What are the typical signs or symptoms associated with a deteriorating head injury?

Any injury you receive to your head, that does not go through the skull, is a closed head injury. Closed head injuries can range from minor injuries to devastating, life-threatening major injuries. Count on our experts to help you when you need it the most.

Closed head injury can cause broken bones to the skull or face, as well as significant damage to the brain. The damage to the brain can be in the form of bruising of the brain, or a concussion, or can cause bleeding in or around the brain, a intracranial hemorrhage.

Causes of closed head injury / concussion

The most common causes of a closed head injury are: 

• Falls, from height or from standing can cause significant injuries
• Sports injuries, commonly from contact sports such as boxing, wrestling, football, hockey
• Car or motorcycle accidents
• Bike accidents

Symptoms of a closed head injury / concussion

Symptoms depend on the type of injury a person has and how severe it is. People with a mild closed head injury, such as a bump on the head, might not have any symptoms. Symptoms include:

• A headache, could be at the area of impact or over the entire head
• Nausea or vomiting
• Vision or hearing problems
• Swelling, bleeding, or bruising on the scalp or around the face or eyes
• Blood or clear fluid draining from inside the ears or the nose: this could be a sign of fractured skull
• Dizziness or feeling lightheaded
• Confusion or memory problems: some people can have trouble remembering the accident, and in more severe cases they may have difficulty remembering things from before the accident
• Difficulty concentrating on tasks or difficulty paying attention
• Feeling tired
• Mood or behavior changes, or feeling easily irritated
• Difficulty walking, or difficulty keeping their balance
• Difficulty speaking
• Seizures – Seizures are waves of abnormal electrical activity in the brain. They can make you pass out, or move or behave strangely.
• Passing out or losing consciousness
• Being overly sensitive to bright lights or noises

Symptoms can start right after a closed head injury, or a few hours or days later. Some people have symptoms that last a short time only. Other people have symptoms that cause long-lasting problems, lasting for weeks or months.

In cases of severe head injury, a person can be in a coma and may need mechanical life support.

If you have had a head injury and have any of the symptoms listed, seek immediate medical attention.

Testing for closed head injury

If you have significant head injury, or your doctor suspects you have any fractures, he or she will want to do testing to check for serious injuries. He or she will do an examination and ask questions to test your thinking and memory.

If we have concerns that you have a serious injury, we will order imaging test of your brain, such as a CT or MRI scan. These tests create pictures of your skull and brain. These images allow us to check for bleeding in or around your brain or broken bones associated with a head injury.

With a concussion, your imaging can be normal, but you still have significant symptoms.

Treatment for closed head injury

Treatment depends on your injury and how serious it is.

Hospital treatment 

If you have a more significant injury, such as bleeding around the brain or skull or facial bone fractures, we treat you in the hospital. This allows us to closely observe you for conditions that may be worsening. If there is bleeding around the brain, this can continue to enlarge. With a brain injury, it may swell, like any other part of the body. But because your hard skull surrounds your brain, there is not space for enlargement. When you have excess fluids in the skull, it can cause extreme pressure on your brain. This can cause permanent brain damage. Injury to the brain can also cause seizures, which in turn can cause more damage to the brain. The length of your hospital stay depends on the severity of your injury, as well as your age, other injuries and severity of symptoms.

Treatment often includes:

• Brain rest with minimal brain stimulation
• Medications to prevent seizure
• Medications to help with the headaches
• Physical and occupational therapy to assist with walking and balance
• Speech therapy to help regain cognitive brain function or higher level thinking skills, assist in regaining memory, speech, concentration, etc.

If we need to treat you in our Intensive Care Unit (ICU), it is becuase you have a significant injury or more serious symptoms.

In some of the worst cases of severe bleeding, we may do surgery to open your skull and remove the blood around the brain. This is meant to prevent further brain injury.

Home treatment 

Most of the time, your symptoms go away after a short time and you can leave the hospital after a few hours. Mild closed head injuries do not need treatment. Your doctor will tell you what medications you can take, and those to avoid, to help treat the symptoms. Your doctor will also recommend someone be with you at home for 24 hours to make sure your symptoms don’t worsen.

You should seek medical attention immediately if you have any of the following:

• Your headache gets worse or you have any vision changes.
• You are vomiting.
• Your thinking or behavior changes, if you are becoming more confused.
• You can’t walk or speak normally.
• You have a seizure.

Plus, the person watching you should call the doctor or nurse if he or she can’t wake you up. This could be a sign that a more serious injury is developing.

If you fall asleep, he or she needs to wake you up every few hours to make sure that you can wake up. If your symptoms get worse, you need them to bring you to an Emergency Room immediately.

Help your brain heal

To help your brain heal after a concussion, you can:

• Rest your body – Make sure to get plenty of sleep. When you are awake, you should avoid heavy exercise or too much physical activity.
• Rest your brain – Avoid doing activities that need concentration or a lot of attention.
• Not drink alcohol after the injury until your symptoms have resolved.
• Take a pain-relieving medicine, if you have a headache – You can choose one with acetaminophen (sample brand name: Tylenol®) or ibuprofen (sample brand names: Advil®, Motrin®).

Recovery after closed head injury / concussion

The severity of symptoms of a closed head injury or concussion can vary with each patient. Some people have mild symptoms with a headache and others have more significant symptoms. Your symptoms will resolve with time, but exactly how long that will take is different for everyone. It could be days to weeks or it could take months to resolve. Some of the symptoms may never go away entirely.

You will need clearance from your doctor before participating in any contact sports or activities where you risk falling. The timing of this depends on your symptoms and the severity of the injury.

It is very important to prevent head injuries in the future. After you have had a concussion, your brain is more sensitive, and a new head injuries can cause more significant damage. The damage to the brain from head injuries is additive or worse than the one before it.

To prevent future head injuries you should wear a helmet when participating in any sport where a helmet is available. These include football, hockey, skiing and snowboarding, horse-back riding, riding bicycle or motorcycle. Also, always wear a seat-belt when riding in a vehicle.

Learn more about traumatic brain injuries