Medicines for Head injury and concussion

What it is

Head injuries range from minor bumps and knocks to the head, which are very common and usually not serious, through to more serious injuries that can affect the brain and need urgent attention. Concussion is a common form of minor traumatic brain injury, in which a blow or jolt to the head (or a whiplash-type movement) temporarily affects how the brain works, without causing lasting structural damage in most cases. Head injuries can result from falls, sports, road accidents, blows, or other impacts. After a minor head injury or concussion, symptoms can include: a headache; feeling dazed, dizzy, or "not quite right"; nausea; a brief loss of consciousness or memory around the event; difficulty concentrating or remembering; tiredness; irritability; sensitivity to light or noise; and blurred vision. These symptoms of concussion usually settle over days to a couple of weeks with rest. Most head injuries are minor and settle on their own with simple care. However, some head injuries are more serious and can cause bleeding or swelling in or around the brain, which can be life-threatening, and this can sometimes develop over hours after the injury. It is therefore very important to recognise the warning signs that need urgent medical attention after a head injury — such as loss of consciousness, repeated vomiting, worsening or severe headache, drowsiness or difficulty staying awake, confusion, seizures (fits), weakness or numbness, problems with speech or vision, unequal pupils, clear fluid or blood from the nose or ears, or other concerning symptoms. Certain injuries and situations (such as a significant impact, injury while on blood-thinning medicines, or particular groups) also warrant assessment. The key messages are that most head injuries are minor and settle with rest, that concussion needs rest and a graded return to activities, and that certain warning signs after a head injury are a medical emergency needing urgent assessment.

How it is treated

Head injuries are managed according to their severity — most are minor and settle with rest and simple care, but it is essential to recognise the warning signs that need urgent assessment, as some head injuries are serious. After a head injury, it is important to watch for "red flag" symptoms that indicate a possibly serious injury and need urgent medical attention (calling emergency services, or going to A&E): loss of consciousness (even briefly); being knocked out, or difficulty staying awake or being woken; repeated vomiting; a severe or worsening headache; confusion, or unusual behaviour; seizures (fits); weakness, numbness, or problems with balance, walking, speech, vision, or understanding; unequal or unusual pupils; clear fluid or bleeding from the nose or ears; a significant wound or a suspected skull fracture; and other concerning symptoms. Certain circumstances also warrant assessment, such as a forceful impact, a fall from a height, an injury in someone taking blood-thinning (anticoagulant) medicines, drug or alcohol involvement, or particular vulnerability — when in doubt, it is safest to seek advice. For a minor head injury or concussion without red-flag symptoms, care is usually rest and simple measures at home: resting, applying a cold pack (wrapped) to a bump to reduce swelling, taking simple pain relief such as paracetamol for a headache (avoiding certain painkillers unless advised), and having someone stay with the person for the first day to watch for any warning signs developing. Concussion symptoms usually settle over days to a couple of weeks; recovery is helped by rest initially, then a gradual, staged return to normal activities, screen use, work or school, and — importantly — a careful, graded return to sport (following concussion guidance, and not returning to contact sport too soon, as a further head injury before recovery can be dangerous). If symptoms are severe, persistent, or worsening, further assessment is needed. In hospital, serious head injuries are assessed (which may include a CT scan of the head) and treated, sometimes needing observation, and, for significant bleeding or swelling, urgent treatment including surgery in some cases. Preventing head injuries — for example wearing helmets for cycling and relevant sports, and reducing falls risk — is worthwhile. The key messages are: recognise the warning signs after a head injury and seek urgent help if any are present; manage minor head injury and concussion with rest, simple care, and someone watching for red flags initially; allow concussion to recover with rest and a graded, careful return to activities and sport; and seek advice if in doubt.