Head injury is defined as trauma to the scalp, skull, or brain.

Mechanisms of injury include motor vehicle accidents, blast events, falls, or a blow or gunshot/shrapnel wound to the head.

Signs and symptoms typically include obvious wounds to the scalp or skull, raccoon eyes/Battle’s sign, CSF otorrhea/ rhinorrhea, altered or loss of consciousness, headache, visual changes, ringing in ears, nausea/vomiting, dizziness, impaired balance/coordination, amnesia, etc.

Casualties with suspected head injury/TBI should be referred to medical personnel for MACE 2 evaluation.

Management of suspected head injury/TBI in TFC is focused on preventing secondary brain injury due to hypoxia and hypotension.

Although not treated in TFC, it is important to be able to identify signs and symptoms of impending cerebral herniation requiring urgent evacuation to a higher level of medical care.