What are the indications for surgery in head injury cases?

Surgery in head injury cases is typically indicated when there are large hematomas, depressed skull fractures, or significant brain edema. These conditions can lead to increased intracranial pressure, which poses a critical risk to the patient. Large hematomas can compress brain tissue, potentially leading to serious complications such as brain herniation. Depressed skull fractures can also puncture or damage the underlying brain tissue, leading to hemorrhage or infection. Significant brain edema indicates that there is swelling of the brain, which can cause life-threatening pressure on the brain structures.

In contrast, small hematomas and minor concussions usually do not necessitate surgical intervention due to their manageable nature. General swelling of the head is nonspecific and may not require surgical treatment unless there are clear complications. Simple skull fractures, while they need to be monitored, often do not require surgery unless they are associated with other more severe injuries such as those mentioned. Thus, the presence of large hematomas, depressed skull fractures, or significant brain edema highlights scenarios where immediate surgical intervention is essential to prevent further neurological damage.