Head Injury
Onset prior to evaluation
Onset while:
Injury at:

Impact at
<-- nasal drainage/bleeding
<-- ear drainage/bleeding

Associated Pain (0=none, 10=severe)
Location:
Radiation:
Severity now (0-10):
Severity at worst (0-10):
Duration:
Characterized as .

<-- remembers the accident
<-- remembers after the accident

Episode was witnessed by and they reported:
<-- complete loss of consciousness for a duration of
<-- Seizure activity
<-- Confusion following the episode
<-- associated incontinence of urine or stool

Episode was followed by the following symptoms that lasted :
<-- headache
<-- neck pain
<-- lightheadedness
<-- extremity weakness
<-- Vision change
<-- Hearing change
<-- nausea or vomiting
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Result - Copy and paste this output: