Neuro Asia Care ~ Neurosurgery Specialist Clinic ~ Singapore

Conditions & Treatments

Some of the conditions that we treat

Head Concussion

Head injury severity varies from mild, moderate to severe life-threatening.

The most common (95%) type of mild head injury often results in a concussion. The word “concussion” comes from the Latin concutere, which means "to shake violently".

Symptoms

Symptoms of concussion can last for weeks to months. Headaches and mild cognitive problems are common after concussion. Patient may also feel more tired than usual. Some people may experience tenderness over the bruise or mild swelling of the scalp. 

When do I need to seek medical help for my concussion?

Anyone who has had a head injury, however minor, needs to be monitored for the first few days.

  • This is because symptoms of bleeding in the brain do not always develop immediately after a knock to the head.
  • Rarely, symptoms from a slow bleed can develop even weeks after a head injury.

Please seek medical advice promptly. Do not delay.

  • In case of any doubt, if there are risk factors based on the person’s health, or there are red flag symptoms.

The following red flag symptoms may indicate that something serious is happening, and require immediate medical attention:

  • Headaches that will not go away
  • Frequent vomiting
  • Drowsiness or unable to wake up
  • Confusion or behaving strangely
  • Problems speaking or being understood
  • Weakness or tingling in an arm or leg
  • Problems with vision
  • Collapse or having a seizure (shaking or twitching)

Causes

Our skull and facial bones function as a hard shell to protect the brain, which is soft and suspended in Cerebrospinal fluid. When someone has a knock to the head, their brain moves about suddenly and can hit the skull internally, which causes injury to the brain.

In more serious cases, a knock to the head damages the blood vessel of the brain causing internal bleeding or damage to the brain itself. In severe cases, this is a medical emergency. In mild cases, the bleeding stops on its own but in some people, however, blood can accumulate over time (blood clot in the brain) and cause significant problems which may require delayed surgery. 

Diagnosis

  • History and neurological examination
  • Imaging:
    • CT scan: Factors such as age, seizure, neurological signs and vomiting are used to weigh the need for CT scan.
    • MRI scan may also be required especially if other problems are suspected. 

Treatment

It takes time for the brain to recover after an injury. The two most important things you need to do are rest and careful observation. Pain killers may be prescribed for relieving headaches or pain. During the recovery period, it is critical that you:

  • Reduce cognitive strain to allow the brain to heal. You need to be patient because healing takes time. Prematurely engaging in activities involving mental exertion or multitasking may exacerbate or prolong symptoms, and delay recovery.
  • Be extremely careful to avoid activities that may aggravate your symptoms. Suffering a second brain injury can cause a much longer recovery.
  • Work with your doctor on a recovery plan to return to work, school or other activities. A step-wise approach appropriate for each individual may be helpful. 

What is post-concussion syndrome?

Post-concussion syndrome refers to a collection of symptoms that people develop following a concussion. These symptoms often resolve with time after the initial head injury. Some examples are:

  • Physical complaints

    • Headache
    • Dizziness, nausea
    • Problems tolerating bright light and loud noise
  • Cognitive changes

    • Poor concentration, memory problems
    • Problems performing complex tasks)
  • Emotional and behavioural

    • Irritable
    • Anxious easily
    • Trouble sleeping

Moderate to Severe Head Injury

For moderate to severe head injuries, the first thing to do is to stabilize the person and to prevent further injury. 

  • Patients may need to be monitored in a specialist intensive care unit.
  • Brain surgery is required to stop bleeding, to remove blood clots or repair skull fractures.
  • If the brain is very swollen, a procedure called a craniectomy may be performed and will require a delayed Cranioplasty.
  • Serious head injury may leave a person with significant disabilities that requires rehabilitation.

Summary

  • After a concussion, ample rest for your mind and body is required.
  • Do not delay seeking medical advice if there are risk factors.
  • Work with your doctor on a recovery plan.

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