Head Injuries: Symptoms, Headaches, and How to Manage Them

Symptoms Caused By a Head Injury

Johns Hopkins outlines the severity of head injuries well in the following:

Mild signs and symptoms

• A swollen area from a bump or a bruise

• Small, superficial (shallow) cut in the scalp

• Headaches

• Sensitivity to noise and light

• Irritability

• Confusion

• Lightheadedness and/or dizziness, nausea

• Problems with memory and/or concentration

• Change in sleep patterns.

• Blurred vision

• "Tired" eyes

• Ringing in the ears (tinnitus)

• Alteration in taste

• Fatigue or lethargy

  
  

Moderate to severe symptoms:

• Loss of consciousness

• Severe headache that does not go away

• Repeated nausea and vomiting

• Loss of short-term memory, such as difficulty remembering the events that led right up to and through the traumatic event  - Asking the same question over and over again

• Slurred speech

• Difficulty with walking

• Weakness in one side or area of the body

• Sweating

• Pale skin color

• Seizures or convulsions

• Behavior changes, including irritability

• Blood or clear fluid draining from the ears or nose

• One pupil (dark area in the center of the eye) is dilated or looks more significant than the pupil of the other eye and doesn't constrict or get smaller when exposed to light in a dimly lit room (this can be difficult to detect if there is outside light that typically changes pupil size)

• Deep cut or laceration on the scalp

• Open wound on the head

• A foreign object penetrating the head.

• Coma (a state of unconsciousness from which a person cannot be awakened; responds only minimally, if at all, to stimuli; and exhibits no voluntary activities)

A SPECIAL NOTE ABOUT HEADACHES CAUSED BY HEAD INJURIES

​After a head injury, a person can develop post-concussion syndrome. Typically, this appears the first 7-10 days after injury, so it may surprise you when you think someone is OK and out of the water, then suddenly begins to get neurologic symptoms a week after the injury.

Headache After a Fall

These headaches vary in nature, similar to a tension headache or sometimes a cluster headache. Pain is often described as dull and throbbing, frequently occurring around the temple, the forehead area, at the top and back of the head, behind the eyes, and at the place of impact. These headaches can last from days to months.

Head injuries occur on a spectrum from mild to severe. A concussion is usually on the milder end of the spectrum of a head injury.

-After a Head Injury

IF THERE IS ANY QUESTION ABOUT THE EXTENT OF A PERSON’S HEAD INJURY, GO TO THE EMERGENCY ROOM FOR A MORE EXTENSIVE EVALUATION AND TESTING (SCANS/MRI TO DETERMINE THE SEVERITY OF THE INJURY

Head Pain After an Injury

Head Injuries: Symptoms, Headaches, and How to Manage Them

-General Approaches to a Head Injury

• Someone should stay with this patient for at least 48 hours after the injury to observe for worsening symptoms, like changes in behavior.

• Lie down with your head and shoulders slightly elevated.

• Rest (usually about 24-48 hours, or longer until feeling better). Gradually return to regular activities.

• Avoid overexertion.

• Apply ice to the area of injury for 15 minutes at a time.

• Avoid bright lights, computers, televisions, and reading for the first 24-48 hours.

Over-the-Counter Treatments 

Acetaminophen (common: Tylenol) as directed over the counter. Avoid NSAIDS like ibuprofen and aspirin products for the first 24-48 hours, which can cause increased bleeding. Avoid medications that can cause a change in level of consciousness, particularly prescription pain medications (narcotics), unless prescribed by a practitioner after tests. Also, avoid antihistamines (which tend to make a person tired).

Natural Remedies: N/A

Prescriptions

These are rarely prescribed for an outpatient with a head injury because they can artificially change a person's sensorium. That is, it may change a person's level of consciousness, and it will be difficult to tell if any changes in behavior are due to the injury or due to the medication. You must be able to assess any change in a person's level of consciousness when they get a head injury. Additionally, many prescription pain medications can depress respirations; a head injury can do the same. A head injury victim needs to maintain optimal breathing, and for an observer to be able to detect a change in breathing patterns due to a head injury. If these are prescribed, it is typically done so after the victim has been cleared by radiologic testing.

Following Up...

• In general, symptoms in a person who has sustained a mild to moderate head injury, should improve within about 1-2 weeks. If they do not, a healthcare provider should be consulted. This is particularly true for persistent symptoms such as sleep disturbances, memory issues, behavioral issues or difficulty concentrating—a healthcare provider may recommend further treatment such as therapy or medication to manage these ongoing effects to support recovery.

• Those with moderate to severe head injuries should be followed regularly by a healthcare provider(s).

• For any questions or concerns

Note: The guidelines above, in Head Injuries: Symptoms, Headaches, and How to Manage Them, are for general guidance and should not replace medical advice. Always consult a healthcare professional for diagnosis and treatment.

Head Injury Q&A

Can you let someone with a head injury go to sleep?

“Back in the day,” they told us not to let these people sleep because you might miss a change in their level of consciousness. Now they say to let them sleep-they need sleep for recovery BUT check on their breathing status now and then – to check for normal breathing patterns.