Head Injury

ExitCare ImageThe head may be injured, even if there are no obvious signs of injury. Obvious signs of injury include, loss of consciousness (being "knocked out"), or physical signs, such as an open wound (the skin is broken) or bruising (ecchymosis).


  • Symptoms depend on the extent of injury.

  • The seriousness of a head injury is not related to the presence of physical signs, such as swelling.

  • Headache.

  • Nausea and vomiting.

  • Drowsiness.

  • Memory loss (amnesia).

  • Vision problems.

  • Confusion or irritability.

  • Pupils of different size.

  • Pupils that do not react to light.

  • Loss of consciousness, either temporary or for long periods.

  • Bleeding of the scalp, if the skin is broken.


The most common cause of head injury is direct hit (trauma) to the head. Common causes of this injury include: motor vehicle crashes, falls, or tackling with the head (football).


  • Contact sports (i.e. football, boxing), riding bicycles, motorcycles, or horses without a helmet.

  • Seizure disorders.

  • Drinking alcohol.

  • Use of mind-altering drugs.


  • Wear properly fitted and padded protective headgear.

  • Do not drink alcohol or use mind-altering drugs and drive.


If treated early, most head injuries can be cured. However, certain problems involved with head injuries can be life threatening.


  • Subdural hemorrhage or epidural hematoma (bleeding under the skull).

  • Concussion (injury to the brain).

  • Bleeding into the brain.


Any injury to the head should be evaluated by a medical professional, especially if the injury involves loss of consciousness or other symptoms noted above. Severe head injuries may require hospitalization and possible surgery, to relieve pressure on the brain. After evaluation, if you are sent to be watched at home, it is important to have someone else wake you up every 2 hours, for at least 24 hours following the injury. If the person is not able to wake you, or if there appears to be a change in your responsiveness, he or she must contact your caregiver immediately. This may be a sign of a more serious injury. Also, report any of the following symptoms: nausea, vomiting, inability to move arms and legs equally well on both sides, fever (above 100° F or 37.8° C), neck stiffness, pupils of unequal size or shape or reaction to light, convulsions, noticeable restlessness, severe headache that persists for longer than 4 hours after injury, confusion, disorientation, or mental status changes.


Do not take any medicines, unless advised by your caregiver. This includes over-the-counter pain medicines (i.e. ibuprofen, acetaminophen, aspirin).


  • Symptoms get worse or do not improve in 24 hours.

  • Any of the following symptoms occur:

  • Vomiting.

  • Inability to move arms and legs equally well on both sides.

  • Fever above 100° F (37.8° C).

  • Stiff neck.

  • Pupils of unequal size, shape, or reaction to light.

  • Convulsions (violent shaking).

  • Noticeable restlessness.

  • Severe headache that persists for longer than 4 hours after injury.

  • Confusion, disorientation or mental status changes.