When should you worry about a bump on the head?
A bump on the head may appear after a fall or without injury. Even if the bump is small and doesn’t hurt, it may still be cause for concern – so it’s important to know the signs and symptoms to look for.
According to the National Institute for Care and Health Excellence (NICE), 700,000 people visit A&E with head injuries every year in the UK, of which 140,00 are admitted for further investigation.
But what are the symptoms – in adults and children – that indicate it’s something more serious? We speak to consultant neurosurgeon Colin Shieff and clinical fellow Dr Edward Gaynor about the head bump symptoms to look out for:
Bump on head vs brain injury
As a general rule of thumb, the harder the bang to the head, the greater the potential for harm.
‘Any contact with the head which alters how the brain works including sight, hearing, speech or cognitive thought, should be investigated as soon as possible,’ says Shieff.
Heady injuries usually fall into the following two categories:
Haematoma
The head and scalp benefit from a plentiful blood supply, and the bleeding that occurs under the skin after a bump causes the area to bruise and swell, also known as a haematoma.
Intercranial haemotoma
Bleeding in and around the brain, known as intercranial haemotoma, is much more serious, as this puts pressure on the brain itself.
Diffuse brain injury occurs when the brain moves within the skull (more common if the head is shaken), causing damage in each of areas where the brain hits the skull. ‘A traumatic brain injury (TBI) may occur after a blow to the head and can be classified as mild, moderate or severe,’ explains Shieff.
What is concussion?
Although it might feel serious, a concussion is a temporary injury to the brain, usually caused by a bump or blow to the head.
‘A concussion happens after a traumatic brain injury (TBI) changes the way the brain functions and results in temporary effects such as altered levels of consciousness, headaches, confusion, tiredness and dizziness,’ says Dr Gaynor.
‘Occasionally, concussion can also cause periods of memory loss and impact vision.’ It’s normally treated with rest, an ice pack to reduce any swelling and staying under observation for 48 hours to make sure symptoms don't get worse, but this can be at home.
Brain injury symptoms
Regardless of how a head injury occurs, there are specific symptoms that indicate it’s more serious, according to Dr Gaynor. ‘If you experience any of these, seek medical attention as soon as possible,’ he says.
Look out for the following brain injury symptoms, and head for A&E if you have any concerns:
Losing consciousness for a prolonged period of time
Confusion
Distorted vision
A persistent or recurring headache
Feeling drowsy and not responding to prompts or conversation
Vomiting more than twice
Fitting
Pupils of unequal size, or arm and leg weakness
What to do if you are concerned about a head injury
If you are concerned that you or your child has a serious heady injury, you should seek urgent medical assistance. ‘If an injury requires hospital attention, in most cases, the person will be assessed to make sure there aren’t signs of a more significant injury and will be observed for six hours afterwards,’ says Dr Gaynor. ‘Fortunately, severe head injuries are uncommon.’
If there’s call for further investigation, these might include the following:
• CT scan
A computerised tomography scan allows doctors to see if there’s any swelling or bleeding on the brain.
• MRI scan
A magnetic resonance imaging scan gives a detailed picture of the brain and assessment using a tool called the Glasgow Coma Scale, which scores the patient on verbal and physical responses to evaluate whether the head injury is minor, moderate or severe.
What to do if your child bumps their head
If your child takes a knock, it’s understandably worrying. ‘Children do bump their heads a lot, and although it’s frightening for the parents, after the initial shock, the child usually recovers quite quickly,’ says Shieff.
‘That’s not to say you shouldn’t keep an eye on them. Look out for anything unusual, such as wobbly, unfocused eyes, a child who is unresponsive – either not hearing you call their name or not being able to respond, in which case speech might be affected, vomiting or appearing disorientated. All of these indicate your child should been seen by a doctor. If your child has been knocked unconscious, get medical help immediately.’
Is it OK to let your child sleep after a bump on the head?
If your child bumps their head and you have any concerns whatsoever, keep them awake. ‘If you’re concerned your child has sustained a significant head injury, it’s important to check they respond to you normally,’ says Dr Gaynor. ‘This is most easily done by keeping them awake for a few hours after an injury.’
However, bear in mind that it's normal for young children who’ve had a bit of a shock and a big cry to then feel tired. ‘If your child resumes and sustains normal activity levels fairly quickly, they’re probably OK,’ says Shieff. ‘However, if you have any cause for concern whatsoever, seek medical help.’
Last updated: 05-10-2020
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