Head injury Health Article

Symptoms

The symptoms of a head injury can occur immediately or develop slowly over several hours or days. Even if the skull is not fractured, the brain can bang against the inside of the skull and be bruised. The head may look fine, but complications could result from bleeding or swelling inside the skull.

When encountering a person who just had a head injury, try to find out what happened. If he or she cannot tell you, look for clues and ask witnesses. In any serious head trauma, always assume the spinal cord is also injured.

The following symptoms suggest a more serious head injury -- other than a concussion or contusion -- and require emergency medical treatment:

• Changes in, or unequal size of pupils
• Convulsions
• Distorted features of the face
• Fluid draining from nose, mouth, or ears (may be clear or bloody)
• Fracture in the skull or face, bruising of the face, swelling at the site of the injury, or scalp wound
• Impaired hearing, smell, taste, or vision
• Inability to move one or more limbs
• Irritability (especially in children), personality changes, or unusual behavior
• Loss of consciousness, confusion, or drowsiness
• Low breathing rate or drop in blood pressure
• Restlessness, clumsiness, or lack of coordination
• Severe headache
• Slurred speech or blurred vision
• Stiff neck or vomiting
• Symptoms improve, and then suddenly get worse (change in consciousness)

First Aid

Get medical help immediately if the person:

• Becomes unusually drowsy
• Behaves abnormally
• Develops a severe headache or stiff neck
• Loses consciousness, even briefly
• Vomits more than once

For a moderate to severe head injury, take the following steps:

1. Call 911.
2. Check the person's airway, breathing, and circulation. If necessary, begin rescue breathing and CPR.
3. If the person's breathing and heart rate are normal but the person is unconscious, treat as if there is a spinal injury. Stabilize the head and neck by placing your hands on both sides of the person's head, keeping the head in line with the spine and preventing movement. Wait for medical help.
4. Stop any bleeding by firmly pressing a clean cloth on the wound. If the injury is serious, be careful not to move the person's head. If blood soaks through the cloth, DO NOT remove it. Place another cloth over the first one.
5. If you suspect a skull fracture, DO NOT apply direct pressure to the bleeding site, and DO NOT remove any debris from the wound. Cover the wound with sterile gauze dressing.
6. If the person is vomiting, roll the head, neck, and body as one unit to prevent choking. This still protects the spine, which you must always assume is injured in the case of a head injury. (Children often vomit ONCE after a head injury. This may not be a problem, but call a doctor for further guidance.)
7. Apply ice packs to swollen areas.

For a mild head injury, no specific treatment may be needed. However, closely watch the person for any concerning symptoms over the next 24 hours. The symptoms of a serious head injury can be delayed. While the person is sleeping, wake him or her every 2 to 3 hours and ask simple questions to check alertness, such as "What is your name?"

If a child begins to play or run immediately after getting a bump on the head, serious injury is unlikely. However, as with anyone with a head injury, closely watch the child for 24 hours after the incident.

Over-the-counter pain medicine, such as acetaminophen, may be used for a mild headache. DO NOT take aspirin, ibuprofen, or other anti-inflammatory medications because they can increase the risk of bleeding.