Head Injury, Age 4 and Older

Head Injury, Age 4 and Older

British Columbia Specific Information

Knowing the signs and symptoms of a serious head injury will help you get the right care. Speak with a health care provider about the injury as soon as possible. If you think a head injury might be serious, call 9-1-1 or visit an emergency department right away. For non-emergency information or advice, call 8-1-1 to speak with a registered nurse any time of the day, every day of the year.

If your child’s health care provider finds no signs of a serious head injury, you may be advised to monitor your child in the hours, days and weeks following the injury. Only when your child’s health care provider advises you that it is safe for your child to go home in your care, follow the advice on caring for your child at home: Parachute: Concussion guide for parents and caregivers.

For more information about head injury, including concussion recognition, diagnosis, treatment and management, see:

Overview

Most injuries to the head are minor. Bumps, cuts, and scrapes on the head and face usually heal well and can be treated the same as injuries to other parts of the body. Minor cuts on the head often cause heavy bleeding. This is because the face and scalp have many blood vessels close to the surface of the skin. Often the injury is not severe, and you can stop the bleeding with home treatment.

Some head injuries are more serious. This is called a traumatic brain injury (TBI). A TBI can range from a mild concussion to a severe head injury. Common causes of a severe head injury include car crashes, falls, sports-related injuries, work-related injuries, and assaults and violent attacks. Adults age 65 or older, who have had a fall, need to be seen by a doctor right away, even if you don't see any symptoms. 

Anyone with a head injury should be watched, especially when it's from the above causes. If you think any symptoms are serious, see a doctor to be checked.

When a head injury has occurred, look for other injuries to other parts of the body that also may need attention. Trouble breathing, shock, spinal injuries, and severe bleeding are all life-threatening injuries that may occur along with a head injury and require medical attention right away. Injuries to the spine, especially the neck, must be considered when there has been a head injury. Be sure to check for other injuries to the face, mouth, or teeth when there is a head injury.

Check Your Symptoms

Have you had a head injury?
Yes
Head injury
No
Head injury
How old are you?
Less than 4 years
Less than 4 years
4 to 59 years
4 to 59 years
60 years or older
60 years or older
Are you male or female?
Male
Male
Female
Female

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Is the wound bleeding?
If you think the wound may need stitches, it's best to get them within 8 hours of the injury.
Yes
Bleeding wound
No
Bleeding wound
Would you describe the bleeding as severe, moderate, or mild?
Severe
Severe bleeding
Moderate
Moderate bleeding
Mild
Mild bleeding
Do you have symptoms of shock?
Yes
Symptoms of shock
No
Symptoms of shock
Do you think there could be a spinal cord injury?
Yes
Possible spinal cord injury
No
Possible spinal cord injury
Are there any signs that the head injury is serious?
These could appear at the time of the injury or later.
Yes
Symptoms of serious head injury
No
Symptoms of serious head injury
Did a seizure occur after the head injury?
Yes
Seizure after head injury
No
Seizure after head injury
Did the seizure occur within the past 2 days (48 hours)?
Yes
Seizure occurred within past 2 days
No
Seizure occurred within past 2 days
Is there a wound that goes through the skull, such as a knife or gunshot wound?
Yes
Penetrating wound
No
Penetrating wound
Are there any symptoms of a skull fracture?
Yes
Symptoms of skull fracture
No
Symptoms of skull fracture
Is there swelling anywhere on the head?
Swelling in certain areas of the head can be a sign of a skull fracture.
Yes
Swelling on head
No
Swelling on head
Is the only swelling a bump or "goose egg" on the forehead?
Swelling in any other area of the head, such as the temple area or the side or back of the head, could be more serious.
Yes
Only swelling is bump or goose egg on forehead
No
Only swelling is bump or goose egg on forehead
Did you pass out (lose consciousness) after the injury?
Yes
Lost consciousness after injury
No
Lost consciousness after injury
When did you pass out?
Within the past 24 hours
Loss of consciousness within past 24 hours
More than 24 hours ago
Loss of consciousness more than 24 hours ago
Was there a lot of force involved in the head injury?
Some examples are: 
  • A fall onto the head.
  • A hard blow to the head, a car crash or a forceful sports injury.  
  • A fall in which your head hits something hard, like concrete or ice.
Yes
A lot of force involved in head injury
No
A lot of force involved in head injury
When did the head injury occur?
Less than 24 hours ago
Injury occurred less than 24 hours ago
From 1 full day (24 hours) to 1 week ago
Injury occurred from 1 day to 1 week ago
More than 1 week ago
Injury occurred more than 1 week ago
Are you under the influence of drugs or alcohol right now?
Yes
Currently under the influence of alcohol or drugs
No
Currently under the influence of alcohol or drugs
Have you vomited more than once since the injury?
Yes
Vomited more than once after injury
No
Vomited more than once after injury
Do you suspect that the injury may have been caused by abuse?
This is a standard question that we ask in certain topics. It may not apply to you. But asking it of everyone helps us to get people the help they need.
Yes
Injury may have been caused by abuse
No
Injury may have been caused by abuse
Do you take a medicine that affects the blood's ability to clot?
This may include blood thinners and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. These medicines can cause bleeding and can make it harder to control bleeding.
Yes
Takes medicine that affects blood's ability to clot
No
Takes medicine that affects blood's ability to clot
Have you had any memory loss after the injury?
Yes
Memory loss after injury
No
Memory loss after injury
Have you been getting headaches?
Yes
Headaches
No
Headaches
Have the headaches been:
Getting worse?
Headaches are getting worse
Staying about the same (not better or worse)?
Headaches are unchanged
Getting better?
Headaches are getting better
Are there any other symptoms that may be related to the head injury?
Some symptoms may appear days or even more than a week after a head injury.
Yes
Other symptoms after head injury
No
Other symptoms after head injury
Are the symptoms:
Getting worse?
Symptoms are getting worse
Staying about the same (not better or worse)?
Symptoms are unchanged
Getting better?
Symptoms are improving
Have you had symptoms for more than 2 weeks after the injury?
Yes
Symptoms for more than 2 weeks after injury
No
Symptoms for more than 2 weeks after injury

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
HomeTreatment
RelatedInformation

Symptoms of a spinal cord injury in an adult or older child may include:

  • Severe neck or back pain.
  • Not being able to move a part of the body. (This is not the same as being unable to move because of pain or because of a direct injury to that area.)
  • Weakness, tingling, or numbness in the arms or legs.
  • New loss of bowel or bladder control.

Symptoms of a skull fracture may include:

  • Clear or bloody fluid draining from the ears or nose.
  • Bruising under the eyes or behind the ears.
  • Drooping of the face.
  • A dent anywhere on the head.

The symptoms of a skull fracture may appear at the time of the injury or hours or days later.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Feeling very dizzy or light-headed, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Symptoms of a serious head injury may include:

    • Passing out.
    • Confusion.
    • Repeated vomiting.
    • Worsening headache.
    • Extreme sleepiness.
    • Unsteady walking.
    • Slurred speech.
    • A difference in the size of the pupils of the eyes.
    • New vision problems.

Other symptoms related to a head injury that may appear later include:

  • Repeated episodes of feeling dizzy or light-headed.
  • Changes in mood or personality. For a baby or toddler, you may notice this as the child being a lot fussier than normal.
  • Changes in the ability to concentrate and listen.
  • Ringing in the ears.

With severe bleeding, any of these may be true:

  • Blood is pumping from the wound.
  • The bleeding does not stop or slow down with pressure.
  • Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may be true:

  • The bleeding slows or stops with pressure but starts again if you remove the pressure.
  • The blood may soak through a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be true:

  • The bleeding stops on its own or with pressure.
  • The bleeding stops or slows to an ooze or trickle after 15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.
HomeTreatment
RelatedInformation

Call 9-1-1 Now

Based on your answers, you need emergency care.

Call 9-1-1 or other emergency services now.

Sometimes people don't want to call 9-1-1. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 9-1-1 for medical transport to the hospital.

Call 9-1-1 Now

Based on your answers, you need emergency care.

Call 9-1-1 or other emergency services now.

Do not move the person unless there is an immediate threat to the person's life, such as a fire. If you have to move the person, keep the head and neck supported and in a straight line at all times. If the person may have a spinal injury from diving into the water and is still in the water, float the person face up in the water.

Sometimes people don't want to call 9-1-1. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 9-1-1 for medical transport to the hospital.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
HomeTreatment
RelatedInformation

Call 9-1-1 Now

Based on your answers, you need emergency care.

Call 9-1-1 or other emergency services now.

Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.

Sometimes people don't want to call 9-1-1. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 9-1-1 for medical transport to the hospital.

Head Injury, Age 3 and Younger

Self-Care

Many minor head injuries, such as bumps, cuts, and scrapes, can be treated at home. But anyone with a head injury should be watched. If you think that any symptoms may be serious, see a doctor for an evaluation.

Follow these steps to treat at home a minor head injury, such as a bump, cut, or scrape.

  1. Stay calm.

    If you or a loved one have an injury, try to stay calm. This will help reduce everyone's anxiety and allow you to assess the situation.

  2. Stop any bleeding.

    Apply firm pressure directly over the wound with a clean cloth or bandage for 15 minutes. If the cut is deep and may have penetrated the skull, emergency treatment is needed.

  3. Use ice or cold packs.

    Apply ice or cold packs to reduce the swelling. A "goose egg" lump may appear anyway, but ice will help.

  4. Check for other injuries.

    Check for injuries to other parts of the body, especially if a person has fallen. The alarm from seeing a head injury may cause you to miss other injuries that need attention.

  5. Relieve pain.

    You may be able to relieve pain from a minor head injury. Ask the doctor if your child can take an over-the-counter pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Be safe with medicines. Read and follow all instructions on the label.

  6. Watch for symptoms.
    • Call 9-1-1 or go to an emergency room right away if unconsciousness or seizure activity develops.
    • Seek medical care right away, usually in the emergency room, if you notice symptoms of a concussion. These include vomiting, a severe headache, blurred or double vision, confusion, or unsteadiness.

Signs of possible abuse

Most injuries are not caused by abuse. But bruises are often the first sign of possible abuse. Suspect physical abuse of a child or vulnerable adult when:

  • Any injury cannot be explained or does not match the explanation.
  • Repeated injuries occur.
  • Explanations change for how the injury happened.

You may be able to prevent further injuries by reporting abuse. Seek help if:

  • You suspect child abuse or elder abuse. Call your local child or adult protective agency, police, or a health professional, such as a doctor, nurse, or counsellor.
  • You or someone you know is a victim of intimate partner violence (IPV).
  • You have trouble controlling your anger with a child or other person in your care.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

  • Seizure.
  • New or worse swelling or bleeding.
  • New or worse headache. (A baby with a headache may cry and be fussy.)
  • New or worse nausea or vomiting.
  • New trouble waking up or extreme sleepiness.
  • New or worse confusion or not acting normally.
  • New or worse weakness in any part of the body.
  • Symptoms occur more often or are more severe.

Learn more

Preparing For Your Appointment

You can help your doctor diagnose and treat your condition by being prepared for your appointment.

Credits

Adapted ByHealthLink BC
Adaptation Reviewed ByHealthLink BC
Adaptation Date6/14/2023