Which finding would indicate a scalp injury should be treated as a head injury?

• A. Bright red minor scratch
• B. Dip, soft area or pieces of bone
• C. Minor swelling only
• D. Hair loss

Answer: (B)

Recognizing signs that a scalp injury might involve the skull and brain is the key idea. A dip, a soft area, or visible bone fragments in the scalp indicates possible skull fracture or underlying brain injury, so this finding means the injury should be treated as a head injury and requires urgent medical evaluation. Act as if there could be serious damage: call emergency services, keep the person still and supported, monitor for changes in consciousness, confusion, severe headache, vomiting, or drowsiness, and be prepared to start CPR if breathing stops. Do not press on a depressed area or try to replace exposed bone fragments. By contrast, a bright red minor scratch or only minor swelling can be typical of a superficial scalp wound and generally does not by itself indicate a head injury requiring emergency treatment. Hair loss alone isn’t a reliable sign of a skull fracture.