George Chiampas, MD, assistant professor of emergency and orthopedic surgery, Northwestern University Feinberg School of Medicine, Chicago.
Hitting your head can give you anything from a headache to dangerous bleeding in the brain, and it’s not always easy to know how serious a head injury is. Here’s a quick guide to three common consequences of hitting your head.
The most common head injury is a concussion, a mild traumatic brain injury (TBI) that is caused when a blow or fall causes your brain to bounce or twist inside the skull. The motion can create chemical changes in the brain or damage brain cells. It can cause memory loss, difficulty concentrating, foggy thinking, anxiety, depression, or mood swings. Symptoms usually go away in a few weeks, but repeated concussions can cause lasting damage.
If your symptoms also include repeated vomiting, convulsions or seizures, a headache that gets worse or does not go away, slurred speech, dilated pupils, or limb weakness, you may have a moderate to severe TBI. These injuries can cause long-term symptoms that can be debilitating, including cognitive difficulties, muscle stiffness, vision problems, loss of fine motor skills, difficulty expressing ideas, problems with socialization, a loss of inhibition, and more.
The damage from hitting your head isn’t always apparent right away. “Sometimes people have a head injury and feel O.K., but progressively get worse,” says George Chiampas, MD. That can happen if you strike an artery in your brain and blood accumulates between the skull and the membrane that covers the brain (epidural hematoma). The bleed causes inflammation, but there’s no space inside the skull for the brain to expand. Emergency surgery can relieve the pressure, but left untreated, it can be fatal.
The risk of injury from hitting your head increases with age, Dr. Chiampas notes. As you get older, your brain atrophies and becomes smaller. As a result, the veins and blood vessels in your brain are stretched and more fragile, so a jarring injury to your head can injure your blood vessels and cause bleeding in your brain. Taking blood thinners increases the risk.
If you hit your head, pay attention to any symptoms that could suggest a concussion, such as sensitivity to noise and light, confusion, fatigue, irritability, and nausea. If you’re alone, call a family member or friend who can stay with you for 24 hours. Don’t drive during that time, and follow up with your physician in a day or two.
If you experience symptoms such as a worsening headache, trouble finding words, slurred speech, visual disturbances, or numbness or tingling in the arms or legs, don’t wait. These could signal an emergency, and you should be seen right away.
If you feel fine after the bump but begin to develop worsening or new symptoms later, immediately go to an emergency room. If you don’t have someone to drive you, call an ambulance. Do not drive yourself.
A health-care provider may check the pressure inside your skull and the level of oxygen getting to your brain. Surgery may be needed to relieve pressure, repair a fracture, or remove damaged tissue or blood clots.
Later, medications may be used to prevent blood clots and seizures or to address anxiety, depression, and mood changes. Some people may also need physical or occupational therapy to regain lost function.