| ICD-9-CM: |
| 900.9 - | Injury to Unspecified Blood Vessel of Head and Neck |
| 910 - | Superficial Injury of Face, Neck, and Scalp Except Eye |
| 910.9 - | Superficial Injury of Face, Neck, and Scalp, Infected, Other and Unspecified |
| 920 - | Contusion of Face, Scalp, and Neck Except Eye(s), including Cheek, Ear (Auricle), Gum, Lip, Mandibular Joint Area, Nose, Throat |
| 959.0 - | Injury of Head, Face, and Neck, Other and Unspecified |
| 959.01 - | Head Injury, Unspecified |
| A superficial head injury is an injury to the head that does not involve damage to the skull or brain as evidenced by imaging studies such as x-ray, CT, or MRI scans. Injuries can include scrapes (abrasions), cuts (lacerations), bruises (contusions), burns, or animal bites (See Abrasions; Lacerations; Contusion; and Burn of Head and Neck for further details). The formal definition of minor head injury is loss of consciousness for less than 10 minutes, no amnesia, no coma, no skull fracture, no new neurological damage, and no detected brain injury. All head injuries are classified by the Glasgow Coma Scale (GCS). A minor head injury is given the score of 14 to 15, whereas a moderate injury has a score of 9 to 13, and a severe injury has a score of 8 or less.
Most, if not all, individuals in the US experience a minor injury to their heads at least once in their lives from minor traffic accidents, sports injuries, falls, criminal violence, and accidents at work or home. Airbags prevent serious head injury in vehicle crashes but can themselves cause minor injuries to the head, neck, and upper body. Helmets worn while riding bicycles, motorcycles, or horses and in sporting activity can prevent head trauma.Risk: Children under the age of 5 years and adults over the age of 85 years are at greatest risk of minor head injuries. Automobile drivers are at increased risk for this injury, as are young males and athletes, particularly those involved in contact sports (boxing, martial arts, football, rugby, etc.). Incidence and Prevalence: Approximately 800,000 cases of minor head trauma are reported in the US each year (Biros). |
Source: Medical Disability Advisor
| History: The individual may report a recent bite, bump, cut, or scrape to the head causing minor bleeding that stops within a few minutes. The most frequently reported symptom of minor head injury is headache. Superficial head injuries should not include the symptoms of persistent or severe headache; blurred or double vision; difficulty walking or maintaining balance; lethargy or inability to arouse from sleep; blurred speech; numbness or loss of sensation; nausea or vomiting; bleeding; or drainage of fluid from the nose, mouth, or ear. These symptoms are suggestive of more serious head injuries, and, since 50% of patients with concussions are misdiagnosed as having minor head injuries, a thorough history is essential (Biros). Physical exam: In addition to a physical exam appropriate for the specific superficial injury, all individuals need to have their neurologic system evaluated. Screening neurologic examinations may be done for very minor injuries. Complete neurologic examinations should be done if there are any suggestions of neurologic problems, and should be performed to rule out a more severe head injury unless the wound is very superficial. The pulse should be above 50 beats per minute in adults. Pupils are equal in size and react equally to light. The individual must be totally oriented (person, place, and time). Tests: Skull x-ray rules out skull fractures. CT scanning rules out delayed bleeding into the brain (hematoma), and MRI determines the degree of brain injury. These tests are generally only required if neurologic signs give any suggestion that the head injury is more serious. |
Source: Medical Disability Advisor
| Minor head injuries are treated as minor scrapes and injuries through the use of ice packs, bandages, and mild pain relievers (analgesics). Cuts deeper than 0.04 inches (1 mm) may be closed with stitches after the individual is given a topical anesthetic. A superficial animal bite is additionally treated with a course of antibiotics. The individual is observed for development of symptoms associated with more serious head injury. Individuals may be admitted into the hospital for overnight observation if they start showing signs of concussion or brain injury after an initial diagnosis of minor head injury (See Concussion, Cerebral; Post Concussion Syndrome; and Brain Injury for further details). |
Source: Medical Disability Advisor
| Wounds treated with stitches should heal within 10 days, depending on the depth of injury. The individual requiring stitches to close a wound will need to schedule a visit to a general practitioner to have the stitches removed after 7 to 10 days. During the follow-up visit, the diagnosis will either be confirmed and the individual can return to all his or her duties, or the diagnosis will be changed to something more serious. A changed diagnosis can lengthen the disability.
Full recovery is expected within a few days for an individual with a superficial head injury that needs no special treatment. |
Source: Medical Disability Advisor
| Complications of superficial head injuries are uncommon and generally involve problems of healing of wounds. |
Source: Medical Disability Advisor
| A superficial head injury should not require any work restrictions or accommodations. |
Source: Medical Disability Advisor
| If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case. Regarding diagnosis:
- Has the diagnosis of superficial head injury been confirmed?
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Did individual suffer a more serious injury such as a skull fracture, concussion, penetrating injury, or hematoma?
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Did MRI and CT rule out brain injury?
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Did a neurologist examine individual?
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Has follow-up in 1 to 2 weeks of injury been scheduled with neurologist?
Regarding treatment:
- Did individual follow the prescribed therapy?
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Have there been any complications (such as a wound infection) despite treatment? What additional treatment has been required?
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Was individual admitted for observation? Was diagnosis updated to a more serious or more specific diagnosis?
Regarding prognosis:
- Has diagnosis been revised?
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Has individual had an additional head injury since the one causing the disability?
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Since the disability, has individual reported blackouts or other symptoms indicating postconcussive syndrome?
|
Source: Medical Disability Advisor
| Biros, M. H., and W. Heegaard. "Head." Rosen's Emergency Medicine. Ed. J. A. Marx. 5th ed. St. Louis: Mosby, Inc., 2002. 286-314. |
Source: Medical Disability Advisor
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