What features of head injury are there?
Symptoms of damage or bleeding may not develop for some hours, or even days, after a knock to the head. In rare cases, symptoms from a slow bleed can develop even weeks after a head injury.
If you develop any of the following you need to seek immediate medical help:
- Drowsiness when you would normally be wide awake (but see below).
- The injury was associated with loss of consciousness or penetrating injury to the head.
- Worsening headache - which does not go away with paracetamol (but see below).
- Confusion, strange behaviour, and any problems with understanding or speaking.
- Inability to remember events before or after the head injury.
- Unresolving headache.
- Being sick (vomiting).
- Loss of use of part of the body - for example, weakness in an arm or a leg.
- Dizziness, loss of balance or walking strangely.
- Fitting (convulsions) or collapse followed by feeling strange afterwards.
- Any visual problems, such as blurring of vision or double vision.
- Blood or clear fluid leaking from the nose or ear.
- New deafness in one or both ears.
- Unusual breathing patterns.
Also, if you have a history of bleeding easily, or are taking medications which thin the blood or, you have previously had brain surgery, you will need immediate help.
If none of the above is present, your doctor may still send you to be assessed in accident and emergency. Your doctor will do this if there are any concerns regarding the diagnosis, there is altered behaviour or irritability (particularly in children) or there is no one to be with you for the first 24 hours of the head injury.
A note about drowsiness
After a knock to the head, children will often cry, be distressed and then settle down. It is then quite common for them to want to sleep for a short while. This is normal. However, it will appear to be a normal 'peaceful' sleep, and they wake up fully after a nap.
Some parents are afraid to let their children go to sleep if the accident happens just before bedtime. Do let them. Drowsiness means they cannot be roused. If you have a concern, wake the child up after an hour or so. They may be grumpy about being woken up but that is reassuring. You can then let him or her go back off to sleep again. You can do this a few times during the night if there is particular concern. When asleep, check to see that he or she appears to be breathing normally and is sleeping in a normal position.
Some paracetamol or ibuprofen will help. It is a headache that becomes worse and worse which is of more concern.
What other symptoms of head injury might occur?
Some people develop some mild symptoms after a head injury that are not serious and usually go away within two weeks. These can include:
- A mild headache.
- Feeling a bit sick without being sick (vomiting).
- Being irritable and grumpy.
- Poor appetite.
- Some difficulty concentrating.
These may develop just as a reaction to a knock on the head and not due to bleeding or serious injury. However, if you have any doubt about a symptom following a head injury then it is best to get it checked out by a doctor as soon as possible. Also, see a doctor if you feel that you have not completely recovered after two weeks.
Further reading and references
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