FAQs: Head Trauma

If you or someone you love takes a good knock on the head—in a sports game, while skiing or riding, or during a fall, for instance—it is wise to understand the symptoms and first aid for head trauma. Your quick response could make a big difference in the person’s recovery.

What is head trauma? Serious head trauma ranges in severity from mild concussions, the most common and least serious type, to more serious brain injury, skull fractures, and intracranial hematomas. It takes specialized medical training and, sometimes, imaging tests to determine the difference and the specific type of each injury. 

What are the immediate symptoms of a mild concussion?  A concussion is a sudden temporary loss of normal mental function that occurs after a blow to the head. Symptoms may include brief loss of consciousness, periods of memory loss, vision disturbances (like blurry vision or “seeing stars”), headache, nausea, dizziness, and a period of confusion or delayed responses.

What if the symptoms are more serious? More concerning symptoms include prolonged loss of consciousness, seizures, repetitive speech, severe persistent headaches or confusion, repeated vomiting, and irritability. Call an ambulance right away if the person is experiencing any of these, or bleeding, trouble walking, double vision, or weakness in an arm or leg. Some of these symptoms overlap with those indicative of a stroke, so responding promptly is very important.

What will the doctor tell me to do? The treatment and advice you will receive depends greatly on the extent of the injury and age of the patient. Any person over age 65 should seek medical attention.  If there is a scalp laceration or bleeding, apply direct, firm pressure. If you are determined to have had a concussion, the doctor will recommend avoidance of strenuous activity and contact sports and some rest with gradual return to activity. Use the pain reliever acetaminophen for headache (rather than ibuprofen or aspirin, as they can cause bleeding), and make sure to avoid alcohol and recreational drugs. More serious injuries may require hospitalization, surgery, or other treatments.

How well do people usually recover? How well people recover depends on the severity of the injury. For instance, most people can recover after a single concussion very well and have no lasting effects. Multiple concussions, like those experienced by professional athletes, can cause long-term mental difficulties and may lead to permanent loss of function. Recovery from more serious brain injuries can be a slow process, taking months or years.

How can I prevent head trauma? Wearing a helmet when biking, skiing, snowboarding, skateboarding, or playing contact sports, like football or hockey, can reduce the risk of some more serious injuries. Make sure they fit, are well maintained, and are worn properly. Avoid head injuries, even when wearing a helmet, and stop play immediately when one has occurred. Also, taking steps to maintain strength and balance and preventing falls in older patients is critical.

Adam Cohen, MD, leads Emergency Medicine at Southwestern Vermont Medical Center, part of Southwestern Vermont Health Care, in Bennington.