Err on the side of caution with head trauma

Bob Saget’s death — the result of a blow to the back of his head, according to his family — is a stark reminder of how even brain trauma that seems mild might merit medical attention, experts say.

Authorities concluded that the actor, who was found dead in a hotel room in January, accidentally hit his head, “thought nothing of it and went to sleep,” his family announced Wednesday, adding that no drugs or alcohol were involved.

With few other details released, neurologists were unable to speculate on Saget’s medical situation. But they said the mindset that he found himself in is not rare: It’s common for people to minimize head injuries.

“We unfortunately hear this frequently, where people have bad headaches after, and they tend to downplay it,” said Dr. Shazam Hussain, director of the Cerebrovascular Center at Cleveland Clinic. “They say, ‘Well, I’ll just see if it gets better,’ and then something catastrophic happens.”

Not every knock to the head requires a trip to the emergency room. The force of the impact plays a role, Hussain said, meaning something as significant as a car accident would need to get evaluated, while walking into ceiling rafters likely would not.

How someone feels after a head injury is an important indicator of whether they should seek care. A persistent or worsening headache, nausea and vomiting are causes for concern, as is having a poor recollection of sustaining the injury, said Dr. Joshua Marcus, a neurosurgeon with Nuvance Health.

Loss of consciousness or droopiness in the face, paralysis in the arms or legs, walking or speaking difficulties need to be looked at immediately, Hussain said.

“If this feels like the worst headache of your life, or anything that feels like a stroke-like symptom — it’s better not to wait on that stuff,” he said. “We’ve seen too often that people wait on those to get better. Get it checked out and make sure that you’re safe.”

What happens when you get a head injury

Untreated head trauma can turn fatal due to swelling that the skull does not have room to accommodate, Marcus said.

“What happens if there’s bleeding or swelling in the brain from a traumatic brain injury, that can lead to increased pressure in the head,” he said. “As there’s increased pressure, it affects your breathing and it can affect your heart rate, and ultimately, you can have a respiratory arrest phenomenon.”

It’s unclear when or how Saget got his head injury. Marcus said while it’s not incredibly common for people to experience a medical emergency in their sleep after head traumas, doctors advise not going to bed immediately after.

“The reality is that bleeding or swelling can progress over time, and that is usually over the first few hours, which is why it’s important to monitor your symptoms for at least a few hours.”

“The reality is that bleeding or swelling can progress over time, and that is usually over the first few hours, which is why it’s important to monitor your symptoms for at least a few hours,” he said.

Lying flat to go to sleep also elevates your head pressure slightly, he added, “so it’s better to be upright immediately following a trauma.”

People might have lingering symptoms for a few days after a traumatic brain injury, Marcus said, including headaches, concentration issues or even some vision problems. If the symptoms worsen, that’s an urgent reason to get checked out.

Some people are more prone to complications from minor trauma to the head, the experts said. That includes senior citizens and people who are on blood thinners or any antiplatelet medications, or who take aspirin daily.

Overall, Marcus said, it’s better to be safe than sorry. And in most cases, patients will be fine.

“I think it’s important that we remember that the majority of brain injuries that are mild are very recoverable and don’t require any intervention, but we need to be aware of the concerning symptoms and when to seek medical attention,” he said.

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