Head Trauma (Head Injury)

Overview

Head trauma is any injury to the head, including the scalp, skull, and brain. It covers a wide spectrum, from a minor bump or cut on the scalp to a concussion or a severe, life-threatening brain injury with bleeding inside the skull.

Even when the outside of the head looks fine, the brain can still be hurt by the force of an impact or a sudden jolt. Because the brain controls vital functions, serious head trauma is a medical emergency. Recognizing warning signs early and getting prompt care can prevent permanent damage and save lives.

Symptoms

Symptoms range from mild to severe and may appear immediately or develop over hours.

• Mild: Headache, a brief dazed feeling, mild dizziness, a bump or bruise, and a small cut.
• Concussion: Confusion, brief memory loss, nausea, sensitivity to light, and feeling foggy.
• Serious (seek emergency care): Loss of consciousness, repeated vomiting, worsening or severe headache, seizures, unequal pupils, weakness or numbness, slurred speech, clear fluid or blood from the nose or ears, and increasing drowsiness or confusion.

In young children, watch for persistent crying, refusal to eat, and unusual irritability or drowsiness.

Causes

Head trauma results from a force applied to the head:

• Falls: The most common cause, especially in young children and older adults.
• Motor vehicle crashes: Including pedestrians and cyclists.
• Sports and recreation: Contact sports, cycling, and falls during activity.
• Assaults and violence.
• Struck by or against objects.

Risk Factors

• Very young or older age
• Participation in contact sports
• Use of alcohol or drugs that impair balance and judgment
• Not wearing seat belts or helmets
• Conditions or medications that increase fall risk or bleeding (such as blood thinners)

Diagnosis

Assessment focuses on the brain and ruling out bleeding or fractures:

• Neurological examination: Checking alertness, memory, pupils, strength, coordination, and reflexes; clinicians often use a standard scoring system to grade severity.
• CT scan of the head: The main test to detect bleeding, swelling, or skull fractures after significant injury.
• MRI: Sometimes used to assess subtle or ongoing brain injury.
• Observation: Monitoring for worsening symptoms over hours.

Treatment

Treatment depends on severity:

• Minor injuries: Rest, pain relief, wound care, and watching for warning signs at home.
• Concussion: Physical and mental rest with a gradual, guided return to activity.
• Serious injuries: Hospital care to control pressure inside the skull, prevent further damage, and treat bleeding or swelling; surgery may be needed to remove a blood clot or relieve pressure.
• Rehabilitation: Physical, occupational, and speech therapy after significant brain injury.

People sent home after a head injury should have someone watch them and return urgently if symptoms worsen.

Prevention

• Wear seat belts and use child car seats correctly
• Wear helmets for cycling, skiing, and contact sports
• Reduce fall hazards at home, especially for children and older adults
• Use handrails and grab bars where needed
• Avoid driving or using machinery while impaired

When to See a Doctor

Call emergency services or go to the nearest emergency department after a head injury if any of the following occur:

• Loss of consciousness, even briefly
• Repeated vomiting or a severe, worsening headache
• Seizures, confusion that worsens, or unusual drowsiness
• Weakness, numbness, slurred speech, or unequal pupils
• Clear fluid or blood draining from the nose or ears

People taking blood thinners should be evaluated even after a seemingly minor head injury.

Related Topics

Frequently Asked Questions

References

1. Centers for Disease Control and Prevention (CDC). Traumatic Brain Injury and Concussion.
2. Mayo Clinic. Traumatic brain injury — Symptoms and causes.
3. MedlinePlus, U.S. National Library of Medicine. Head injury — first aid.
4. National Institute of Neurological Disorders and Stroke (NINDS). Traumatic Brain Injury.