Schematically, there are 3 different levels of severity:

– mild head trauma,

– moderate head trauma  

– severe head trauma.

All intermediaries are possible between the 3 degrees of severity. Among the parameters retained for the classification, we find the existence of an initial loss of consciousness, prolonged or not, of lesions of the scalp, of associated neurological signs, of epilepsy or even of an alteration of consciousness after head trauma. This classification, which remains relatively subjective, should make it possible to determine the course of action to be taken. In this sense, the clinical examination and the collection of information concerning the accident are essential.

Schematically, there are three groups that condition the behavior to be taken:

• Head trauma patients group 1 (light). No neurological symptoms, headache, small dizziness, small scalp lesions, no signs of severity.

What to do: return home with family and friends supervised.

• Head trauma patients group 2 (moderate). Initial loss of consciousness or disturbances of consciousness since the head trauma, progressive headaches, vomiting, multiple trauma, fracture due to facial trauma with effusion of cerebrospinal fluid in the nose, ears, intoxication (alcohol, drugs, etc.), amnesia from the accident.

What to do: hospitalization for monitoring, CT scan and facial x-ray if necessary.

• Head trauma patients group 3 (severe). Altered consciousness, neurological signs of localization of a cerebral or extra-cerebral lesion, penetrating wound of the skull and / or depression.

Action to be taken: hospitalization in a neurosurgical environment, CT scan.

Treatments

It is not the head trauma that we treat, but its consequences. Each head trauma is unique. Many treatments exist and can be combined, depending on the type (s) of lesion presented

• Surgical : evacuation of hematomas (drainage)
• Medical : fight against intracranial hypertension when the measurement of the pressure in the cranial box (intracranial pressure or ICP) so requires, oxygen therapy, artificial sleep, treatment against epileptic seizures, drugs intended to combat cerebral edema.
• And of course suturing and cleaning scalp wounds