I’ve hit my head: should I be worried?
70–90% of traumatic brain injuries treated are mild. However, a small percentage may develop complications such as intracranial haemorrhages, which are more common in older people.
Traumatic Brain Injury (TBI) is one of the most common causes of emergency care. According to the World Health Organization, TBIs are a major cause of mortality and disability worldwide.
Approximately 70–90% of TBIs seen are mild (known as a concussion). However, a small percentage may be complicated by intracranial haemorrhages, which are more common in older people, patients who are being treated with blood thinners or after high-energy accidents.
What happens inside the head?
When we are hit, the brain, which is a soft structure that is not rigidly attached, shifts inside the skull. This can result in:
- A concussion: causes the accumulation of blood (epidural, subdural or intracerebral), which can increase the pressure inside the skull.
- A cerebral contusion: causes a small injury with tissue damage, i.e. inflammation, pain and possibly some minor functional impairment.
- An intracranial hematoma: causes the accumulation of blood (epidural, subdural or intracerebral), which can increase the pressure inside the skull.
With any of these options, the risk is not always immediate, as some bleeding may develop slowly in the first 24–48 hours, hence, it is recommended to monitor the progression and seek emergency medical attention if symptoms such as severe headache, vomiting, excessive drowsiness, or any neurological changes appear.
Quick checklist after a blow to the head
- Have I lost consciousness, even for a few seconds?
- Do I have trouble remembering what happened before and after the blow?
- Am I taking blood thinners?
- Am I over 65?
- Is the pain getting worse instead of better?
If the answer to any of the first three questions is affirmative, or if symptoms appear that might indicate the problem is getting worse, a doctor should be consulted urgently.
How can a blow to the head evolve?
