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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Head injury introduction
• What are the causes of head injury?
• What are the symptoms of a head injury?
• What is the Glasgow Coma Scale?
• When should I contact a doctor about a head injury?
• How is a head injury diagnosed?
• How is a head injury treated?
• What is the prognosis for a head injury?
• How can a head injury be prevented?
• What about a head injury in infants and young children?
• Head Injury At A Glance
• Patient Comments: Head Injury - Cause
• Find a local Doctor in your town
• Head Injury Index

By definition, trauma is required to cause a head injury, but that trauma does not necessarily need to be violent. Falling down a few steps or falling into a hard object may be enough to cause damage. Motor vehicle crashes account for more than 50% of traumatic brain injuries, with sports related injuries adding another 20%. Almost 80% of head injuries occur in males.

Penetrating head injuries describe those situations in which the injury occurs due to a projectile, for example a bullet, or when an object is impaled though the skull into the brain. Closed head injuries refer to injuries in which no lacerations exist.

The symptoms of head injury can vary from almost none to loss of consciousness and coma. As well, the symptoms may not necessarily occur immediately at the time of injury. While a brain injury occurs at the time of trauma, it may take time for enough swelling or bleeding to occur to cause symptoms that are recognizable.

Initial symptoms may include a change in mental status, meaning an alteration in the wakefulness of the patient. There may be loss of consciousness, lethargy, and confusion.

Head injury symptoms may also include:

• vomiting,
  
  
• difficulty tolerating bright lights,
  
  
• leaking CSF from the ear or nose,
  
  
• bleeding from the ear ,
  
  
• speech difficulty,
  
  
• paralysis,
  
  
• difficulty swallowing, and
  
  
• numbness of the body.

Other symptoms may be more subtle and include:

• nausea,
  
  
• dizziness,
  
  
• irritability,
  
  
• difficulty concentrating and thinking, and
  
  
• amnesia.

Late signs of significant head injury and raised pressure within the brain and skull include a dilated pupil, high blood pressure, low pulse rate, and abnormal breathing pattern.

Coma may be present if the patient doesn't waken completely and is defined as a prolonged episode of loss of consciousness. There are different levels of coma, and the Glasgow Coma Scale is one way of measuring its depth.