Head Injury, Age 4 and Older

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1 Head Injury, Age 4 and Older Table of Contents Topic Overview Check Your Symptoms Home Treatment Prevention Preparing For Your Appointment Related Information Credits Topic Overview Head injury Most injuries to the head are minor. Bumps, cuts, and scrapes on the head and face usually heal well and can be treated the same as injuries to other parts of the body. Minor cuts on the head often bleed heavily because the face and scalp have many blood vessels close to the surface of the skin. Often the injury is not severe, and you can stop the bleeding with home treatment. Many head injuries can be prevented. Use seat belts and helmets, and make your home safe to prevent falls. Common causes of serious head injuries in adults include: Car crashes. Almost half of all head injuries occur during a car crash. Teens and young adults are more likely to be hurt in car crashes than other age groups. Falls, which are more likely to involve children younger than age 5 and adults older than age 60. Sports-related injuries and work-related accidents. Men have about twice as many head injuries as women. Sports-related injuries are very common but are not always reported. Assaults and violent attacks. Gunshot wounds are the leading cause of death from a head injury. Head injuries that involve force are more likely to cause a serious injury to the brain. A high-energy injury to the head increases the likelihood of a serious injury even more. Be sure to evaluate the person for signs and symptoms of a head injury after a fall or other type of head injury. It is sometimes hard to tell the difference between a concussion and a more serious head injury. A person with a concussion may appear dazed, stare blankly, or cry for no apparent reason. Nausea, vomiting, headache, or dizziness may be present. A visit to a

2 doctor is needed anytime mild symptoms persist. Even if a visit to a doctor is not needed, watch anyone who has had a head injury carefully for at least 24 hours to see whether signs of a serious head injury develop. Occasionally, after a head injury you may feel as if you are not functioning as well as you did before the injury (postconcussive syndrome). You may have blurred vision, headache, nausea, vomiting, forgetfulness, or trouble concentrating. Some people have problems with balance and coordination and personality changes. These changes may be related to stress from the events around the accident that caused the injury or from the injury itself. Many people have symptoms for as long as 3 months after a head injury, and some even have problems for as long as a year afterward. When a head injury has occurred, look for other injuries to other parts of the body that also may need attention. Trouble breathing, shock, spinal injuries, and severe bleeding are all life-threatening injuries that may occur along with a head injury and require immediate medical attention. Injuries to the spine, especially the neck, must be considered when there has been a head injury. Be sure to check for other injuries to the face, mouth, or teeth whenever there is a head injury. Check your symptoms to decide if and when you should see a doctor. Check Your Symptoms Have you had a head injury? How old are you? Less than 4 years 4 years or older Are you male or female? Male Female Is the wound bleeding?

3 If you think the wound may need stitches, it's best to get them within 8 hours of the injury. Would you describe the bleeding as severe, moderate, or mild? Severe Moderate Mild Do you have symptoms of shock? Do you think there could be a spinal cord injury? Are there any signs that the head injury is serious? These could appear at the time of the injury or later. Did a seizure occur after the head injury? Did the seizure occur within the past 2 days (48 hours)?

4 Is there a wound that goes through the skull, such as a knife or gunshot wound? Are there any symptoms of a skull fracture? Is there swelling anywhere on the head? Swelling in certain areas of the head can be a sign of a skull fracture. Is the only swelling a bump or "goose egg" on the forehead? Swelling in any other area of the head, such as the temple area or the side or back of the head, could be more serious. Did you pass out (lose consciousness) after the injury? When did you pass out? Within the past 24 hours More than 24 hours ago Was there a lot of force involved in the head injury? Some examples are a fall onto the head from more than a few feet, or a very hard blow to the head, such as in a car crash or a forceful sports injury.

5 When did the head injury occur? Less than 24 hours ago From 1 full day (24 hours) to 1 week ago More than 1 week ago Are you under the influence of drugs or alcohol right now? Have you vomited more than once since the injury? Do you think that the injury may have been caused by abuse? Have you had any memory loss after the injury? Have you been getting headaches? Have the headaches been: Getting worse? Staying about the same (not better or worse)? Getting better?

6 Are there any other symptoms that may be related to the head injury? Some symptoms may appear days or even more than a week after a head injury. Are the symptoms: Getting worse? Staying about the same (not better or worse)? Getting better? Have you had symptoms for more than 2 weeks after the injury? Home Treatment Home treatment for a head injury is only appropriate if there was no loss of consciousness or inability to recall current events (amnesia) after the injury. If either loss of consciousness or amnesia has occurred, check your symptoms to determine when to see your doctor. Immediately after a head injury: Check for: Seizure. Confusion or not acting normal. Ask the person his or her name, address, age, the date, location, and the name of the president. Severe irritability or wanting to fight. Inability to remember what happened just before or after the injury. Trouble speaking or slurred speech. Dizziness, lightheadedness, or unsteadiness that makes it hard to stand or walk. Symptoms that affect one side of the body more than the other side, such as numbness, weakness, or trouble moving. Loss of vision.

7 Vomiting. A severe headache. Abnormally deep sleep, trouble waking up, or extreme sleepiness. To stop any bleeding, apply firm pressure directly over the wound with a clean cloth or bandage for 15 minutes. If the cut is deep and may have penetrated the skull, emergency treatment is needed. Check for injuries to other parts of the body, especially if the person has fallen. The alarm of seeing a head injury may cause you to overlook other injuries that need attention. Apply ice or cold packs to reduce the swelling. A "goose egg" lump may appear anyway, but ice will help ease the pain. Be sure to follow any home care instructions from your doctor. If you have questions about the instructions, call your doctor. Minor head injuries Many minor head injuries that do not involve loss of consciousness or amnesia may be treated at home. A person who has had a head injury should be watched for any problems from the injury. Home treatment can also help relieve swelling and bruising of the skin or scalp and pain caused by a minor head injury. If a visit to your doctor is not needed immediately: Apply ice or cold packs to reduce the swelling. A "goose egg" lump may appear anyway, but ice will help ease the pain. You may use acetaminophen, such as Tylenol, to relieve a mild headache or pain from the injury. Watch Rest The injured person should be watched by a responsible adult for the next 24 hours. Call 911 or go to an emergency room immediately if unconsciousness or seizure activity develops. Seek medical care if any new symptoms, such as vomiting, a severe headache, blurred or double vision, or unsteadiness, develop after the injury (postconcussive syndrome). Rest is the best treatment for a concussion. Get plenty of sleep at night, and take rests during the day. If a mild to moderate headache develops, lie down and try to relax your entire body. Take only acetaminophen, such as Tylenol, to relieve a mild headache or pain from the injury. Do not use other nonprescription or prescription medicines for pain without approval from your doctor. Do not drink alcohol or use illegal drugs. Alcohol and illegal drugs can slow your recovery and increase your risk of a second head injury. If vomiting occurs: Wait 1 hour after the last episode of vomiting before taking liquid. After an hour, drink 4 fl oz (125 ml) of clear liquid every 20 minutes for 1 hour.

8 As you feel better, begin to eat small amounts of clear soups, mild foods, and liquids. Keep eating clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Gelatin dessert, dry toast, crackers, and cooked cereal are good choices. Recovery Return to your normal activities gradually. Don't try to do too much at once. Avoid activities that could lead to another head injury. If your head injury occurred during a sporting event, you should be evaluated for a concussion and cleared by a doctor before returning to play. Ask your doctor when it will be safe for you to drive a car or operate equipment, if that is a concern. Take only acetaminophen, such as Tylenol, to relieve a mild headache or pain from the injury. Do not use other nonprescription or prescription medicines for pain unless your doctor tells you to. Do not use alcohol until your doctor tells you that you are well enough to do so. Alcohol and illegal drugs can slow your recovery and increase your risk of a second head injury. Symptoms to watch for during home treatment Call your doctor if any of the following occur during home treatment: Bleeding increases. Other symptoms, such as confusion, speech or vision problems, vomiting, or headache develop. Symptoms become more severe or more frequent. Prevention Prevent injuries Wear your seat belt when in a motor vehicle. Use child car seats. Help your child prevent injury during sports and other activities. Do not use alcohol or other drugs before participating in sports or when operating a motor vehicle or other equipment. Wear a helmet and other protective clothing whenever you are biking, motorcycling, skating, skateboarding, kayaking, horseback riding, skiing, snowboarding, or rock climbing. Wear a hard hat if you work in an industrial area. Do not dive into shallow or unfamiliar water. Prevent falls in your home by removing hazards that might cause a fall. Do not keep guns in your home. If you must keep guns, lock them up and store them unloaded. Lock ammunition in a separate area.

9 Preparing For Your Appointment To prepare for your appointment, see the topic Making the Most of Your Appointment. Questions to prepare for your appointment You can help your doctor diagnose and treat your condition by being prepared to answer the following questions: When and how did the injury occur? Do you remember all the details before, during, and after the injury? If you do not remember, are there witnesses available who can tell you about the injury? How did you act after the head injury? Did you lose consciousness? If yes, for how long? What are your main symptoms? How long have you had symptoms? Have you ever had a concussion (traumatic brain injury) in the past? How long ago? How severe was it? How was it treated? Do you continue to have problems because of this injury? Was this injury intentionally caused by another person? What object caused the injury? Was there or is there an object in a cut on the head? What home treatment measures have you used to treat the head injury? Did they help? What prescription or nonprescription medicines do you use? If a cut or scrape occurred, is your tetanus immunization up-to-date? Were alcohol or drugs involved in the injury? Do you have any health risks? Related Information Cuts Credits By Healthwise Staff Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine Current as of May 27, 2016

10 te: The "printer friendly" document will not contain all the information available in the online document. Some information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

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