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Head injury

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 3 minutes read
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Head injuries are fairly common, especially in children, but they can happen to anyone, from trips and falls, to 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 afterward. 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 of 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 the 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 a car and pedestrian, bike, or another car passenger
  • They have fallen from a height of more than 3 feet or 5 stairs

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

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

What should I look out for afterward?

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 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
  • Behavior changes such as being more irritable or short-tempered, 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 the skull we have as adults. All of the above applies, but particularly take notice of changes to behavior – lacking interest in anything, crying more than usual.

Aftercare

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

Acetaminophen 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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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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