Let’s start with a true story. A few years ago, my 2-year-old daughter in my father-in-law’s home, the teenage sister-in-law carried her daughter out to play, running back tripped and fell, my daughter flew out of the head on the ground, hit a big bag was sent to a nearby hospital. I was informed and rushed to the hospital, it is the doctor to discuss whether to check the head CT, I myself carefully give my daughter looked after, decided not to check the CT! Why, of course, you can simply say that I am a doctor I understand. But the truth is that I just thought it was very unlikely that there was a serious problem, and this time I was a family member, and I was willing to take the risk in order to avoid my daughter having to be dosed with sedative medication and exposed to radiation again! (I wouldn’t dare to do that if I were not a family member but a doctor, because I couldn’t answer the question “Can you guarantee that there is absolutely nothing wrong with the child?”) Okay, so why do I think that my daughter’s injuries are very unlikely to cause serious problems? There are several reasons: 1. The mechanism of the injury is clear: the head hit the ground and the part that hit the ground was the forehead, so the possibility of intracranial hemorrhage or hematoma arising from this mechanism of injury is small. 2. 2, There is no history of coma with crying immediately after the injury. 3, physical examination of the situation, the child did not find neurological abnormalities manifested. 4, I believe that in the unlikely event that there is a problem, my timely detection and then further examination or even surgery, generally able to ensure the success of the rescue. Against the cases I have seen: the child fell from the bed to the floor, crying, came to the hospital in good spirits, responsive. There were no obvious signs of injury to the head on examination. Children were hit on the head by other children at school, there is no history of coma, there is no obvious scalp injury (the child said that a certain place pressure pain) middle school students in the school kicking a soccer ball and fell on the head, there is no history of coma, feel dizzy. There were significant skin contusions on the head and face. In all of these examples, the injuries were much less severe than my daughter’s, but the family’s anxiety was palpable. “You must make sure the child is okay!” , my response was that it was highly unlikely that there was an intracranial problem, but guaranteeing that there was absolutely nothing wrong I couldn’t say. Should I have a CT scan? This question has been bothering me. Now we move to the core of what I want to talk about, how as a layperson we can self determine the likelihood of intracranial injury after suffering a head trauma. We won’t talk about those who are unconscious or unconscious, because there is no need to judge in this case, hurry to the hospital! For minor injuries, the first thing to look at is how the injury was sustained, termed the mechanism of head impact. A direct blow to the head with a fist/stick/rock is called an acceleration injury (meaning the head is moved by an external force). For accelerative injuries, the skull is generally not injured unless the force is so great that it breaks through the protection of the skull and causes a skull fracture. What do I mean by great force, explained this way, for an adult, hitting the head with a fist that is not in the temporal region (at the temples), I believe that a fracture of the fist is no less likely than a fracture of the skull. To be clearer, this mechanism of injury, if the force of injury is large enough to cause skull fracture or intracranial damage, it must lead to severe scalp injury, such an injury even if conscious, usually no need to judge, hurry to the hospital! As for hand or fist injuries, small packets on the top of the head, small packets on the brain, etc., the likelihood of damage to the intracranium is very small. Acceleration injuries are not as likely to result in a skull fracture if it is a sharp or angular object such as a bayonet or sharp knife, but again, there may be no need to judge, and you will need to rush to the hospital for an injury to the scalp! Falling and landing on your head is called a deceleration injury (meaning the head stops in motion). First of all, deceleration injuries are most likely to cause intracranial hemorrhages and hematomas, but because of the anatomical characteristics of the skull and the brain within it, deceleration injuries that land on the occipital region (back of the head) are most likely to cause intracranial hemorrhages, and if the injury is a back-of-the-head landing with a history of coma, it is important to seek prompt CT, regardless of whether or not the injured person is later very lucid. a frontal landing with intracranial hemorrhages is less likely to be a result of a fall on the forehead. A history of unconsciousness is very important, and a history of unconsciousness with forgetfulness of recent events is sufficient in itself to confirm a diagnosis of concussion. If you have a head injury from a car accident such as a motorcycle, don’t judge for yourself, go to the hospital! Elderly people, you are also not to judge for yourself, playing mahjong in a hurry can cause brain hemorrhage, go to the hospital!