Head Injury
What is a head injury?
A head injury is any injury that hurts the scalp, skull, or brain. Some injuries can cause mild pain but no lasting problems. Other injuries can be very serious. Some head injuries can cause a concussion, which is an injury to the brain. Injuries can be mild to severe. Severe head injuries can cause permanent disability or death.
What is the cause?
A head injury can happen in different ways:
- When you fall and land on your head
- When you hit your head on something, such as a cupboard door or a windshield during a car accident
- When an object hits you on the head, such as a rock or a ball
- When your head is whipped back and forth and your brain is severely shaken, such as in a car accident
Common causes of head injuries are car or motorcycle accidents, bicycle accidents, sports activities, and falls.
What are the symptoms?
Even a minor head injury can be quite painful. The head has a rich blood supply. Small cuts in the face or scalp may bleed a lot. You may have a large swollen area where blood collects under the skin. The area may bruise and change colors over a week or two.
In addition to pain, the symptoms may include:
- Loss of consciousness
- Confusion or trouble concentrating
- Sleepiness
- Dizziness, weakness, or loss of balance
- Blurred vision or sensitivity to light
- Nausea or vomiting
- Seizures
Symptoms of a head injury may not show up for 2 to 3 days. If you are concerned that you may have suffered a serious head injury or a concussion, contact your healthcare provider or go the nearest emergency department to be examined.
How is it diagnosed?
Your healthcare provider will ask about how you hurt your head and examine you. Your provider will do several types of exams. One of those exams will test your ability to think and speak clearly and to follow directions. Another exam will test your balance, strength, and reflexes.
Some people who have had a head injury will need:
- A CT scan, which is a series of X-rays taken from different angles and arranged by a computer to show cross sections of the brain.
- An MRI, which uses a strong magnetic field and radio waves to take pictures from different angles to show cross sections of the brain.
How is it treated?
No one with a possibly serious head or neck injury should be moved. An ambulance should be called right away. If your neck hurts after a head injury, try not to move until you can be checked by a healthcare provider.
If you have a deep or long cut on your head, you may need stitches. You may also need a tetanus shot, depending on how you were injured and when you had your last shot.
For a minor head injury, you can take acetaminophen for pain if you don’t have a medical reason for not taking this medicine. Don’t take aspirin or other NSAIDs, like ibuprofen or naproxen, because these medicines may make any bleeding worse. Acetaminophen may cause liver damage or other problems. Read the label carefully and take as directed. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours or take it for longer than 10 days. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
Don’t take any medicines that might make you sleepy or confused (like narcotics or sedatives) unless you take these medicines regularly for another medical problem. The effects of these drugs might be confused with signs of a concussion.
If the injury happened while you were playing sports, don’t return to the game on the same day of the injury. Ask your healthcare provider when you can return to playing sports.
Ask your healthcare provider:
- How and when you will hear your test results
- How long it will take to recover from this injury
- What activities you should avoid, and when you can return to your normal activities
- How to take care of yourself at home
- What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
How can I help prevent a head injury?
- Wear a helmet or protective gear and follow safety rules when you play sports or do high-risk activities, such as rock climbing, skiing, cycling, and snowboarding.
- Always wear a seat belt when you travel in a car.
- Take extra precautions when you walk on uneven or slippery surfaces.
- Follow safety practices in the workplace and at home, like when you climb a ladder.
- Make living areas safe. For example, remove loose rugs, install handrails on stairs, and install adequate lighting throughout the house.
- Don’t drive or operate machinery if you have been drinking alcohol or using drugs.
Head Injury: References
Heads Up: Preventing Concussion (2011). http://www.cdc.gov/concussion/headsup/pdf/Heads_Up_factsheet_english-a.pdf.
Marx, J (2009) Rosen’s Emergency Medicine, 7th ed. Mosby.
UpTodate online 16.2, Accessed Nov 19’08 from http://www.utdol.com/online/content/search.do.