American Medical Association Family Medical Guide - American Medical Association [423]
WARNING!
Never Shake or Toss a Baby
Activities such as shaking or tossing a baby—or jogging with a baby in a carrier or backpack—can tear the fragile veins around the child’s brain or make the brain bang against the hard bone of the skull, injuring the brain. These brain injuries can cause loss of vision; severe, permanent brain damage; or death.
Diagnosis
If you have had a recent head injury (even within the past few months) and are having symptoms, your doctor will probably recommend a CT scan (see page 112) or MRI (see page 113) to see if you have any brain damage and, if so, to determine the extent of the damage.
Treatment
If you have had a minor head injury, rest for 2 to 3 days; don’t take any medication that hasn’t been prescribed by your doctor. Make sure family and friends know about the injury so they can watch for any problems. If you develop symptoms, they should call the doctor right away. If you have had a severe head injury, have someone call 911 or take you to the nearest hospital emergency department. You will be admitted to the hospital and may be given medications such as mannitol or corticosteroids to reduce the swelling in your brain. A surgeon may place a monitoring device in your brain to measure the amount of pressure and to remove cerebrospinal fluid to relieve some of the pressure. If your skull is fractured, the surgeon will remove any bone fragments from your brain and may replace the damaged area of the skull with a metal plate. Recovery from a severe brain injury may take many months and you may need rehabilitation therapy (see page 672) and counseling.
Spinal Cord Injury
The nerves that make up the spinal cord transmit impulses between the brain and the rest of the body, allowing you to control your movements and detect sensations such as pain. If the spinal cord is injured, parts of the body below the point of injury may be affected; the closer to the head, the more areas will be affected. Most spinal cord injuries result from motor-vehicle collisions, diving injuries, sports injuries, falls, or knife or gunshot wounds.
Spinal cord injuries can be permanent and can cause severe disability. If the injury causes numbness, you can hurt the numbed area because your nerves are not transmitting pain messages to your brain. Injury to part of the spinal cord in the neck can be fatal if the injury damages the nerves that control the muscles necessary for breathing.
Symptoms
The symptoms of a spinal cord injury are almost always immediate but can worsen gradually over a few hours to days as the affected area becomes inflamed and swells. Symptoms depend on the location of the damage and include numbness and muscle weakness or paralysis below the level of the injury (including the muscles that control the intestines and bladder). Sometimes the injury affects muscles on only one side of the body. If nearby bones and nerves are injured, you may have severe pain, although pain is not always a symptom of a spinal cord injury.
Diagnosis
To diagnose a spinal cord injury, after immobilizing your spinal cord (to prevent further damage), your doctor will test different parts of your body and may ask you to try to move them. He or she will order X-rays, a CT scan (see page 112), or an MRI (see page 113) to verify the location of the injury and determine the extent of the damage. Your doctor may perform a procedure called myelography. In this procedure, he or she injects a contrast medium (dye) into the cerebrospinal fluid (the liquid that surrounds the brain and spinal cord); the contrast medium, which can be seen on an X-ray or CT scan, will highlight the damaged areas of the spinal cord.
Treatment
Treatment of a spinal cord injury starts immediately. You will be immobilized because any movement could cause more damage to your spinal cord. Your doctor will immediately give you high doses of a corticosteroid medication to quickly reduce inflammation and swelling in the