What are the common symptoms of a mild head injury?

Head injuries are common, and their severity can range from minor to serious. Often, head injuries are mild because the brain is protected by the hard casing of the skull. However, it is important to know the common symptoms of a mild injury and how to distinguish them from those requiring emergency care.

A head injury is defined as any trauma to the scalp, skull, or brain. These injuries can be closed, where the head sustains a forceful blow without the object penetrating the skull, or open (penetrating), where an object pierces the skull and enters the brain. Closed injuries are not necessarily less dangerous than open ones [2].

Symptoms of a mild head injury

After sustaining a head injury, some symptoms may appear that indicate it might be a mild injury. It is important to monitor these symptoms carefully, as serious symptoms can develop slowly over several hours or days [1].

• Mild headache: You may feel a dull ache in the head after the injury.
• Mild dizziness: A slight feeling of lightheadedness or imbalance.
• Nausea or a single episode of vomiting: Especially in children, a single episode of vomiting after a head injury may occur and is not necessarily a serious problem, but a healthcare provider should be consulted [1].
• Minor changes in consciousness: You may feel momentarily confused or disoriented.
• Fatigue or drowsiness: You may feel more tired than usual.

Even if the head looks fine on the outside, problems may occur due to bleeding or swelling inside the skull [1].

When does a head injury require emergency care?

It is essential to seek medical help immediately if any of the following symptoms appear, as they may indicate a moderate to severe head injury [1], [2]:

• Changes in level of consciousness: The person becomes extremely drowsy, loses consciousness even for a brief moment, or cannot be awakened [1], [2].
• Severe or worsening headache: A headache that gets worse or does not go away [1], [2].
• Repeated vomiting or nausea: If the person vomits more than once [1], [2].
• Seizures or convulsions: The occurrence of any seizure or convulsion [1], [2].
• Changes in pupil size: The pupils (the dark central part of the eye) are unequal in size [1], [2].
• Weakness or numbness: Inability to move part or all of an arm or leg, or weakness or numbness in the limbs [1], [2].
• Speech or behavioral problems: Abnormal behavior, slurred speech, or difficulty speaking [1], [2].
• Increased confusion or agitation: Increasing confusion, restlessness, or agitation [2].
• Severe bleeding from the head or face: Any heavy bleeding [1].
• Stiff neck: This may indicate a spinal injury [1].

First aid for head injuries

In cases of moderate to severe head injuries, call emergency services immediately. While waiting for medical help, follow these steps [1]:

• Check airway, breathing, and circulation: If necessary, begin rescue breathing and CPR.
• Stabilize the head and neck: If the person is unconscious but breathing and has a heartbeat, treat them as if they have a spinal injury. Stabilize the head and neck by placing your hands on both sides of the person's head, keeping the head aligned with the spine and preventing movement.
• Stop bleeding: Apply firm pressure with a clean cloth to the wound to stop any bleeding, unless you suspect a skull fracture. If the bleeding is severe, do not remove the blood-soaked cloth; place another cloth on top of it.
• Avoid direct pressure in cases of skull fracture: If you suspect a skull fracture, do not press directly on the bleeding site, and do not remove any debris from the wound. Cover the wound with a sterile gauze bandage.
• Handling vomiting: If the person is vomiting or about to vomit, to prevent choking, turn the person's head, neck, and body as a single unit while stabilizing the head and neck onto their side. This protects the spine, which you should always assume is injured in the case of a head injury.
• Apply ice packs: Apply ice packs to swollen areas (cover the ice with a towel so it does not touch the skin directly).

For more information about head injuries and how to deal with them, you can visit Head injuries: When is it a simple bruise and when does it require emergency care? (Arabic).

What to avoid

There are some actions to avoid when dealing with a head injury [1]:

• Do not wash a deep head wound or one that is bleeding heavily.
• Do not remove any object stuck in the wound.
• Do not move the person unless absolutely necessary.
• Do not shake the person if they appear dazed.
• Do not remove a helmet if you suspect a serious head injury.
• Do not pick up a child who has fallen and shows any sign of a head injury.
• Do not drink alcohol or use recreational drugs within 48 hours of a serious head injury.

Medical follow-up

Even in cases of mild injuries, it is recommended to contact a healthcare provider for medical advice and to monitor symptoms that may appear later. The healthcare provider will explain what to expect, how to manage any headaches, how to treat other symptoms, and when you can return to normal activities [1].

Medical references

• Head injury - first aid
• Head Injuries