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Injury Prevention and Safety

Fell from horse

10/24/2006

Question:

My horse stepped in a hole today and I unbalanced myself and fell off hitting my head, but splitting the helmet. Still I was dizzy and nausous for five minutes before I could walk it off. I am concerned as to what to watch for as far as signs go. I am tired, and know I should avoid napping. I have a dull almost no headache...I banged the heck and bruised my pride though. So, what do I watch for. Thanks

Answer:

You have a great sense of humor! I hope your horse is unharmed as well. You are the living proof of the value of riding helmets. I am so glad you were wearing one. Without it, you could have been very seriously injured given how bad you felt despite the helmet and that it was split open. Please replace it quickly.

Basically you are watching for the signs of increased intracranial pressure caused by swelling of the brain tissue that was banged up against the bones in your skull when you fell. When injured, all tissues leak fluid from the small blood vessels the tissue contains. This build up of fluid in the tissues is what causes swelling, compressing the brain tissue inside the rigid skull bones. This pressure causes the symptoms of headache and nausea as well as the malfunctioning of the nervous system reflected in dizziness, inability to stay awake, blurred vision, trouble thinking and reasoning, and any new problems with balance and movement. If you notice any of these symptoms, it's a good idea to go to the nearest emergency room for care as soon as possible - either driven by a friend or by EMT transport.

It is possible that you may have ongoing headaches and difficulty concentrating for some time. If this is the case, check in with your doctor.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University