Severe head injury
Severe head injuries require immediate medical attention because there's a risk of serious brain damage.
These pages focus on severe head injury.
Symptoms of a severe head injury can include:
- unconsciousness – where a person has collapsed and is unresponsive, even for a brief period of time
- concussion – a sudden but short-lived loss of mental function that occurs after a blow or another injury to the head; a person with concussion may have a glazed look or appear confused, but won't necessarily be unconscious
- fits or seizures
- difficulty speaking or staying awake
- problems with the senses – such as hearing loss or double vision
- repeated episodes of vomiting
- blood or clear fluid coming from the ears or nose
- memory loss (amnesia)
- sudden swelling or bruising around both eyes or behind the ear
- difficulty with walking or co-ordination
Dial 999 immediately to request an ambulance if you're with someone who experiences any of these symptoms after a head injury.
Alternatively, take them immediately to your nearest A&E department.
You should also go to A&E if someone has injured their head and:
- the injury was caused by a forceful blow to the head at speed, such as being hit by a car or falling 1 metre or more
- the person previously had brain surgery
- the person previously has had problems with uncontrollable bleeding or a blood clotting disorder, or is taking medication that may cause bleeding problems, such as warfarin
- the person has been drinking alcohol or has taken drugs
- the injury wasn't accidental – for example, you deliberately hurt yourself or someone else hurt you on purpose
Diagnosing a severe head injury
If you have had a severe head injury and there's a chance you may have a brain injury, you'll have a CT scan to assess the seriousness of the injury.
The Glasgow Coma Scale (GCS) is often used to assess head injuries. This is a scale from 3 to 15 that identifies how serious your head injury is, based on your symptoms and whether the brain has been damaged (with 3 being most severe and 15 the least severe).
A GCS score of 13 or above would indicate a minor head injury. A score of 9 to 12 would be a moderate head injury.
If a person has a severe head injury, they'll have a score of 8 or less.
Some people with significant head injuries have a high GCS score initially, but their score decreases when they're reassessed at a later stage.
If you have a severe head injury, you'll be closely monitored and frequently reassessed to check your condition.
Treating a severe head injury
Severe head injuries always require hospital treatment.
This may involve:
- observing the condition for any changes
- running tests to check for further damage
- treating any other injuries
- breathing support (ventilation) or brain surgery
Most people are able to go home within 48 hours. But a small number of those admitted to hospital require skull or brain surgery.
When you're discharged from hospital, your doctor will advise you on the best way to help your recovery when you return home.
A severe head injury can result in pressure being placed on the brain because of bleeding, blood clots or a build-up of fluid.
This can sometimes lead to brain damage, which can be temporary or permanent.
A severe head injury can also cause other potentially serious complications, including:
- an infection after a skull fracture
- impaired consciousness
- brain injury
Preventing head injuries
It can be difficult to predict or avoid a head injury, but there are some things you can do to reduce the risk of serious injury.
- ensuring your home (or those of elderly relatives) are free of trip hazards that could cause a fall, such as loose carpets or unnecessary items on the floor
- childproofing your home – for example, by ensuring young children can't reach windows or balconies
- using the right safety equipment for work, sport and DIY
Wearing a safety helmet during certain activities, such as skiing or cycling, may also help to prevent a serious head injury.