Head injury at home: When rest is enough and when to visit an ER

After a head injury at home, knowing the warning signs of concussion can help you decide when rest is enough and when to seek emergency care.

Nobody likes a bump on the head, but some head injuries require more than just a moment to catch your breath. A blow or jolt to the head can cause a concussion, which is a mild traumatic brain injury. While most concussions are minor, they can sometimes require immediate medical care and can cause serious complications if not treated promptly. Knowing the signs and symptoms to look out for can help you know when to go to the hospital for concussion.

What is a concussion?

A concussion occurs when a blow to the head or sudden movement causes the brain to move in the skull. This temporarily disrupts brain functioning and creates chemical changes in the brain. These changes can cause symptoms either immediately after the accident or sometimes days or even weeks later.

As many as four in 10 adults in the U.S. have experienced a concussion at some time in their lives. Common causes of concussions include falls, getting hit in the head and car accidents. One in five concussions occurs during sport activities. Children under age four and teens between the ages of 15 and 19 are most likely to experience a brain injury, including concussions. Older people are also at high risk from concussion because of falls.

When to go to hospital for concussion

Some concussion symptoms are more obvious than others, and symptoms can vary depending on age and other factors. They are usually more severe right after the injury but may change or evolve over time. When you, your child or another person has a head injury, it's important to monitor for signs of concussion. Although loss of consciousness is always a sign of a brain injury, most people who experience a concussion do not lose consciousness.

The following danger signs mean you should call 911 or go to the nearest emergency room:

• Convulsions or seizures
• Nausea and vomiting
• Confusion or inability to make sense or recognize people or places
• Loss of consciousness or inability to wake up
• Worsening headache
• Double vision
• Unable to move an arm or leg
• Slurred speech, weakness or difficulty walking
• In infants or toddlers, continuous crying or refusal to eat or nurse

Other symptoms of concussion are less obvious. They may worsen or even appear in the first 24 to 48 hours or sometimes days later.

Having a concussion not only causes physical pain, but also can affect how you think, remember, sleep and even how you feel emotionally. If you, your child or someone else in your care experience these symptoms after a head injury, it's important to seek medical care:

• Sensitivity to light or other vision problems
• Feeling tired or sleepy or slow
• Headaches
• Difficulty with attention or memory
• Unclear or foggy thinking
• Anxiety or irritability
• Feeling extreme emotions or sadness
• Changes in sleep patterns, including trouble sleeping or sleeping more than usual

In babies or young children, a concussion may cause them to cry more than usual and refuse to eat. They may not want to play and instead want to be held or comforted. They may show changes in behavior, such as irritability or tantrums.

While it's important to monitor changes in sleep patterns after a head injury, it's not usually necessary to keep a person with a possible concussion from sleeping. However, if you can't wake them after falling asleep, that's a sign to get medical attention.

Treatment and recovery from concussion

Doctors can usually diagnose concussion based on a history of injury, a physical exam and symptoms. They will look at neurologic function as well as memory and cognitive processing as well as emotional state. Depending on the findings, most people can recover from concussion with rest and quiet at home for at least a couple of days, gradually returning to school or work, and with less time spent on screens, reading and writing. Because repeat concussions can be especially dangerous, your doctor may advise sitting out sports or other risky activities until symptoms are completely resolved.

Preventing head injuries

Studies show that concussions — especially repeated concussions — can lead to problems with memory and learning and may even increase the risk of dementia in older people. Here are some tips for preventing head injuries:

• Protect yourself and your loved ones from concussion and other brain injuries by wearing helmets when biking, skateboarding or playing sports.
• Make sure everyone in your vehicle is buckled up in a car seat, booster seat or regular seat belt, depending on their age. Kids aged four to eight who use a booster seat have nearly half the risk of injury as kids who use a seatbelt alone.
• Older adults can prevent concussions from falls by exercising regularly, which improves balance and coordination and can decrease falls by nearly 25%. Removing trip hazards around the house also helps prevent falls and concussions. Some hospitals and community centers offer classes on improving balance and preventing falls.

While you can't prevent every bump on the head, knowing how to prevent head injury and when to go to a hospital are smart moves for your brain health.