After performing a stand-up comedy act in Orlando, Florida, on January 9, comedian and actor Bob Saget was found unresponsive in his hotel room, and he was pronounced dead at the scene.
According to a statement from his family to The Hollywood Reporter, the 65-year-old “accidentally hit the back of his head on something, thought nothing of it and went to sleep.” It was later revealed in an autopsy report that Saget suffered a “significant blow to the head,” and had multiple skull fractures and brain bleeding, The New York Times reports.
Life-threatening brain injuries like Saget’s aren’t uncommon: According to the Centers for Disease Control and Prevention (CDC), about 61,000 people died from traumatic brain injuries (TBIs) in 2019. And the majority of these TBIs occur from falls, Angela K. Lumba-Brown, MD, clinical assistant professor of emergency medicine and neurosurgery at the Stanford School of Medicine, tells Health.
While TBIs can result in severe medical complications, including brain bleeding, swelling, and death, knowing when to seek emergency medical care for yourself or another person can be life-saving. Here’s what you need to know about traumatic brain injuries, and what to do if you hit your head (especially if you’re alone).
Head injuries, explained
When you bump your arm or sprain your ankle, you can usually see physical signs of injury, which might prompt you to seek medical attention. Brain injuries, on the other hand, aren’t visible.
“It’s very different from other injuries where you can see bruising on your skin or swelling in your ankle,” George T. Chiampas, DO, assistant professor of emergency medicine and orthopedic surgery at Northwestern University Feinberg School of Medicine, tells Health. “That’s why it’s so important to be cognizant of developing symptoms and when to address them.”
According to the CDC, traumatic brain injuries happen from a “bump, blow, or jolt to the head.” In addition to falls, TBIs can occur from direct hits to the head, vehicle accidents, or inflicted injuries (like an assault or suicide attempt), Dr. Lumba-Brown tells Health.
TBIs also occur on a spectrum—the most common being a mild TBI or concussion. Hitting your head on a cabinet door, falling, or getting injured playing a sport might cause one of these mild TBIs, says Dr. Lumba-Brown. And while you might experience pain and neurological symptoms while suffering from a concussion, a brain scan won’t show symptoms like bleeding, bruising, or swelling, she adds. The CDC says most people who suffer a concussion feel better within a few weeks.
Moderate or severe TBIs, however, will show up on brain scans—usually in a variety of ways. Hematomas—specifically epidural hematomas or subdural hematomas—are one way a TBI can manifest, Anthony P. Kontos, PhD, director of the University of Pittsburgh Medical Center Sports Medicine Concussion Program, tells Health. An epidural hematoma involves bleeding from a ruptured blood vessel in the space between the skull and the covering around the brain, called the dura mater. A subdural hematoma involves bleeding from a ruptured blood vessel between the dura mater and the area just outside the brain (the arachnoid).
Moderate to severe TBIs can also include contusions, or bruising of the brain tissue; or hemorrhages—both intracerebral hemorrhages and subarachnoid hemorrhages—which is when active bleeding is present, according to the American Association of Neurological Surgeons (AANS).
These moderate to severe TBIs can be especially dangerous—any type of bleeding or swelling in the skull can increase pressure in the brain (known as increased intracranial pressure), which is a life-threatening situation, says Dr. Chiampas. Extra pressure in the brain can press on brain structures and restrict blood flow, which can lead to severe brain damage or death, according to the US National Library of Medicine.
TBIs can also progress from one degree to another, which is why it’s so important to seek medical care if you’re concerned. “[Epidural and subdural hematomas] can occur several days or even weeks following an injury to the head, so it is important to stay vigilant and monitor your symptoms,” says Kontos. “Do not hesitate to go to the ER if something feels off.”