When a person suffers a head injury, the greatest danger is that his brain may be severely damaged. Whether or not the skull is fractured is a matter of secondary importance. In some cases, injuries that fracture the skull do not cause serious brain damage. But brain damage can, and frequently does, result from apparently slight injuries that do not cause damage to the skull itself.

It is often difficult to determine whether an injury has affected the brain because symptoms of brain damage vary greatly. Any person who has suffered a head injury of any kind must be handled carefully and given immediate medical attention.

Some of the symptoms that may indicate brain damage are listed below; however, you must remember that these symptoms are not always present in any one case and the symptoms that do occur may be greatly delayed.

1. Bruises or wounds of the scalp may indicate that the victim has sustained a blow to the head. Sometimes the skull is actually depressed at the point of impact. When the fracture is open, you may find bullets, glass, shrapnel, or other objects that have penetrated the skull.

2. The victim maybe conscious or unconscious. When conscious, the victim may feel dizzy and weak, as though he were going to faint.

3. Severe headache sometimes (but not always) accompanies head injuries.

4. The pupils of the eyes maybe unequal in size and may not react normally to light.

5. There maybe bleeding from the ears, nose, or mouth.

6. The victim may vomit.

7. The victim may be restless and perhaps confused and disoriented.

8. The arms, legs, face, or other parts of the body may be partially paralyzed.

9. The victim's face maybe very pale, or it may be unusually flushed.

10. The victim is likely to be suffering from shock, but the symptoms of shock maybe disguised by other symptoms.

It is not necessary to determine whether or not the skull is actually fractured when you are giving first aid to a person who has suffered ahead injury. The treatment is the same in either case, and the primary intent is to prevent further damage to the brain.

TREATMENT. Keep the injured person lying down. When facial flushing is apparent, raise the victim's head and shoulders slightly. When facial pallor is present, position the victim so the head is level with or slightly lower than the body. Watch carefully for vomiting. If the victim begins to vomit, position the head so choking on the vomitus does not occur.

When there is serious bleeding from wounds, try to control it by applying direct pressure, using caution to avoid further injury to the skull or brain.

You must exercise care when moving or handling the victim. Transport the person only when necessary. If you must transport the victim, keep him lying down. Be sure the victim is kept comfortably warm but do not overheat him. Do NOT provide the victim with anything to eat or drink. DO NOT GIVE ANY MEDICATION.

Finally, obtain medical care for the victim as soon as possible.