Head Injury, Age 4 and Older

Home Treatment

Home treatment for a head injury is only appropriate if there was no loss of consciousness or inability to recall current events (amnesia) after the injury. If either loss of consciousness or amnesia has occurred, return to the Emergencies and Check Your Symptoms sections of this topic to determine when to see your doctor.

Immediately after a head injury:

• Check for:
  • Seizure.
  • Confusion or not acting normal. Ask the person his or her name, address, age, the date, location, and the name of the prime minister.
  • Severe irritability or wanting to fight.
  • Inability to remember what happened just before or after the injury.
  • Difficulty speaking or slurred speech.
  • Blurred or double vision.
  • Dizziness, light-headedness, or unsteadiness that makes it hard to stand or walk.
  • Symptoms that affect one side of the body more than the other side, such as numbness, weakness, or difficulty moving.
  • Significant changes in the pupils.
  • Vomiting that continues after the first 2 hours.
  • A severe headache or stiff neck that is getting worse or not improving after the first 4 hours.
  • Abnormally deep sleep, difficulty waking up, or extreme sleepiness.
• If there is bleeding, apply firm pressure directly over the wound with a clean cloth or bandage for 15 minutes. See how to stop bleeding. If the cut is deep and may have penetrated the skull, emergency treatment is needed.
• Check for injuries to other parts of the body, especially if the person has fallen. The alarm of seeing a head injury may cause you to overlook other injuries that need attention.
• Apply ice or cold packs to reduce the swelling. A "goose egg" lump may appear anyway, but ice will help ease the pain.
• Be sure to follow any home care instructions from your doctor. If you have questions about the instructions, call your doctor.

Minor head injuries

Many minor head injuries that do not involve loss of consciousness or amnesia may be treated at home. A person who has had a head injury should be watched closely for at least 24 hours after the injury. Home treatment can also help relieve swelling and bruising of the skin or scalp and pain caused by a minor head injury.

If a visit to your doctor is not needed immediately:

• Apply ice or cold packs to reduce the swelling. A "goose egg" lump may appear anyway, but ice will help ease the pain.
• You may use acetaminophen, such as Tylenol or Panadol, to relieve a mild headache or pain from the injury.

Watch

• Check for the following signs of a severe head injury immediately afterwards and then every 2 hours for the next 24 hours:
  • A significant change in the person's level of consciousness
  • Confusion or not acting normal
  • Abnormally deep sleep, difficulty waking up, or extreme sleepiness
  • Vomiting
  • Symptoms that affect one side of the body more than the other side, such as weakness or problems moving an arm or leg
  • Significant changes in the eyes, such as crossed eyes, droopy eyelid (usually just one eyelid), problems using the eyes, or changes in the pupils
• Continue to check on the person often during the night. If the person had a head injury right before going to bed or taking a nap and falls asleep soon afterward, check him or her for changes in colour or breathing, or for twitching arms or legs. You do not need to try to wake the person unless you notice changes. Call911or go to an emergency room immediately if you notice changes and cannot wake the person (unconsciousness). Seek medical care if the person has any symptoms of a serious head injury.
• Seek medical care if any new symptoms, such as vomiting, a severe headache, blurred or double vision, or unsteadiness, develop after the injury (post-concussive syndrome).

Rest

• Rest is the best treatment for a mild concussion. Get plenty of sleep at night, and take rests during the day.
• If a mild to moderate headache develops, lie down and try to relax your entire body.
• Take only acetaminophen, such as Tylenol or Panadol, to relieve a mild headache or pain from the injury. Do not use other non-prescription or prescription medications for pain without approval from your doctor.
• Do not drink alcohol or use illegal drugs. Alcohol and illegal drugs can slow your recovery and increase your risk of a second head injury.

If vomiting occurs:

• Wait 1 hour after the last episode of vomiting before taking liquid.
  • After an hour, drink 120 mL (4 fl oz) of clear liquid every 20 minutes for 1 hour.
  • As you feel better, begin to eat small amounts of clear soups, mild foods, and liquids.
• Keep eating clear soups, mild foods, and liquids until all symptoms are gone for 12 to 48 hours. Gelatin dessert, dry toast, crackers, and cooked cereal are good choices.

Recovery

• Return to your normal activities gradually. Don't try to do too much at once.
• Avoid activities that could lead to another head injury. If your head injury occurred during a sporting event, you should be evaluated and cleared by a doctor before returning to play.
• Ask your doctor when it will be safe for you to drive a car or operate equipment, if that is a concern.
• Take only acetaminophen, such as Tylenol or Panadol, to relieve a mild headache or pain from the injury. Do not use other non-prescription or prescription medications for pain unless your doctor tells you to.
• Do not use alcohol until your doctor tells you that you are well enough to do so. Alcohol and illegal drugs can slow your recovery and increase your risk of a second head injury.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate the symptoms if any of the following occur during home treatment.

• Bleeding has not stopped after 15 minutes of direct pressure.
• Bruising or discoloration behind the ears or around the eyes develops after a head injury.
• Other symptoms develop, such as:
  • Seizure activity.
  • Confusion or not acting normal. Ask the injured person his or her name, address, age, the date, location, and the name of the prime minister.
  • Severe irritability or wanting to fight.
  • Inability to remember what happened just before or after the injury.
  • Difficulty speaking or slurred speech.
  • Blurred or double vision.
  • Vertigo, light-headedness, or unsteadiness that prevents standing or walking.
  • Symptoms that affect one side of the body more than the other side, such as numbness, weakness, or difficulty moving.
  • Significant changes in the pupils.
  • Vomiting.
  • A severe headache or stiff neck that is getting worse or not improving after the first 4 hours.
  • Abnormally deep sleep, difficulty waking up, or extreme sleepiness.
• Symptoms become more severe or more frequent.

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Author:	Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated: September 15, 2006
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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