There are many possible causes for a head injury. Some common causes are bicycle accidents, automobile accidents, falls, and work-related injuries. Contact sports, especially football, are another common source of head injury. Other sports that place a person at risk for head injuries include:
almost any other contact sport
Head injuries are more common in an individual with:
an altered mental state as a result of drugs or disease
difficulty walking because of arthritis, leg injury, or neuromuscular disease
loss of balance or poor coordination from aging or disease
Symptoms & Signs
What are the signs and symptoms of the injury?
Symptoms of a head injury may include one or several of the following:
change in the level of consciousness
bleeding from a wound at the site of the injury
a bump or bruising at the site of the injury
fracture of the bone at the site of the injury
discharge from the nose, mouth, or ears, which may be clear or bloody
loss of consciousness
loss of memory for the event, also known as amnesia
difficulty paying attention
swelling around the eyes, or at the site of the injury
visual impairments, including blurred vision
changes in the size of the pupils of the eyes, or in their response to light
sleep disorders, including insomnia
fatigue, or lethargy
Diagnosis & Tests
How is the injury recognized?
A head injury can be diagnosed by a healthcare professional with a standard neurological exam and complete history. An EEG, or electroencephalogram, may be ordered to look for abnormalities in the brain waves.
Tests such as a cranial CT scan, X-ray, and cranial MRI may also be used to determine the amount of damage to the brain. Often, all tests will be normal because the injury is not severe enough to detect.
Prevention & Expectations
What can be done to prevent the injury?
Sports safety guidelines should be followed for children, adolescents, and adults. Helmets and seat belts are especially important in the prevention of head injuries.
Adults who have difficulty walking should use the proper equipment. Canes, crutches, walkers, or wheelchairs can lower the risk of falling. Homes should also be checked to see what devices are needed and what risks can be eliminated.
Treatment & Monitoring
What are the treatments for the injury?
Most head injuries require some first aid. The following steps are important when using first aid for a head injury:
The first thing to check is a person’s airway and breathing. If necessary, begin CPR, or cardiopulmonary resuscitation, right away.
Always consider a possible spinal cord injury when there is an injury to the head, especially if the person is unconscious. Support the head and neck, keep the head in line with the spine, and prevent movement.
Try to stop any bleeding by applying direct pressure to the wound with a clean cloth.
If there is a possible skull fracture, do not place too much pressure on the site of bleeding. Do not try to remove any objects from the wound. Cover the wound with sterile gauze and get medical help immediately.
If the wound is not deep, wash it with soap and warm water and let it dry.
If there is no suspected spinal cord injury, try to turn the head of a vomiting person to one side to prevent choking.
The emergency medical system should be contacted at once if:
there is severe bleeding
there are many facial cuts
there is a change in the person’s level of consciousness
the person is having trouble breathing
a spinal cord injury is suspected
Some important safety measures include:
Avoid removing a helmet from a person who may have a serious head injury. Leave the helmet in place and allow a healthcare professional to remove it.
Avoid washing a head wound that is very deep or bleeding heavily.
Refrain from removing any objects that are sticking out of a wound, especially if they are going very deep into the wound.
Avoid moving the person unnecessarily. Avoid shaking the person if he or she seems dazed or has a decreased level of consciousness. The person may have a spinal cord injury. The spinal cord may be further injured by movement.
Avoid picking up a child or any other person who has fallen and has signs of a head injury.
What are the side effects of the treatments?
It is important to avoid worsening of a spinal cord injury while treating the head injury. Significant airway swelling caused by other injuries to the face is another problem. It is important to keep checking the airway and the person’s breathing.
What happens after treatment for the injury?
After treatment for a minor head injury, the person will generally be at home. Follow-up care includes:
applying ice to areas of swelling
using over-the-counter pain medication, such as acetaminophen, as needed. Aspirin should be avoided because it interferes with normal blood clotting.
following the healthcare provider’s instructions about rest and vigorous activity
avoiding alcohol for at least 2 days after the head injury
reporting any new or worsening symptoms to the healthcare provider
Serious head injuries may require rehabilitation by a team of doctors, nurses, physical therapists, occupational therapists, speech therapists, and psychologists.