All head injuries are potentially serious because they may damage the brain. A head injury may cause damage to the brain tissue, a skull fracture or an injury to the spine or neck. Learn what to do.
Brain injury; Head trauma; Concussion - head injury; Traumatic - head injury A head injury is any trauma to the scalp, skull, or brain. Head injury can be either closed or open (penetrating). Head injuries include: Head injuries may cause bleeding: Head injury is a common reason for an emergency room visit. A large number of people who suffer head injuries are children. Traumatic brain injury (TBI) accounts for over 1 in 6 injury-related hospital admissions each year. A concussion may result when the head strikes against an object or is struck by an object. Concussions may produce unconsciousness or bleeding in or around the brain.
 Helmets can save lives and prevent trauma, but only if they are worn properly. A helmet should be worn squarely on the top of the head, covering the top of the forehead. The chinstrap must be fastened and the helmet should fit snugly and comfortably. The helmet should not be able to move side-to-side or front-to-back. Most helmets come with removable pads so you can customize the fit for any child.
Head injuries can range from a minor bump on the head to a devastating brain injury. Learning to recognize a serious head injury, and implementing basic first aid, can make the difference in saving someones life. Common causes of head injury include traffic accidents, falls, physical assault, and accidents at home, work, outdoors, or while playing sports.
Intracerebellar hemorrhage shown by CT scan. This hemorrhage followed use of t-PA.
Head injury can be classified as either closed or penetrating. In closed head injury, the head sustains a blunt force by striking against an object. In penetrating head injuries, a high velocity object breaks through the skull and enters the brain. The signs and symptoms of a head injury may occur immediately or develop slowly over several hours.
You've fallen and hit your head. It hurts a little, but you're not bleeding and you feel okay. Do you have a head injury, or are you fine? Knowing how to tell a minor head injury from a serious one could literally save your life. Let's talk about head injuries. Millions of people get head injuries every year. They get into car accidents or fights, they fall, or they get hit in the head while playing sports or working on the job. Most head injuries are minor, because your head comes equipped with its own natural hard hat, a protective skull that surrounds and protects your brain. But sometimes that protection isn't enough. More than a half-million people each year get head injuries severe enough to send them to the hospital. The most common type of head injury is a concussion. That's when a hit in the head makes your brain jiggle around in your skull. You can also get a bruise on your brain, called a contusion. Brain contusions are a lot more serious than bruises from a bump on the arm or leg. Other types of head injuries include a fractured skull or a cut on your scalp. If you get hit in the head or fall and you don't bleed, you've got a closed head injury. If an object enters your brain, like glass from a windshield during a car accident or a bullet from a gunshot, then you have an open head injury. It can be very hard to tell if you've got a minor closed head injury or a serious one. Your head might look perfectly fine from the outside, when you actually have bleeding or swelling inside your brain. To tell the difference, look for other signs of a serious head injury, such as a severe headache; Clear or bloody fluid coming from your nose, ears, or mouth; Confusion, drowsiness, or a loss of consciousness; Changes in the way you hear, see, taste, or smell; memory loss; mood changes or strange behaviors; slurred speech or recurrent vomiting. If you or someone else has any of these symptoms, call for medical help right away. If you don't have these symptoms and you think it's just a minor head injury, you probably don't need to be treated. Just ask a friend or family member to keep an eye on you. If it's your child or someone else with the head injury, wake them up from sleep every 2 or 3 hours to ask questions like, Where are you? and What's your name? just to make sure they're alert. If you're in any doubt about whether a head injury is serious, play it safe and get medical help. To play it even safer, protect your head during any activities that could lead to an injury. Wear a helmet whenever you skateboard, roller skate, ski, snowboard, or ride a bike or motorcycle. Put on your seatbelt whenever you're in the car. And put kids in an age-appropriate car seat or booster seat.
Common causes of head injury include:
Most of these injuries are minor because the skull protects the brain. Some injuries are severe enough to require a stay in the hospital.
Head injuries may cause bleeding in the brain tissue and the layers that surround the brain (subarachnoid hemorrhage, subdural hematoma, epidural hematoma). Symptoms of a head injury can occur right away or may develop slowly over several hours or days. Even if the skull is not fractured, the brain can hit the inside of the skull and be bruised. The head may look fine, but problems could result from bleeding or swelling inside the skull. The spinal cord is also likely to be injured from falls from a significant height or ejection from a vehicle. Some head injuries cause changes in brain function. This is called a traumatic brain injury. Concussion is a traumatic brain injury. Symptoms of a concussion can range from mild to severe.
Learning to recognize a serious head injury and give basic first aid can save someone's life. For a moderate to severe head injury, CALL 911 OR THE LOCAL EMERGENCY NUMBER RIGHT AWAY. Get medical help right away if the person:
Then take the following steps:
Follow these precautions:
A serious head injury that involves bleeding or brain damage must be treated in a hospital. For a mild head injury, no treatment may be needed. However, call for medical advice and watch for symptoms of a head injury, which can show up later. Your physician or health care provider will explain what to expect, how to manage any headaches, how to treat your other symptoms, when to return to sports, school, work, and other activities, and signs or symptoms to worry about. Both adults and children must follow the doctor or the provider's instructions about when it will be possible to return to sports.
Call 911 or the local emergency number right away if:
Not all head injuries can be prevented. The following simple steps can help keep you and your child safe:
Hockenberry B, Pusateri M, McGrew C. Sports-related head injuries. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2022. Philadelphia, PA: Elsevier; 2022:790-794. Hudgins E, Grady S. Initial resuscitation, prehospital care, and emergency room care in traumatic brain injury. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 348. Papa L, Goldberg SA. Head trauma. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 34.
Last reviewed on: 11/13/2021 Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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