. Sometimes, patients show different kinds of cognitive problems, such as not having the ability to remember new information. Doctors have a variety of cognitive tests they can give to patients to evaluate their cognitive faculties.

There are also a number of imaging tests that can show the presence of head injuries. These tests include magnetic resonance imaging, computed tomography scanning and electroencephalography.

It is important to note that none of the above tests and imaging technologies will always show conclusive evidence of a head or brain injury. For this reason, personal injury plaintiffs with head injuries may need to employ the services of a medical expert witness to prove their head injury damages in court.

Source: Medscape, "Head Injury," David A Olson, MD, accessed Oct. 22, 2015

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