Patient education: Head injury in adults (The Basics)

What causes head injuries? — A head injury can happen when a person hits their head on a hard surface or is hit in the head with something. The most common causes of head injury are falls, sports injuries, and car and bike accidents.

Some head injuries are minor, like a bump on the head. With minor head injuries, the skull protects the brain from damage. Others can be more serious and cause brain injury. A "concussion" is the medical term for a mild brain injury. Sometimes, head injuries can be serious or life-threatening.

A more serious head injury can cause:

●Broken bone of the skull or face (figure 1)

●Brain injury or swelling

●Bleeding in or around the brain

This article discusses head injuries in people 18 years and older. Head injuries in children might be managed differently.

What are the symptoms of a head injury? — Symptoms depend on the type of injury a person has and how severe it is. People with a minor head injury, such as a bump on the head, might not have any symptoms.

Some people pass out or lose consciousness when they get a head injury. If a person does not wake up quickly, or blacks out several minutes or hours after a head injury, they might have bleeding in the brain. The person needs emergency help.

Other symptoms that can happen after a head injury include:

●Headache

●Nausea or vomiting

●Swelling, bleeding, or bruising on the scalp

●Dizziness

●Confusion or memory problems

●Vision problems

●Feeling tired or sleepy

●Mood or behavior changes, or not acting like yourself

●Trouble walking or talking

●Seizures – Seizures are waves of abnormal electrical activity in the brain. They can make you pass out, or move or behave strangely.

A head injury that involves a broken skull or face bone can also cause:

●Bruising around the eyes or behind the ear

●Blood or clear fluid draining from the nose or ear

Symptoms can start right after a head injury, or a few hours or days later.

Some people have symptoms that last a short time only. Other people have symptoms that cause long-lasting problems.

Will I need tests? — It depends on your injury and symptoms. Your doctor or nurse will ask about your symptoms and do an exam. They will also ask questions to find out if you are able to think clearly.

If your doctor or nurse thinks that you might have a serious injury, they might order an imaging test of your brain. This might be a CT or MRI scan. These tests create pictures of your skull and brain.

How are head injuries treated? — Treatment depends on your injury and how serious it is.

Usually, minor head injuries do not need treatment. But your doctor might recommend things like:

●Having someone stay with you for 24 hours after your injury – This person should watch for new symptoms or the symptoms listed above. They should also make sure that you can wake up at a normal time after you fall asleep. It is not usually necessary to wake you up during the night.

●Taking over-the-counter pain medicines – Acetaminophen (sample brand name: Tylenol) might help relieve a headache.

●Rest – It can be important to rest if you have symptoms after a concussion. This means resting your body and avoiding activities that make you feel worse. It can also help to rest your brain. Avoid looking at screens until you are feeling better.

●Ice – If you bumped your head, ice can help with pain and swelling. Apply a cold gel pack, bag of ice, or bag of frozen vegetables on the area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your head. Use the ice (or other cold object) for at least 6 hours after your injury.

Severe head injuries need to be treated in the hospital. In this case, treatment can include:

●Medicines – Different medicines can help prevent brain swelling, bleeding in the brain, or seizures.

●Surgery – If you have bleeding in or around your brain, or if your brain swells, you might need surgery.

When should I call for help? — If you had a head injury, there are certain problems that you or your caregiver should watch for.

Someone should call for an ambulance (in the US and Canada, call 9-1-1) if you:

●Cannot be fully woken up

●Are acting confused or disoriented

●Have a sudden and persistent change in your behavior

●Cannot walk normally

●Have trouble speaking or slurred speech

●Have severe weakness or cannot move an arm, leg, or 1 side of your face

●Have a seizure, or jerking of your arms or legs you cannot control

Call the doctor or nurse for advice if you:

●Have trouble concentrating, thinking clearly, or remembering things

●Have trouble waking from sleep or staying awake

●Have nausea or vomiting that is not improving

●Have blurry eyesight, double vision, or other problems seeing

●Have blood or clear liquid draining from your ears or nose

●Feel dizzy or faint

●Seem weak or have numbness in an arm, leg, or other body part

●Have a stiff neck

●Have a headache that is severe, gets worse, feels different, or does not get better with over-the-counter medicines

If any of the above symptoms seem severe, or if you are concerned but cannot reach the doctor or nurse, seek emergency help. These things don't always mean there is a serious problem, but seeing a doctor or nurse is the only way to know for sure.

When can I play sports or do my usual activities again? — Ask your doctor when you can play sports or do your usual activities again. It depends on your injury and symptoms.

How can head injuries be prevented? — To help prevent another head injury, you should wear a helmet when you ride a bike or motorcycle, or when you play sports where you could hit your head. You should also wear a seat belt every time you drive or ride in a car.

More on this topic

Patient education: Head injury in children and teens (The Basics)
Patient education: Concussion in adults (The Basics)
Patient education: Skull fractures (The Basics)
Patient education: Headaches in adults (The Basics)
Patient education: Vertigo (a type of dizziness) (The Basics)
Patient education: Seizures (The Basics)
Patient education: Coma (The Basics)
Patient education: Head injury observation in adults (The Basics)
Patient education: Moderate to severe traumatic brain injury (The Basics)

Patient education: Head injury in children and adolescents (Beyond the Basics)
Patient education: Vertigo (Beyond the Basics)
Patient education: Headache causes and diagnosis in adults (Beyond the Basics)
Patient education: Headache in children (Beyond the Basics)
Patient education: Seizures in children (Beyond the Basics)
Patient education: Seizures in adults (Beyond the Basics)