All head injuries should be considered as potentially serious.
A blow to the head may cause concussion – a brief period of unconsciousness, caused by a jolt to the brain. Concussion is not normally associated with any long-term damage. However, a more serious condition is compression of the brain (cerebral compression), caused by a build up of pressure on the brain. This may develop immediately after a head injury, or a few hours or days later and can be life-threatening.
A head wound, or clear fluid or watery blood coming from the ear or nose may also be signs of a possible skull fracture.
- Impaired consciousness (but only brief, i.e., a few minutes) – followed by full recovery
- Dizziness, confusion or nausea on recovery
- Short-term memory loss
- Mild headache
- Deteriorating level of response / delayed unconsciousness
- Intense headache
- Unequal pupil size
- Weakness/paralysis down one side of the face or body
- Drowsiness, loss of balance or confusion
- Slurred speech
- Repeated vomiting
- Clear fluid or watery blood from nose or ear
- Wound or bruise on head, or depression on scalp
- Deterioration in level of response
What to do
- Monitor the casualty and if they have been unconscious, stay with them until they fully come around.
- If you suspect a skull fracture call for an ambulance on 999 (or 112). Control any bleeding but do not apply direct pressure to the wound. Do not turn the head in case of neck injury. If fluid or blood is coming from ear, secure a sterile dressing lightly in place but do not plug ear. You may need to be prepared to give CPR.
- If you suspect compression, call for an ambulance and monitor the casualty until help arrives. Keep them supported in comfortable position. You may need to be prepared to give CPR.
- In the case of concussion, monitor the casualty and watch for any signs of subsequent deterioration: if there is a deterioration in level of response, call for an ambulance.
- If the casualty recovers fully, place them in the care of a responsible person and warn the person to go to hospital if they later develop signs of cerebral compression.