Head Injuries And Concussion

Overview

A head injury is any bump, knock, or blow to your head. It can be mild, like a small bruise, or more serious, like a bleed inside the skull. A concussion is a type of mild head injury that affects how your brain works for a short time. It happens when the brain gets shaken inside the skull. Most people with a concussion feel better within a few weeks with rest and a slow return to normal life.

Yes, head injuries are very common. They are one of the most frequent reasons people go to an emergency department or see their doctor. Concussion in particular is common in sport, at home, and after falls.

Anyone can get a head injury, at any age. Young children, teenagers in contact sports, people who play sport, older adults who are more likely to fall, and people who drink a lot of alcohol are among those most often affected.

Symptoms

Common symptoms

• Headache, often worse in the first few hours
• Feeling sick or being sick
• Dizziness or problems with balance
• Feeling confused, or struggling to remember what happened just before or after the injury
• Trouble concentrating or thinking clearly
• Blurred vision or eyes that feel tired quickly
• Feeling sleepy, or finding it hard to sleep
• Being more sensitive to light or noise
• Feeling tired, irritable, anxious, or low in mood
• A short loss of memory about the injury itself

Symptoms in children

• Crying more than usual, or being hard to comfort
• Being unusually sleepy, or hard to wake
• Not feeding or eating as normal
• Being sick more than once
• Being fussy, clingy, or very quiet and still
• Changes in behavior or play, or losing skills they had
• Complaining of a headache, or saying their head or neck hurts
• A lump or swelling on the head, or a cut

Symptoms in older adults

• Symptoms may be less obvious and can be mistaken for normal aging
• New confusion or memory problems after a bump, even a small one
• A headache that keeps getting worse
• New problems with walking, balance, or weakness on one side
• Being on blood-thinning medicine makes any head knock more serious, even if you feel fine
• Falls are the most common cause, so a head injury may be found after a fall

Causes

Main causes

• Falls, especially at home, in young children, and in older adults
• Road traffic crashes, including cycling and motorbike crashes
• Sports injuries, particularly contact sports like rugby, football, and boxing
• Being hit by an object, or banging your head on something hard
• Assault or violence
• Work accidents, such as falls from height

Risk factors

• Not wearing a helmet when cycling, skating, riding a motorbike, or doing certain sports
• Drinking a lot of alcohol or using drugs, which affects balance and judgment
• Taking blood-thinning medicine, or having a condition that makes you bleed more easily
• Having had a concussion before, especially recently
• Being very young or older, where falls and bumps are more common
• Playing contact or high-speed sports
• Poor lighting, clutter, loose rugs, or uneven floors at home
• Problems with vision, balance, or muscle strength that make falls more likely

When to see a doctor

See a doctor urgently if:

• You were knocked out, even briefly
• You have vomited more than once
• You cannot remember what happened around the injury
• Your headache is getting worse
• You feel confused, or others say you are not yourself
• You have a seizure or fit
• You have weakness, numbness, or trouble speaking
• You take blood-thinning medicine and have hit your head
• You have a severe cut on your head, or a large swelling
• Your baby or child is unusually sleepy, is hard to wake, or is not feeding

Book a routine appointment if:

• Symptoms such as headache, foggy thinking, or tiredness are not improving after about 10 to 14 days
• You are finding it hard to return to work, study, or sport
• You keep getting headaches, dizziness, or trouble sleeping
• You feel low, anxious, or easily upset after the injury
• You want advice on returning to sport safely

Diagnosis

A doctor will usually ask what happened, how you felt straight after the injury, and whether you were knocked out or lost memory. They will check your symptoms, look at the injury, and do a short nerve and balance exam. They will also ask about medicines you take and whether you have had head injuries before. This is usually enough to diagnose a concussion. Most people do not need a brain scan.

Tests that may be done

• Questions about the injury and your symptoms, often using a simple symptom checklist
• A physical and nerve exam: checking your pupils, strength, coordination, speech, and memory
• Checking your balance and how you walk
• A CT scan of the head, but only if there are warning signs or a higher risk of bleeding
• An MRI scan, in a small number of cases, if symptoms continue or the picture is unclear
• Observation in a hospital or emergency department for a few hours, for some people

What to expect at your appointment

In most cases, you can go home after being checked. You may be given written advice about warning signs to watch for over the next 24 to 48 hours. Someone should stay with you for that time if possible. If you had a scan, you will usually get the result the same day. If your symptoms continue, your family doctor can review you and arrange support.

Treatment

For most head injuries, the treatment is simple: rest for a short time, then a slow and steady return to normal life. Rest means avoiding hard physical or mental effort for the first day or two, not lying in a dark room for weeks. After that, gentle activity, good sleep, and a step-by-step return to work, school, or sport works best. If you have a more serious injury, such as bleeding in the brain or a skull fracture, you will be cared for in hospital.

Self-care at home

• Rest for the first 24 to 48 hours, then start light daily activity such as short walks
• Build up slowly. If symptoms get worse, take a step back and try again the next day
• Sleep well. Keep regular sleep and wake times, and avoid long daytime naps after the first day or two
• Ask a pharmacist or doctor before taking any painkiller, and tell them about the injury
• Avoid alcohol and recreational drugs while you recover
• Limit screen time and loud or busy places at first, then build back up
• Write things down or use reminders if your memory feels foggy
• Ask someone to stay with you for the first 24 hours, and know the warning signs to watch for
• Do not drive until you feel fully back to normal and have been told it is safe. Check the rules for your country
• Do not go back to contact sport until a doctor or qualified sports clinician says it is safe

Medical treatments

Care depends on how serious the injury is. For a mild injury, your doctor will give advice, check your symptoms, and see you again if needed. They may suggest simple pain relief that is right for you, and they may ask you to avoid certain everyday painkillers for a short time because of bleeding risk. If symptoms last, they can refer you to a service that helps with headaches, balance, or thinking and memory problems. Physiotherapy can help dizziness and balance. Some people benefit from a short period of talking therapy or support with mood and sleep. For more serious injuries, hospital teams monitor you closely and may involve brain and nerve specialists.

When is surgery considered?

Surgery is only needed for a small number of head injuries, such as a bleed inside the head that is pressing on the brain, a badly broken skull, or a wound that needs repairing. Brain and nerve surgeons (neurosurgeons) carry out this kind of operation in a specialist hospital. Most people with a head injury never need surgery.

Living with this condition

Recovery is usually a series of small steps forward, with some good days and some harder ones. Plan short bursts of activity with rests in between. Go back to work or school gradually, perhaps with shorter days at first. If you can, tell your employer, teacher, or coach about the injury so they can support you.

Lifestyle tips

• Keep a steady routine with regular meals, sleep, and gentle activity
• Build activity up in steps rather than all at once
• Avoid alcohol until you are fully recovered, as it slows recovery and raises the risk of another injury
• Take breaks from screens, noisy places, and long periods of concentration
• Follow any graded return-to-sport plan, and get medical clearance before contact sport
• Wear a helmet and take care to prevent another head injury while you recover

Diet and exercise

Eat regular, balanced meals and drink enough water. Light exercise such as walking or easy cycling is encouraged early on and often helps symptoms. Start with short walks and build up gently. Avoid heavy weights, contact sport, and anything that could cause another blow to the head until you are cleared. If exercise makes symptoms clearly worse, ease off and try a smaller amount the next day.

Mental health and emotional wellbeing

It is common to feel worried, frustrated, irritable, or low after a head injury. Symptoms can be invisible to others, which can feel lonely. These feelings usually improve as you get better, but tell your doctor if they continue or are affecting your daily life. Talk to family and friends about what you need. If you ever have thoughts of hurting yourself, contact your local emergency number or a crisis support line in your country straight away.

Prevention

Not every head injury can be avoided, but many can. Small changes at home, on the road, and in sport make a real difference. This matters most for people who have already had a concussion, because a second injury before you recover is more serious.

Vaccines

Vaccines do not prevent head injuries. However, keeping up with routine vaccinations helps prevent infections that can be more serious after an injury.

Screening programmes

There is no routine screening test for head injuries. The key is to know the warning signs and get checked if you are worried, especially after a fall in an older adult or a head knock in a child.

Complications

If left untreated

• Bleeding or swelling inside the head, which can be life-threatening if warning signs are missed
• Symptoms that last longer than expected, sometimes called post-concussion symptoms, such as headaches, dizziness, and poor concentration
• A second head injury before you have recovered, which can be much more serious than the first
• Ongoing problems with sleep, mood, thinking, or balance
• Rarely, a higher chance of seizures after a serious injury
• Problems returning to work, study, or sport

Long-term outlook

The outlook is good for most people. The great majority of adults and children feel back to normal within a few weeks of a concussion. A small number take longer, and that can be frustrating, but most still improve over time with the right support. If symptoms continue, ask your doctor for help and further assessment. Recovery is a process, and there is support available along the way.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.