Overview
A head injury is any injury to the head, from a bump or blow to a more serious injury of the skull or brain. Most head injuries are minor, but some are serious and need urgent care.
A concussion is a mild, temporary brain injury caused by a bump, blow or jolt to the head, or a hit to the body that makes the head and brain move quickly back and forth. Most people feel better within a couple of weeks.
Symptoms
After a minor head injury, symptoms may start at once or hours to days later, and can last up to 2 weeks:
- Headache
- Dizziness or balance problems
- Nausea or vomiting
- Tiredness
- Sensitivity to light or noise
- Trouble concentrating or remembering, or feeling foggy
- Irritability, anxiety or sadness
- Sleeping more or less than usual
When to see a doctor
Get urgent advice if the person is being sick or dizzy, takes blood-thinning medicine, or had been drinking alcohol or taking drugs. See a doctor if symptoms last more than 2 weeks, or if you are unsure it is safe to drive or go back to work, school or sport.
Causes
Falls, road crashes, violence and sports injuries are common causes. In a concussion, a blow or sudden jolt makes the brain move quickly back and forth inside the skull, which can damage brain cells.
Risk factors
- Riding a bicycle or motorcycle without a helmet, or travelling in a car without a seat belt
- Contact and high-impact sports
- Falls, especially in young children and older adults
- Driving after alcohol or drugs
- Taking blood-thinning medicine, a reason to get advice after any head injury
- Earlier concussions, which can mean a longer recovery
Complications
Most people recover fully. More serious injuries, and repeated injuries, can lead to:
- Bleeding in or around the brain
- Seizures
- Longer-lasting headaches, balance problems, and trouble with concentration and memory
- Changes in mood, thinking and sleep
Prevention
- Wear a seat belt every time you ride in a car, and never drive after alcohol or drugs
- Wear a helmet when cycling, riding a motorcycle or scooter, and playing contact sports
- For older adults: have the risk of falls checked, medicines reviewed for dizziness and eyes tested yearly, do balance exercises and make the home safer
- For young children: fit window guards, use safety gates on stairs and choose play areas with soft ground
Diagnosis
A doctor asks how the injury happened and checks alertness, thinking, speech, strength, balance and vision. A of the head may be done if bleeding in the brain is possible. A scan is not needed to diagnose a concussion.
Treatment
Most minor injuries can be looked after at home. Hold an ice pack, or frozen peas wrapped in a cloth, on a swelling for short spells. Rest, avoid stress, and take paracetamol for a headache. An adult should stay with the person for at least the first 24 hours. Avoid alcohol and drugs, and do not take sleeping pills unless a doctor advises it.
Do not go back to work or school until you feel better, and do not drive until fully recovered. Avoid contact sports for at least 3 weeks, and follow the doctor's advice on returning to activities safely. More serious injuries need hospital care, and the treatment depends on the type and severity of the injury.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“After a head injury the person must not be allowed to sleep.”What is true?
Fact
A person does not need to stay awake if they are tired. What matters is that an adult stays with them for at least the first 24 hours. Anyone who cannot stay awake, is very drowsy or cannot be woken needs emergency care.
Myth“If there is no bleeding and no lump, the injury cannot be serious.”What is true?
Fact
A head injury can be serious even when nothing shows on the outside. Symptoms can appear right away or hours to days later, so watch for warning signs such as repeated vomiting, a worsening headache, confusion, a fit, or weakness.
Myth“A normal scan means there was no concussion.”What is true?
Fact
A concussion is diagnosed by the doctor's assessment, not by a scan. A CT scan is not needed to diagnose it, and a normal result does not rule it out. Scans are used mainly when there may be bleeding in the brain.
Myth“Once the headache has gone, you can go straight back to cricket, football or driving.”What is true?
Fact
Wait until you feel fully recovered before going back to work or school, and do not drive until then. Avoid contact sports for at least 3 weeks. People who have had repeated concussions may take longer to recover and can have lasting problems.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
How long does a concussion last?
Symptoms usually last up to 2 weeks, and most people feel better within a couple of weeks. See a doctor if symptoms last longer than 2 weeks.
Does everyone with a head injury need a scan?
No. A scan is not needed to diagnose a concussion. A doctor decides whether a CT scan is needed, for example when there may be bleeding in the brain.
When can a child go back to play?
After a minor head injury a child should avoid rough play for a few days, and should not go back to school until feeling better. Contact sports should be avoided for at least 3 weeks, and a doctor can advise on a safe return.
Which painkiller can I take for the headache?
Paracetamol is the pain relief advised for a headache after a head injury, for children too in a child's form. Ask a doctor or pharmacist before using other medicines, especially if you take a blood thinner.