Head, brain and neck injuries occur when the head suffers a direct impact or when it is accelerated, in any direction, too quickly. It is not always easy to determine if an injury has occurred. In fact, the signs and symptoms of these injuries can be very subtle and difficult to detect. It usually requires a trauma physician, or a neurologist/neurosurgeon, to make the determination and even they can miss an indicator of possible distress.
When the brain is injured due to a sudden and rapid change in head position, this is known as either a linear acceleration, (such as whiplash) or the more medical term: flexion-extension injury of the cervical spine. The brain is tethered to the rigid skull by a system of membranes. Moreover, the brain sort of floats inside the skull (intra-cranial cavity) on a cushion of cerebral-spinal fluid (CSF). When the brain is suddenly forced in one direction it may shear off the skull-membrane anchor on the side of the initial force. However, it is more common to have a contra-coup injury, which means that the side opposite the original force shears off. This occurs because the brain tends to rebound to its original position very quickly, causing sudden strain to the anchoring membrane opposite the original trajectory of movement. This explains why a brain injury is looked for first on the side that wasn’t directly impacted by the initial force.
A head/brain injury can be the cause of almost any loss of function that exists. This is because the brain controls the entire system, from moving to sensing, to regulating heart and respiratory rate, to temperature control, and arousability (sensorium). Any change, in any function, (loss of motion, loss of sensation, loss of attention, loss of consciousness, loss of feeling or reaction to pain) to an injured party can indicate a brain injury and must be to treated as such injury until proven otherwise by a competent physician. This means, do as little as possible and keep the person still. Moving a person can easily cause increased nerve and brain damage when the “helping” party is not properly trained or lacks the proper equipment. This damage can be permanent and result in serious, long term disability. I cannot be stressed enough how susceptible the brain is to trauma when a head injury occurs. Obviously, this is a very complex subject and there are many injuries which are not related to head/brain trauma. It is usually apparent if a person has a headache, which could be minor when compared to a serious shoulder injury, versus if they have loss of language control or consciousness.
It is also important to be aware of potential neck injuries and assess the risk prior to administrating any aid. Neck injuries are very common in vehicular accidents as well as slip and fall incidents. The neck connects the head to the body and it is the structure that supplies the head with all of its nutritional support via blood flow. It is the part of the body that all the nerves travel through to get information from the brain to the body, from the body to the brain, and from the brain to the brain. The bones in the neck are called vertebrae. They protect the spinal cord all the way down to the tail bone. The neck vertebrae are smaller and weaker than the vertebrae in the back. This is because the neck is not meant to be a load bearing structure but rather a small, delicate, highly mobile spindle. The ability to move our necks with as much rotation as we do is a very strong survival trait. It allows us to pivot our heads, permitting us to see and sense the world around us quickly. In short, an injury to the neck, either to the vertebral column, the nerves or blood vessels may result in severe brain damage.
Again, it cannot be overstated, if you suspect the possibility of head, brain or neck injury, it is wise not move the afflicted party. You could complete an incomplete injury. It is best to call and wait for first responders. Here, less is more. Less movement, less risk: more chance of recovery.