Developed in collaboration with CASA Medical.
Head injury, also known as traumatic brain injury (TBI), is an injury to the brain caused by an external mechanical force. TBI may lead to temporary or permanent impairment of cognitive, physical and psychosocial functions. Aeromedical decision making and the return to flying or operating for pilots and controllers takes into account a range of factors, including the severity of head injury.
Head injuries can be classified into 5 broad categories – minimal, mild, moderate, severe, and very severe based on Glasgow Coma Scale (GCS), loss of consciousness (LOC), post traumatic amnesia (PTA), clinical outcomes, and neuroradiology imaging findings. There are other features that can help to determine the severity of head injury as described in the table below. There is no universally accepted classification for TBI.
Head injury can lead to overt and subtle incapacitation and affect performance. Pilots and controllers should seek medical care and assessment as soon as possible following a head injury.
A good history of the events at the time of the injury is crucial information. The availability of full information about head injuries eg medical assessments and reports (including paramedic and witness reports) obtained at the time of the head injury may facilitate an earlier return to flying or operating.
A period of surveillance on the ground may be required depending on the severity of the head injury because of the risks related to impaired cognition, mood changes, stroke, or seizures.
High likelihood of seizures is not compatible with flying or controller duties.
For more information, see Medical Manual: Head injury.
