Lucid Interval In Head Injury ~ From A Clinician's Bioscope

It was in the news; son of VIP returned from a party late in the night and found dead in the morning. Family smell foul play in it. In the long run it was found that the person was driving in a drunk state along with his friend after attending a party. He met an accident hitting his head, became unconscious for sometime to regained consciousness; and bought home by his friend. He slept in his room, the history of accident was not disclosed to the family members of the victim. The person was found dead in the morning. There was no external mark of injury on his body,as narrated. This is certainly a tragic incidence; but is a typical story of head injury with an extradural, intracranial haematoma. The period of consciousness preceded by brief unconsciousness is called lucid interval.

There occurs tear of venous sinuses inside the skull due to the acceleration and/or deceleration force following the impact of trauma. Also there may be an external swelling in front and a little above the ear due to blood coming out through a fracture in the skull bone there. The initial unconsciousness is due to the sudden shock of trauma. The person recovers to respond but et the same time blood continues to accumulate below the skull and above the outermost covering of brain, the dura. It gradually accumulates in sufficient quantity to compress the brain matter and the accompanying changes makes the victim unconscious. If left unsuspected during this period there is every possibility of loss of life. Again, if the person is drunk, the symptoms of further changes due to accumulating blood is masked or ignored; thinking it to be due to the effect of alcohol. Some times wandering persons with a smell of alcohol and some swelling in the head are restrained in the jail for alcoholism to be found dead in the morning next.
So, in these cases high degree of suspicion, observation in a hospital set up and a possible CT scan may save the life of a victim of accident.