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What are primary and secondary head injuries?

There are approximately 1.4 million attendances at A&E with head injuries in the UK, and of those 50% will be children
head injuries
Head injuries are a common problem in the children’s emergency department and indeed across emergency departments.

Lorna Bagshaw, a Consultant in Paediatric Emergency Medicine at Sandwell and West Birmingham Hospitals, says:

“There are approximately 1.4 million attendances at the A&E with head injuries in the UK, and of those 50% will be children. It is the commonest cause of death and disability in people under 40. However, the incidence of death from head injuries is quite low at 0.2%.

Primary and secondary injuries

“Usually when a head injury occurs, the primary injury is something which has happened and has happened at the point of injury and there is little which we could do to prevent or alter the course of that.

“However, when we talk about secondary injuries, we are talking about the result of that injury so either in expanding bleed or swelling within the brain.

“The fact that this is occurring within a fixed space, the box of the skull, can result in problems with blood flow to the brain and perfusion to the brain.

“The primary injury has occurred and nothing we can do can alter that. However, we can try to address the secondary injuries, which may for example be the result of expanding bleed or of brain swelling, in order to prevent additional injury to the brain.

“An increasing intracerebral pressure is an important sign to recognise, as early intervention prevents additional injury to the brain and can prevent the more serious brain damage and death from head injuries.”

Here is a useful link to view information about the Glasgow Coma Scale (GCS).

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Emergency and Urgent Care for Children: a Survival Guide

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