Head Injuries

Last Updated October 2023 | This article was created by familydoctor.org editorial staff and reviewed by Peter Rippey, MD, CAQSM

What is a head injury?

A head injury is any harm to your brain, skull, or scalp. Head injuries can be mild, moderate, or severe. Common types include:

  • Concussion: This is a jarring injury to your brain. Most of the time, people remain conscious. They may feel dazed, have visual changes, headaches, neck pain, or other changes in cognitive function.
  • Brain contusion: This is a bruise of your brain. Minor bleeding in your brain causes swelling.
  • Skull fracture: This is a crack in your skull. Sometimes, the broken skull bones can cut into your brain. This causes bleeding and can lead to another injury.
  • Hematoma: This is a collection of blood that can occur inside the skull next to the brain or outside the skull under the scalp. It can appear right away or may take several days.

Symptoms of a head injury

With a head injury, it’s common to have a headache and nausea. You may be dizzy or disoriented right afterward. You also may have problems focusing or remembering. Other symptoms include ringing in your ears, neck pain, emotional or vision problems. These symptoms often go away in a few weeks but may last longer if the injury is severe.

Get help right away if you notice the following:

  • Any symptom that gets worse, such as headaches, nausea, or fatigue
  • Frequent vomiting
  • Drastic changes in behavior, such as anger or confusion
  • Pupils that are bigger than normal (dilated) or different sizes
  • Trouble walking or speaking
  • Problems breathing
  • Drainage of bloody or clear fluids from the ears or nose
  • Weakness or numbness in the arms or legs
  • Loss of consciousness
  • Seizures

What causes a head injury?

There are several causes of head injuries. You may get injured playing a sport or activity. Certain jobs, such as construction, contain risk of a head injury. Children or elderly people may fall around the house and get hurt. Severe head injuries are most likely to occur in a car, motorcycle, or bicycle wreck.

How is a head injury diagnosed?

You should see a doctor if you think you have a head injury. They will ask about how the injury happened, your symptoms, and past health problems. Tell them if you’ve had serious symptoms, such as vomiting or seizures. The doctor also may ask questions to test your memory and mental function. Examples include, “What is your name?” “What day is it?” and “Where are you?” You may need to stay in the hospital. This allows the doctor to watch and monitor your condition.

Most head injuries do not require imaging (taking pictures of your head). If your doctor wants an image, they may order a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan. These scans check for damage and help the doctor diagnose an injury.

Can a head injury be prevented or avoided?

You cannot always avoid head injuries, but you can do things to decrease your risk. These include:

  • Wearing a seatbelt in the car
  • Wearing a helmet on a motorcycle or bicycle
  • Wearing proper protective gear at work or when playing sports
  • Keeping a close watch on children and elderly people for falls or accidents

Head injury treatment

A mild head injury may require only a brief period of rest followed by gradual return to activity. However, you should know the signs to look for in case a problem begins. Your doctor can help you determine this. Severe injuries often require medical attention and a hospital stay. You may need surgery to treat the condition.

Call 911 if you are with someone who has a severe head injury. You also should follow these guidelines:

  • If the person is bleeding, try to stop it. Use gauze, a towel, or a piece of clothing. Do not touch the wound. If the wound is open, do not apply pressure. Cover or wrap the wound instead.
  • If the person is vomiting, keep them upright. If they are lying down, roll their body to the side to prevent choking.
  • If the person is awake, instruct them not to move their head and neck. This can help prevent further damage to their spine and brain.
  • If the person is unconscious and breathing, try to stabilize their body. This includes keeping their neck and head in line with their spine.
  • If the person is unconscious and not breathing, begin the process of CPR (cardiopulmonary resuscitation).

Living with a head injury

Most people recover from head injuries with no lasting effects. However, damage can occur if your brain moves or is pierced. Talk to your doctor about how to manage side effects or symptoms, such as pain.

After a head injury, you may have memory loss. For example, you may forget the events right before, during, and after the accident. Memory of these events may or may not come back. Following treatment, the ability to learn and remember new things often returns.

Questions to ask your doctor

  • How can I tell if a head injury is mild or severe?
  • How do I care for someone who has suffered a head injury?
  • After a head injury, can I take medicine for the pain? If so, what type?
  • When can I return to my normal routine?
  • What are the long-term effects of a head injury?
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