Health and Psychology

Today I get to do one of my favorite exercises with my class.  I downloaded actual accident reports from the internet on train, airplane crashes with diagrams or photos and car accident simulation diagrams for the class.  Then we get to talk about the physics of brain injury, the use of restraints to mitigate injury, and the complexity of orthopaedic injuries and soft tissue injuries compounding brain injuries.

So here's what the class gets to find out:

• The faster a person is traveling at the moment of impact the more likely the brain injury will be greater than the same type of injury at a slower speed
  
• Fatal injuries often have to do with orthopaedic injuries such as broken necks, or hemmorhage and blood loss
• Oxygen loss to the brain produces adverse consequences such as heart attack and stroke
• Damage to the brain can occur hours after impact due to swelling and other complications
• Endocrine complications can produce significant impact on the progress and outcome of TBI rehabilitation
• Endocrine complications are more common with facial fractures
• The risk of post-concussive seiures following traumatic brain injury persists for about 1.5 to 2 years following the injury

Things are much more complicated in children than in adults. 

In a recent study in Sweden at the Neurointensive Care Unit at Lund University Hospital between 2002 and 2007. One hundred children were evaluated following traumatic head injury Results: During 6 years, 100 children with head injury needed neurointensive care or neurosurgery for their injury in southern Sweden.

Traffic accidents (50%) were the main cause of head trauma, followed by falls (36%). Thirty-two percent of all children were injured in bicycle and motorcycle accidents. Both loss of consciousness and amnesia were absent in 23% of the children with intracranial injury.

Seven children with intracranial injury, 6 of them requiring neurosurgery, were classed as having minimal head injury according to the Head Injury Severity Scale (HISS). Interesting differences in intracranial injuries between helmet users and nonusers were observed.

Conclusion: Children with minimal head injuries according to the Head Injury Severity Scale--HISS, may develop intracranial complications and may even require neurosurgical intervention. Hence, the HISS classification, as well as other risk classifications based upon unconsciousness and amnesia, are unreliable in children.