b'Head, Neck and Spinal InjuryChapterAll injuries involving the head, neck and spine can be potentially serious and could result in permanent damage to the spinal cord. A scalp wound will raise your suspicions but often underlying injury may leave little or no visible evidence. The injury is often complicated by altered conscious responses or unconsciousness, which definitely indicates a brain injury.Unfortunately, many serious brain injuries result in death. Many patients may become severely disabled or their brain injury may result in a permanent vegetative state.The recovery process is very slow and often involves months (even years) of continuous rehabilitation. The patient may also exhibit personality changes, weakness, fatigue, depression, loss of hearing and eyesight and inability to communicate and walk effectively.Head InjuryHead injuries can be difficult to assess and are often quite misleading because underlying signs and symptoms do not always occur immediately after the incident. Signs and symptoms sometimes take hours to appear and can result in the patient later collapsing with life threatening complications. There may also be an associated neck and spinal injury.How to RecogniseLoss of memory, particularly of the actual incident.Blurred or double vision, headache.Escape of blood or watery fluid from the ears, nose ormouth. Altered consciousness responses. Blue or black discolouration and swelling becoming apparent under and around the eyes.The patient may be drowsy, confused, vagueand sometimes becomes agitated, irritable and aggressive.The patient may have a seizure.Unequal pupil size.Head Injury in Children - Refer to page 221.90 Head, Neck and Spinal Injury'