Head Injury Pathology and its Clinical, Safety and Administrative Significance

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Head Injury Pathology and its Clinical, Safety and Administrative Significance

S. C. Knapp / T. M. Erhardt

The occurrence of head trauma is so common that its true importance as a major statistic associated with accidental injury and death may be overlooked. A review of head trauma in war, vehicular accidents, sports, and aviation demonstrates that while the head constitutes roughly 9 percent of the body's weight, surface area and volume, it is implicated in 7 out of 10 body injuries. Generally speaking, head trauma causes an unacceptable 1 in 4 deaths and for motorcycling it causes a staggering 1 out of every 2 deaths. Head protective devices have been available since antiquity; but except in isolated circumstances they cannot be shown to have had a mitigating effect on the magnitude of the injury rate. Yet, the technology exists to prevent head-injury deaths and to greatly reduce injury severity in survivable accidents, especially in aviation. While it is accepted that helmets, indeed, provide significant protection, most systems of accident investigation, injury analysis and data recording do not recognize head trauma as endemic or even epidemic. Thus, the problem has not been approached epidemiologically. Instead, the bulk of head injury research is directed toward improved treatment and prevention of disability. These efforts are on the secondary and tertiary levels of prevention.