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Head injury

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 3 minutes read

Head injuries are fairly common, especially in children, but they can happen to anyone from trips and falls, traffic collisions and sporting injuries. It may be obvious from the injury that someone needs professional medical attention, but sometimes signs take a while to manifest.

Let’s talk you through when to seek help immediately, and what to look out for in the hours and days afterwards. It's important to stress that most head injuries are minor and do not result in serious or lasting injury, but it's important to be aware when an injury could be significant.

When should I call an ambulance?

If it’s a yes to any of this checklist, make sure the person you’re looking after gets to hospital:

  • Have been knocked unconscious, even if they have since recovered
  • Are finding it difficult to stay awake
  • Clear fluid running from their ears or nose
  • Bleeding from one or both ears
  • Bruising behind one or both ears
  • Any signs of damage to the skull or skin on the head, like a deep cut, bleeding or a dent
  • They are intoxicated with drugs or alcohol
  • Vomiting
  • A seizure or fit

In relation to the mode of injury:

  • It was caused by a forceful blow to the head or a knock at speed – this might be in an assault with a fist or weapon, a collision between car and pedestrian, bike or another car passenger
  • They have fallen from a height of more than 1 metre or 5 stairs

If you know about the person’s background, they should go to hospital urgently if:

  • They've previously had brain surgery
  • They have problems with bleeding or clotting, either from a condition (like haemophilia) or medication (warfarin, apixaban, or rivaroxaban)
  • You suspect a non-accidental injury, or this is a vulnerable person

What should I look out for afterwards?

Symptoms usually start within 24 hours, but can take up to 3 weeks to show, and may indicate concussion (a mild brain injury), a skull fracture, or a bleed in the brain.

You should get the injured person to the emergency department with urgency if any of the following manifests in the hours or days after the accident:

  • Problems with walking or balance
  • Weakness, numbness, or loss of sensation in any part of the body
  • General weakness
  • Changes to your eyesight
  • A headache that doesn’t go away with painkillers
  • Problems with speaking or understanding, and problems with reading or writing
  • Problems with remembering events before or after the injury
  • Behaviour changes such as being more irritable or short-tempereda, finding concentration difficult, or feeling no interest in things or people around them

Anything particular with children?

Young children and babies can be difficult to assess, and their heads are more vulnerable as it takes time to develop the hard shell of skull we have as adults. All of the above applies, but particularly take notice of changes to behaviour – lacking interest in anything, crying more than usual.


If you didn’t feel someone needed to go to hospital, or they have been sent home from hospital with a minor head injury, make sure that you or another adult stays with them for at least the first 24 hours.

Paracetamol or ibuprofen may be used to relieve pain, and an ice pack (ice or a bag of frozen peas wrapped in a towel) can be held to the sore part of the head. This will also reduce any tissue swelling.

They need more rest than usual to recover, so let them sleep and avoid any stress.

School or work should be avoided until they feel well enough, and adults should avoid driving until fully recovered. Contact sports (or rough play for children) should be avoided for at least 3 weeks. Alcohol and drugs should be avoided until feeling better.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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