Paralysis can lead to issues with skin integrity due to pressure issues. These are wounds that begin inside the body, usually over a bony prominence pushing against the inside of the skin. The pressure causes capillaries to collapse which interrupts the blood supply. The cells in the body cannot receive oxygen or nutrients needed to keep them healthy, so they are starved and eventually die. Once this process has started, a change in pigment on the outside of the skin appears in a range of colors such as a purplish spot in darkly pigmented individuals or as a pinkish spot in lightly pigmented individuals.
There are many locations on the body that are common areas for pressure injury, however, since most individuals have sensation on their heads, the thought of pressure areas here are often overlooked. However, some individuals do have interrupted head sensation, have challenges in moving their head position, develop pressure injury from equipment, lie too long on one side especially while asleep, or are unable to tell a caregiver that something on their head is hurting.
Here are some common areas where pressure can occur on the head: