Page 29 - SSB MED EBOOK

Head Injury or Concussion. A history of severe head injury is a

cause for rejection. The degree of severity may be gauged from the

history of duration of Post Traumatic Amnesia (PTA). Mild brain

injury is associated with 0-1 hour PTA, moderate with 1 – 24 hours

PTA, severe with 1-7 days PTA and very severe with > 7 days of

PTA. Other sequalae of head injury are post concussion syndrome

which has subjective symptoms of headache, giddiness, insomnia,

restlessness, irritability, poor concentration and attention deficits;

focal neurological deficit, posttraumatic epilepsy and posttraumatic

neuropsychological impairment which includes deficits in attention

concentration, information processing speeds, mental flexibility

and frontal lobe executive functions and psychosocial functioning.

Neuropsychological testing including pyschometry can assess

these aspects. It is important to realize that sequelae may persist

for considerable period and may even be permanent. Fracture of

the skull need not be a cause for rejection unless there is a history

of associated intracranial damage or of depressed fracture or loss

of bone. When there is a history of severe injury or an associated

convulsive attack, an electroencephalogram should be carried out

which must be normal. Presence of burr holes will be cause for

rejection for flying duties, but not for ground duties. Each case is to

be judged on individual merits. Opinion of neurosurgeon and

psychiatrist must be obtained before acceptance.