After Bob Saget’s Death, a Q&A on Head Injuries

Feb. 10, 2022 — With the recent news that comedian Bob Saget’s death was due to head trauma, apparently from an accidental blow to the head, doctors say any injury to the head needs to be taken seriously.

Head injuries include any damage to the skull, scalp, or brain caused by trauma. When the brain is affected, it is called a traumatic brain injury, or TBI. About 1.7 million people in the U.S. each year have a TBI. Many others have less serious head injuries.

Saget, 65, died Jan. 9 in Orlando, FL. Law enforcement authorities said no foul play was involved and there were no signs of drugs. This week, his family said an investigation concluded he died of a head injury.

“Now that we have the final conclusions from the authorities’ investigation, we felt it only proper that the fans hear those conclusions directly from us,” the family said, according to published reports. “They have concluded that he accidentally hit the back of his head on something, thought nothing of it and went to sleep. No drugs or alcohol were involved.”

To better understand how head injuries can turn deadly, and what to watch for, WebMD asked for advice from Joshua Marcus, MD, a neurosurgeon who specializes in stroke and brain hemorrhage at Nuvance Health System, in Danbury, CT, and Ben Hoffman, MD, professor of pediatrics at Oregon Health and Science University in Portland.

How can a head injury be fatal?

“If you hit your head in the ‘wrong’ location, you can injure or tear a blood vessel in the brain,” Marcus says. “That is a pretty rare occurrence,” he says, but it does happen. ”That bleeding can lead to increased pressure in the brain and that can be fatal.

“As the bleeding progresses, that increased pressure can affect your breathing. Essentially your breathing stops as a result of that pressure and its effects on the brain.”

What should adults do right after a head injury?

”There are some concerning symptoms after you hit your head your need to watch out for,” Marcus says.

Headache, nausea, vomiting, and confusion are worrisome symptoms. If you don’t remember the event, that puts you at risk for a more serious injury.

Pupil changes, with uneven or very enlarged pupils, may signal brain damage. That may be a difficult symptom for nonmedical professionals to evaluate, however, Hoffman says.

Weakness in the arms or legs, trouble speaking, and seizures are all reasons to get immediate medical attention, Marcus says.

As for the advice not to go to sleep? “We think the first few hours — 2 or 3 — are fairly critical [to decide if it’s serious or not],” Marcus says.

During that time, more symptoms may develop, prompting the person to seek medical care. Avoiding sleep for a few hours is recommended.

What should be done if a child suffers a head injury?

First, the good news.

“In general, kids tend to be very resilient,” Hoffman says. “For the most part, they bounce. I mean that in a good way.”

Consider the fall’s circumstances. Falling off a roof is very different than falling off a bed onto a carpet, he says.

As with adults, it is important to monitor symptoms. Vomiting and altered mental status ”at least warrant a phone call to the doctor if not an ER trip,” Hoffman says.

Loss of consciousness is often associated with concussion and needs immediate attention.

If symptoms don’t seem serious, observe kids for an hour or 2 to see if they return to normal. After that, Hoffman says, it’s fine to get some sleep. In general, he says, it’s fine to give a painkiller like acetaminophen and to put a cold pack on the area if it’s bruised.

Are some people more prone to serious head injuries after a fall or accident?

“We see head trauma more commonly in older patients from more benign type falls,” Marcus says.

Serious head trauma in younger people more commonly happens after a severe car accident, for instance.

If someone is taking blood thinners or antiplatelet medications, brain bleeding is more likely, Marcus says.

What about recovery?

If the injury is a concussion, some symptoms, such as problems with concentration and vision, can linger for a few weeks, Marcus says.

Children with a concussion should not return to sports immediately, Hoffman says.

If any symptoms worsen, medical attention is needed again, Marcus says.

As scary as head injuries are, he says, the majority are mild.

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