Head injury and concussion
You can bang your head almost anywhere: on ice, on a staircase, on the corner of an open cupboard door.
Prescription review online
A doctor will review your case and issue a prescription if medically appropriate.
Talk to a doctor online
Discuss your symptoms and possible next steps with a doctor online.
On this page
Medicines commonly prescribed for Head injury and concussion
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: EFFERVESCENT TABLET, 1000 mgActive substance: paracetamolManufacturer: Dari Pharma S.L.Prescription requiredDosage form: TABLET, 1000 mgActive substance: paracetamolManufacturer: Laboratorios Normon S.A.Prescription not requiredDosage form: ORAL SOLUTION/SUSPENSION, 650 mgActive substance: paracetamolManufacturer: Kern Pharma S.L.Prescription not required
You can bang your head almost anywhere: on ice, on a staircase, on the corner of an open cupboard door. Nearly always it ends in a lump and a couple of days of headache. The difficulty lies elsewhere: the brain does not need a single scratch on the outside in order to be hurt, and bleeding inside the skull does not always show itself straight away, so someone can look perfectly well for an hour, for two, even for a whole day. Everything below therefore comes down to two things: knowing the signs that must not be waited out, and giving the head a few quiet days when those signs are absent.
What concussion is and how it shows itself
Concussion is a temporary disturbance in the way the brain works after a blow or a sudden jolt to the head. Losing consciousness is not required: most concussions happen without a single second of blackout. It announces itself through a cluster of complaints, some of which appear not at the moment of impact but several hours later:
- headache, usually dull and spread across the head, dizziness, nausea;
- a foggy feeling, slowed thinking, trouble finding a word or following a conversation;
- a gap in memory covering the injury itself and the minutes around it;
- bright light and loud noise become irritating;
- unusual irritability, tearfulness, anxiety;
- disturbed sleep, either difficulty dropping off or sleeping twice as long as usual;
- tiredness that arrives quickly with reading, screens or a noisy room.
In a small child the picture looks different: crying that lasts longer and settles less easily than usual, refusing food, losing interest in toys, going quiet and floppy or, conversely, being impossible to soothe. A change in a child's behaviour is as real a symptom as a headache in an adult.
It is worth knowing in advance that concussion itself does not show on scans. A CT scan is not looking for it but for bleeding and fractures. A normal scan means only that there is no blood inside the skull; it cancels neither the symptoms nor the need to rest.
Signs that call for an ambulance
Call an ambulance (in Europe, the single number 112) if any of the following appears after a blow to the head:
- the person has not come round, or is hard to rouse and drifts off in the middle of a conversation;
- a seizure;
- repeated vomiting;
- a headache that is not merely present but getting worse;
- clear watery fluid running from the nose or ear, or blood coming from the ear;
- bruising around both eyes or behind the ears, although the blow did not land there;
- weakness or numbness in an arm or leg, a drooping face, slurred speech, or failure to understand what is said;
- pupils of different sizes, double vision, loss of sight;
- confusion: not recognising family, not knowing where they are, asking the same question over and over;
- inability to stand, walk or keep balance;
- a wound with a dent in the bone, visible bone or something stuck in it;
- a high-speed impact: a road accident, being knocked down, a fall from higher than the person's own height or down a flight of stairs, a diving mishap.
While the ambulance is on its way, do not leave the person alone, give nothing to eat or drink and, if a neck injury is possible, neither turn nor lift the head. If they are unconscious but breathing, roll them onto their side with the trunk moving as one piece and the neck supported. Do not drive the injured person yourself: they may deteriorate on the way.
What needs to be seen by a doctor the same day
An ambulance is not always necessary, but waiting until Monday is not the answer either. Same-day assessment is needed if:
- consciousness was lost, even for a few seconds;
- there is a gap in memory, however short;
- the person has been sick at least once;
- the headache persists and does not settle with an ordinary painkiller;
- you take blood-thinning medicines or have a clotting disorder;
- the person who fell is elderly: in older people bleeding can follow even a modest knock;
- alcohol or drugs were involved at the time, because it then becomes impossible to tell intoxication from brain injury;
- there has been previous brain surgery or a shunt is in place;
- there is a wound that needs stitches, or a large swelling that is growing quickly;
- a child is not behaving as they normally do;
- the injury was inflicted deliberately by someone else.
The first day and the first week at home
If there are no warning signs, the rest is managed at home, and the rules are few.
- For the first twenty-four hours an adult should be nearby, someone who would notice a deterioration.
- Apply something cold wrapped in a cloth in short spells; it eases the swelling and the pain at the site of the blow.
- For headache in the first days paracetamol is the more sensible choice. Aspirin and anti-inflammatory painkillers interfere with clotting, which is unhelpful with a fresh head injury; ask your doctor when you can go back to them.
- Sleep is allowed and needed. Waking someone every hour is outdated advice that only exhausts everyone. What matters is that they can be woken in the usual way.
- No alcohol, sleeping tablets or sedatives while recovery is under way.
- Do not drive while there is dizziness, mental fog or slowed reactions.
A word about rest. Lying in a darkened room beyond the first two days does not speed recovery up; it slows it down. The sensible pattern is a couple of quiet days, then a gradual return to ordinary tasks with some gentle activity such as a slow walk, guided by how the symptoms behave. If they clearly worsen, ease off and try again the next day.
Getting back to work, school and sport
The return happens in steps, and each step is taken only if the symptoms have not come back. First ordinary household activity, then light aerobic exercise such as walking or an exercise bike with no resistance. Then harder exercises, but with no risk of collision. Then non-contact training with the team, and only at the very end a full match.
Contact sport — martial arts, football, hockey, rugby, anything where the head can take another knock — is resumed once no symptoms remain either at rest or on exertion, and after a doctor has confirmed it. Rushing is more dangerous here than it looks: a blow to a brain that has not yet recovered occasionally causes, particularly in teenagers and young athletes, a catastrophic swelling of the brain with a very poor outcome. No single missed match is worth that.
A schoolchild or a student benefits from a shortened day at first, less screen time and postponed exams: mental effort worsens the symptoms just as physical effort does.
When symptoms drag on beyond two weeks
In most adults everything settles within a week or two; in children and teenagers it often takes longer. Some people, though, are left with a trail of complaints: headache, tiring quickly, irritability, ringing in the ears, dizziness on sudden head movements, absent-mindedness, poor sleep, anxiety. This does not mean something dreadful has been found inside the head. It is how the brain recovers, and in almost everyone these complaints gradually fade.
There is no need to wait it out alone. If nothing has improved after two weeks, or the symptoms are getting in the way of work and study, see a doctor: a settled sleep routine helps, as do measured activity instead of rest, specific treatment for the headache, vestibular rehabilitation for the dizziness and psychological support for the anxiety. A child whose complaints have not eased within a month should also be seen.
The knock that is remembered a month later
One scenario is missed more often than any other. In older people, in those taking blood-thinning medicines and in those who drink heavily, the veins running between the brain and its covering tear easily, and blood collects slowly, over weeks. Such a chronic haematoma announces itself not on the day of the injury but two to eight weeks later, when the knock has been forgotten and seems trivial: someone caught their head on a shelf and carried on.
What should raise suspicion is a headache that grows day by day, drowsiness, confusion, a changed personality, weakness of the arm and leg on one side, an unsteady walk, loss of bladder control. All of this is easily put down to old age or to early dementia, and that is the main trap. The collected blood is drained, and after the operation people usually return to how they were, but the later it is done, the poorer the result.
The second scenario unfolds faster. Sometimes after a blow the person improves, says it has all passed, and a few hours later deteriorates abruptly with a ferocious headache, vomiting and drowsiness. That is how bleeding from an artery beneath the skull bone behaves. It is precisely why anyone who has had a head injury is watched for a full day, even if they seemed entirely fine immediately afterwards.
Online consultation
The question that comes first is easy to settle remotely: was this an ordinary knock that can be seen through at home, or a reason to be examined in person, and how urgently? The doctor will go through the circumstances of the injury, your medicines and your long-term conditions, weigh up the symptoms and tell you what to watch for over the next day. An online appointment is also a convenient place to discuss what comes next: how to structure a return to training, what to do about a headache now in its third week, whether a child needs adjustments at school. The signs on the emergency list are not assessed remotely; when they appear, help is called straight away.
This material is for information only and does not replace medical advice.
Consult with a doctor about Head injury and concussion
Discuss your symptoms and possible next steps with a doctor online.
Online doctors for Head injury and concussion
Discuss your symptoms and possible next steps for Head injury and concussion with a doctor online.
