Head Injury (Brain Injury)

  • Medical Author:
    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.

  • Medical Editor: Melissa Conrad Stöppler, MD
    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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When should I contact a doctor about a head injury?

It is not normal to be unconscious or not fully awake. Emergency medical services (call 9-1-1 in your areas if it is available) should be activated for persons who have sustained an injury.

Because head injuries may also be associated with neck injuries, victims should not be moved unless they are in harm's way. If possible, it is important to wait for trained medical personnel to help with immobilizing and moving the patient.

If the patient is awake and feeling normal, it may be worthwhile seeking medical care if there was significant trauma. These patients may be considered to have minor head injury or concussion, and there is a significant amount of research that has been done to decide which persons with head injury should be admitted to the hospital for observation or have a CT (computerized tomography) scan of the head to look for bleeding.

While there are many guidelines from which to choose, recent literature suggests that any of them work well to help a physician decide who might have a brain injury associated with a head injury. These guidelines apply to people ages 16 to 65 who are fully awake and have a Glasgow Coma Scale of 15. Potential brain injury may exist if the patient had any of the following:

  • amnesia to events preceding the injury,
  • vomiting,
  • alcohol or drug intoxication,
  • seizure,
  • trauma above the collarbones,
  • significant headache, and
  • dangerous mechanism of injury like a fall from more than five stairs or being hit by a car.

Those older than 65 years of age are at increased risk of bleeding from head injury because the aging brain shrinks away from the skull, causing the veins that bridge from the skull to the brain surface to be more easily torn.

If a person is taking a blood-thinning medication such as warfarin (Coumadin), clopidogrel (Plavix), prasugrel (Effient), or rivaroxaban (Xarelto), they are also at an increased risk of a brain injury, even if there is relatively minor trauma.

Medically Reviewed by a Doctor on 5/11/2015

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