Head Injury

Overview

A head injury is any bump, blow, jolt or knock to your head. It can affect the skin and bone of your skull, or it can affect the brain inside. The most common type is a concussion — a short-term change in how the brain works after a knock. Most head injuries are mild and people recover fully, but some need medical checks, and a few are serious and need emergency care.

Yes. Head injuries are very common. They are one of the most frequent reasons people go to an emergency department or see their doctor, and most cases are mild.

Anyone can get a head injury, at any age. They happen most often in young children (from falls and play), in teenagers and young adults (from sport, cycling and road crashes), and in older adults (from falls, often while taking blood-thinning medicines).

Symptoms

Common symptoms

• Headache, or a feeling of pressure in the head
• Feeling dizzy, lightheaded or unsteady
• Feeling sick or being sick
• Feeling foggy, slowed down or 'not quite yourself'
• Trouble concentrating or remembering things that just happened
• Being more tired than usual, or sleeping more or less than normal
• Ringing in the ears or sensitivity to light and noise
• Blurred vision
• Mood changes — being irritable, tearful, anxious or easily upset

Symptoms in children

• Crying more than usual, or being hard to comfort
• Being unusually sleepy, floppy, or hard to wake
• Not feeding or drinking as normal
• Being sick (vomiting) more than once
• A bulging or tense soft spot on a baby's head
• Being unusually quiet, withdrawn or irritable
• A change in behaviour, or a seizure (fit)
• Any of the emergency signs listed below

Symptoms in older adults

• Confusion or new memory problems, which can be mistaken for getting older
• Symptoms that appear slowly, hours or even days after the fall
• Unsteadiness, or a new difficulty walking
• Headaches that get worse over time
• Higher risk of bleeding inside the head, especially if you take blood-thinning medicine

Causes

Main causes

• Falls — the most common cause overall, especially in young children and older adults
• Road crashes, including cycling and motorbike injuries
• Sports injuries, such as a clash of heads or a heavy fall in contact sports
• Being struck by an object, or hitting your head on something
• Assault or violence
• Workplace accidents, such as a fall from height

Risk factors

• Being very young (under 5) or older (over 65)
• Taking blood-thinning medicine, which makes bleeding inside the head more likely
• Drinking alcohol or using drugs, which affects balance and judgement
• Playing contact sports or cycling without a helmet
• Not wearing a seatbelt, or not using the right child car seat
• Poor balance, poor eyesight, or trip hazards at home
• Having had a head injury before

When to see a doctor

See a doctor urgently if:

• You or the person was knocked out, even for a second
• You are being sick, or feel very dizzy
• The headache is getting worse instead of better
• You cannot remember what happened
• You take blood-thinning medicine and have had any knock to the head
• A baby or young child has hit their head and is not acting like themselves
• You are not sure how serious it is — it is always fine to get it checked

Book a routine appointment if:

• Headaches, tiredness or poor concentration are still bothering you after a week or two
• You are struggling to return to work, school or sport
• You feel anxious, low, or not yourself since the injury
• You have questions about how to get back to exercise safely

Diagnosis

A doctor will start by asking what happened, whether you were knocked out, and how you have felt since. They will check your alertness, memory, balance, eyes, strength and speech. A short set of questions and simple tests help the doctor decide whether the injury is mild or whether you need a scan.

Tests that may be done

• Questions and checks about alertness, memory and orientation (sometimes called a Glasgow Coma Scale)
• Checking your pupils, eye movements and vision
• Testing strength, sensation, coordination and balance
• A CT scan (a special type of X-ray that shows the brain) if there is concern about bleeding or a skull fracture
• An X-ray or scan of the neck if there is neck pain or the injury involved a lot of force

What to expect at your appointment

For a mild injury, you may not need any scan. You may be watched for a few hours in the emergency department, or sent home with clear written instructions about what to look out for. If you go home, someone should stay with you for the first 24 hours and check on you now and then, including waking you gently to make sure you respond normally. If a scan is needed, it is quick and painless.

Treatment

Treatment depends on how severe the injury is. Most head injuries need rest, time, and a slow return to normal life. More serious injuries need hospital care and monitoring. The aim is to keep the brain safe while it heals and to catch any problems early.

Self-care at home

• Rest for the first 24 to 48 hours, but avoid long periods lying in a dark room — gentle, light activity is usually fine
• Have someone stay with you for the first 24 hours and check on you regularly
• Take simple pain relief only if your doctor or pharmacist says it is safe for you, and follow their advice
• Drink plenty of water and eat normally
• Avoid alcohol and recreational drugs until you feel fully better
• Go back to screens, reading and work slowly, in short bursts, and stop when symptoms build up
• Avoid contact sports and heavy exercise until you have been cleared by a healthcare professional
• Do not drive until you feel fully alert and have checked with your doctor

Medical treatments

In hospital, staff may watch you closely for some hours, checking your alertness, pupils and strength at regular intervals. Pain and sickness can be managed with medicines your doctor chooses for you. If scans show a bleed, a skull fracture or raised pressure inside the head, you may be moved to a specialist unit. After a more serious injury, a team including doctors, nurses, physiotherapists and occupational therapists can help with recovery. Your doctor will talk with you about any medicine, its purpose and what to expect.

When is surgery considered?

Surgery is only needed in a small number of cases — for example, to drain a pool of blood inside the head, repair a skull fracture, or relieve pressure on the brain. It is done in hospital by a specialist team, and your doctors will explain the reasons and risks clearly if it is being considered.

Living with this condition

Recovery is usually a bit up and down. You may feel fine one day and foggy the next. Plan shorter days, take breaks, and keep a simple routine for sleeping and eating. Build activity back gradually rather than all at once. It is helpful to write things down, use reminders, and ask people around you to be patient with you.

Lifestyle tips

• Keep a regular sleep routine — going to bed and getting up at similar times
• Avoid alcohol while you are recovering
• Return to exercise step by step — walking first, then gentle activity, then sport once you are cleared
• Break tasks into small chunks and take a short rest between them
• Ask family, friends or work colleagues for practical help while you recover
• Keep a short diary of symptoms so you can show your doctor how things are changing

Diet and exercise

Eat regular balanced meals and drink water through the day. Gentle walking is a good way to start moving again, and it often helps you feel better. Slowly increase activity over days and weeks. Avoid hard exercise, heavy lifting and contact sport until a healthcare professional says it is safe, because going back too fast can make symptoms last longer.

Mental health and emotional wellbeing

It is very common to feel anxious, irritable, tearful or frustrated after a head injury, and to worry about whether you will fully recover. These feelings usually settle as you improve, but they deserve attention. Talking to friends, family or your doctor helps. If you are feeling very low, hopeless, or having thoughts of harming yourself, please reach out for crisis support in your area straight away — you do not have to cope alone, and help is available. In the UK you can contact NHS 111 or your GP, and emergency services if you are in immediate danger.

Prevention

Many head injuries can be prevented. Helmets, seatbelts and safe home surroundings make a real difference, especially for children and older adults.

Vaccines

There is no vaccine for head injury. Staying up to date with routine vaccines is still good general health advice.

Screening programmes

There is no routine screening test for head injury. If you have had a head injury and symptoms are lingering, ask your doctor about a follow-up check.

Complications

If left untreated

• A bleed inside the head that is not noticed, which can become serious
• A skull fracture that is missed
• Symptoms that last longer than expected, such as headaches, poor concentration, dizziness and tiredness
• Sleep problems, irritability and low mood
• Rarely, seizures after a more serious injury
• Rarely, a second head injury soon after the first, which can be more dangerous

Long-term outlook

The outlook for most people with a head injury is good. Mild injuries usually settle within days to a few weeks, and even when symptoms linger, they nearly always improve with time, rest and a gradual return to activity. Serious injuries need more care, and recovery can take months — but specialist teams, rehabilitation and support from people around you make a real difference. If you are worried at any point, ask for help early.

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