A head injury refers to any trauma to the scalp, skull, or brain, ranging from a minor bump to a serious traumatic brain injury (TBI). A concussion is a mild form of TBI that occurs when a jolt causes the brain to move inside the skull, temporarily affecting normal function. Since internal damage is not always immediately obvious, every head injury must be taken seriously, as symptoms can sometimes be delayed. This guide helps determine when a hit to the head warrants immediate emergency medical attention and when it is safe to monitor the situation at home.
Immediate Danger Signs
Certain symptoms following a head injury are indicators of a medical emergency and require an immediate call to 911 or a visit to the emergency room. A loss of consciousness, even if brief, signals a significant impact and requires professional assessment. Difficulty staying awake, unconsciousness, or the inability to be easily awakened suggests a potentially severe injury.
Any sign of neurological decline is a red flag that must be addressed immediately. This includes seizures or convulsions, which involve uncontrolled shaking of the limbs. Sudden weakness, numbness, or decreased coordination on one side of the body can indicate bleeding or swelling putting pressure on the brain.
Changes in pupil size, such as one pupil appearing larger than the other, are a sign of increased pressure inside the skull. Clear fluid or blood draining from the nose or ears, or bruising around the eyes or behind the ears, can suggest a skull fracture or bleeding. Severe or repeated vomiting, especially multiple episodes, is another sign of internal pressure that should prompt an emergency visit.
Significant disorientation, slurred speech, or profound confusion are urgent signs of altered brain function. Any visible dent or depression in the skull, or a large, deep laceration to the scalp, also needs immediate medical evaluation. If any of these symptoms are present, seek emergency care immediately.
Persistent Symptoms Needing Urgent Care
Some symptoms are not immediately life-threatening but are persistent enough to require urgent medical assessment within 24 to 48 hours. A persistent headache that does not improve after taking over-the-counter pain medication warrants professional evaluation.
Dizziness or balance problems that linger for more than a few hours should prompt a visit to an urgent care center or clinic. These symptoms suggest an ongoing disruption to the brain’s vestibular system, which regulates balance. Persistent nausea, even without repeated vomiting, also indicates the brain is struggling to function normally.
Changes in sensory perception, such as heightened sensitivity to light or noise, are common concussion symptoms that warrant medical review. Other symptoms requiring urgent follow-up include changes in sleep patterns, such as insomnia or sleeping much more than usual. Persistent irritability, anxiety, or noticeable changes in personality or behavior also indicate the brain needs a professional diagnosis.
Safe Monitoring and Home Care
For a minor bump without any immediate danger signs, monitoring at home is appropriate, provided symptoms are mild and temporary. A slight, temporary headache, minor scalp bruising or swelling, or brief lightheadedness that resolves quickly are generally safe to watch. Applying a cold compress to the injury site for 10 to 20 minutes can help reduce swelling and pain.
The injured person must be closely monitored by a responsible adult for at least the first 24 hours. It is safe for the person to sleep, but the caregiver should check on them periodically, ensuring they are easy to wake and respond normally. Avoiding strenuous physical activity, including sports, and intense mental exertion like excessive screen time is important to allow the brain to rest.
Avoid consuming alcohol, recreational drugs, or sleeping pills in the initial recovery period, as these can mask worsening symptoms or interfere with neurological function. If any new, severe, or persistent symptoms develop while monitoring at home, seek immediate medical attention. The goal of home care is rest and observation, maintaining a low threshold for seeking professional help if symptoms progress.
Medical Evaluation and Diagnosis Procedures
Once a patient arrives at the hospital with a suspected head injury, the medical team begins a structured evaluation to assess the injury’s severity. A neurological exam checks reflexes, balance, coordination, and mental status, including memory and concentration. The Glasgow Coma Scale (GCS) is a standard, 15-point test used to objectively assess the patient’s level of consciousness by evaluating eye-opening, verbal response, and motor response.
For patients presenting with signs of a moderate or severe TBI, or those with immediate danger signs, a Computed Tomography (CT) scan is typically the first imaging test performed. The CT scan is fast and effective at identifying acute, life-threatening issues such as skull fractures, internal bleeding (hemorrhage), blood clots (hematomas), and brain swelling. This imaging is used to quickly rule out conditions that require immediate neurosurgical intervention.
Magnetic Resonance Imaging (MRI) may be used later, often after the patient’s condition has stabilized, to provide more detailed images of the brain’s soft tissues. While a CT scan is the primary tool for acute trauma, MRI can sometimes detect more subtle changes that are not visible on a CT. The results from these evaluations guide the subsequent treatment plan, which may range from observation to surgical intervention.