A head injury, whether from a fall, sports collision, or motor vehicle accident, requires a timely assessment of symptoms to determine the appropriate level of care. Deciding whether to go to the hospital emergency department hinges on this assessment. A delay in seeking medical attention for serious signs can lead to severe complications. Quick decision-making is paramount, requiring the distinction between expected, mild symptoms and “red flags” that signal a potentially life-threatening structural injury within the brain.
Defining a Concussion and Mild Symptoms
A concussion is a mild traumatic brain injury (mTBI) caused by a biomechanical force. This injury results in a temporary, functional disturbance of the brain, affecting how it works. It does not typically cause a visible, structural change like bleeding or bruising detectable by a standard CT scan. Common symptoms often appear immediately or within hours, usually resolving within a few days to a couple of weeks.
Initial mild symptoms include temporary confusion, feeling “foggy” or slowed down, or brief amnesia about the event. A mild headache, temporary dizziness, and feeling dazed are also frequently reported. These transient symptoms reflect the brain’s temporary disruption and do not usually necessitate an immediate emergency room visit.
Emergency Signs Requiring Immediate Hospital Care
Certain signs indicate a more severe traumatic brain injury, such as bleeding within the skull (intracranial hemorrhage) or a skull fracture. These “red flag” symptoms require immediate emergency medical care. Call emergency services or go to the nearest hospital immediately if these symptoms are present or begin to worsen over time.
A loss of consciousness lasting longer than 30 seconds is a serious indicator demanding hospital evaluation. Signals of increasing pressure inside the skull include a headache that dramatically worsens, a persistent and severe headache that does not ease, or repeated forceful vomiting (more than two times).
Neurological changes are also serious indicators. These include:
- The onset of a seizure or convulsions.
- Noticeable weakness or numbness on one side of the body.
- Highly concerning eye changes, such as having one pupil larger than the other or experiencing double vision.
- Difficulty waking the person up, slurred speech, or a sudden, dramatic change in behavior like increased agitation or confusion.
Symptoms Warranting Follow-Up Medical Consultation
If initial symptoms are mild and lack severe “red flags,” a hospital visit may not be necessary, but a follow-up consultation with a healthcare provider is recommended. This check-up is important if symptoms persist beyond the first few days or begin to interfere with daily life. Lingering symptoms often require professional diagnosis and management, even if the injury was initially mild.
Symptoms persisting for days or weeks include persistent low-grade headaches, cognitive fog, and difficulty concentrating. Emotional symptoms like increased irritability, sadness, or anxiety are common, as are sleep disturbances. If symptoms have not begun to subside within two to three weeks, or if they worsen, a medical consultation is necessary to rule out post-concussion syndrome and develop a targeted recovery plan.
Safe Monitoring and Home Care
Injuries that do not require immediate emergency care necessitate diligent monitoring and specific home care practices for safe recovery. A responsible adult should stay with the patient for at least the first 24 hours to monitor for any delayed onset of emergency “red flag” signs. Physical and cognitive rest is the foundation of recovery, but this does not mean complete isolation in a dark room.
Rest involves minimizing activities that worsen symptoms, including limiting screen time on phones, computers, and television, especially in the first 48 hours. Sleep is beneficial for brain healing; there is generally no need to wake the patient up every few hours after a medical assessment has deemed it safe. Acetaminophen can be used for headaches, but non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen should be avoided immediately afterward due to the potential for increased bleeding risk.