Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Head injuries

Head injuries
Head injuries occur in most sports, particularly in contact sports and in riders, downhill skiers, and boxers. There is also a risk of injury when heading a soccer ball, especially if faulty technique is used.
A kicked ball in flight can reach a speed of 100 km/h (60 mph) and weigh about 450 g (1 lb) (even more if it is wet), so considerable forces can be transmitted from the ball to the head. Although serious injury can occur without any loss of consciousness, in general the severity of the injury is related to the degree of memory loss and the period of unconsciousness. An attempt should therefore be made as soon as possible after an incident involving a blow to the head to determine the patient’s cognitive ability and to decide whether unconsciousness has indeed occurred. The easiest way to assess the situation is to ask the injured person what happened before, during, and after the accident, and to set a cognitive task such as counting backwards in sevens from 100.After a head injury, the following situations may develop:

1. Head injury without unconsciousness (concussion).
Injuries in this category have a broad range of severity. In general the severity of the injury is graded by the degree and period of cognitive impairment and by the period of memory loss. Athletes with concussion may complain of confusion, headache, nausea, and/or dizziness.
Athletes who have a brief period of confusion and return to a normal cognitive state within 5 minutes, with no memory loss and no symptoms (i.e. no headache, nausea, dizziness, etc.), may be able to return to play after an evaluation by a trained individual.Athletes who have memory loss or symptoms for longer than 5–10 minutes should not return to play. They should be kept under observation, must not be left alone and should consult a doctor for advice.

2. Head injury with unconsciousness of short duration (less than 5 minutes).
If there has been a short period of unconsciousness and the injured person is complaining of symptoms such as headache, nausea, vomiting and/or dizziness, and is generally upset, a serious injury may well have occurred. The
injured person should be transported to a doctor or hospital for further management. As a rule, the symptoms settle without any further problems, and observation in hospital, if it is felt necessary, will be unlikely to last for much longer than 24 hours. A CT scan can assist in evaluation.

3. Head injury with unconsciousness of long duration (more than 5 minutes) is very serious. The injured person should be taken to hospital as soon as possible for diagnosis, observation and treatment.

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