Health A-Z

Head injuries are damage to the scalp, skull, or brain caused by trauma. When it affects the brain, they’re called  a traumatic brain injury, or TBI. 

To most people, head injuries are considered an acceptable risk when engaging in sports and other types of recreational activities. But they’re dangerous. They can lead to permanent disability, mental impairment, and even death. There are steps you can take to lower the risk and protect yourself and your children.

Signs and symptoms of a concussion may show up immediately, or they can take hours or even days to show up. You don’t always lose consciousness with a concussion. A concussion causes changes in a person's mental status and can disrupt the normal functioning of the brain. Multiple concussions can have a long-lasting, life-changing effect.

 Signs of a TBI, like a concussion, include:

• Confusion

• Depression

• Dizziness or balance problems

• Double or fuzzy vision

• Feeling foggy or groggy

• Feeling sluggish or tired

• Headache

• Memory loss

• Nausea

• Sensitivity to light or noise

• Sleep disturbance

• Trouble concentrating

• Trouble remembering

Signs or symptoms that a head injury may be more than a concussion and requires emergency treatment include:

• Changes in size of pupils

• Clear or bloody fluid draining from the nose, mouth, or ears

• Distorted facial features

• Facial bruising

• Fracture in the skull or face

• Impaired hearing, smell, taste, or vision

• Inability to move one or more limbs

• Irritability

• Lightheadedness

• Loss of consciousness

• Low breathing rate

• Restlessness, clumsiness, or lack of coordination

• Severe headache

• Slurred speech or blurred vision

• Stiff neck or vomiting

• Sudden worsening of symptoms after initial improvement

• Swelling at the site of the injury

• Persistent vomiting

If you think you may have a concussion or suspect that someone else has one, the most important step to take is to prevent further injury. Stop whatever activity you are involved in and tell someone you think you may have been injured. Then get medical attention. If you're playing as part of a team, ask to be taken out of the game and tell the coach what happened. If a fellow player has signs of being confused or a sudden loss of coordination, be sure to report this to a coach. If you are coaching a team and you notice a potential injury, take the person out of the game, and see that the person gets medical care.

Receiving medical attention as soon as possible is important for any type of potentially moderate to severe TBI. Undiagnosed injuries that don't receive proper care can cause long-term disability and impairment. Keep in mind that although death from a sports injury is rare, brain injuries are the leading cause of sports-related deaths.

Symptoms should be closely monitored often with a moderate to severe injury. It may require an overnight stay in the hospital. A doctor may take X-rays to check for potential skull fracture and stability of the spine. In some cases the doctor may ask for a CT scan or an MRI to check on the extent of the damage that occurred. More severe injuries may need surgery to relieve pressure from swelling. 

If a child sustains a head injury, don’t automatically have them X-rayed. Monitor them carefully for age appropriate symptoms of a TBI such as confusion or behavioral change. Don’t give them medications, including aspirin, without advice from your doctors.

If the doctor sends you home with an injured person, they may instruct you to watch that person closely. That may involve waking the person every few hours to ask questions such as "What's your name?" or "Where are you?" to be sure the person is OK. Be sure you've asked the doctor and understand what symptoms to watch for and which ones require immediate attention.

Guidelines urge doctors not allow someone who has been injured to return to activity that involves risk of further injury until completely free of symptoms. Most teens recover within two weeks, while it may take younger children up to four weeks to recover. But symptoms of severe injury could persist for months or even years. A person with a moderate to serious injury will likely require rehabilitation that may include physical and occupational therapy, speech and language therapy, medication, psychological counseling, and social support.