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Head injury

What happens?

The patient has sustained a head injury that appears to be mild. After being observed, he or she is showing no serious signs of damage, can go home and expect that rapid recovery will follow. However, very rarely, complications may follow at any time over the next few days.

What causes complications?

The brain is housed, very compactly, in a rigid case-the skull-and cannot tolerate any increase in pressure. If this occurs due to bleeding or swelling, pressure is exerted on the base of the brain, which contains the vital centres controlling such functions as breathing and heart action.

The problem may occur gradually, and certain warning signs will develop that indicate the pressure will have to be relieved.

What should you do?

Someone in the household should keep the patient under close observation over the next 24 hours (at least) and bring him or her back to the surgery or to the casualty department of the nearest hospital immediately if they notice any of the following features:

• unconsciousness or undue drowsiness, such as difficulty waking up
• confused, irrational or delirious behaviour
• headache that continues
• bleeding or discharge from the ear or nose
• repeated vomiting
• fits or spasms of the limbs or face
• blurred or double vision

In children

Children should be allowed to go to sleep, but should be woken every 4 hours to see if they are rousable and conscious.

Other points

Diet
Any food and drink can be taken in moderation, but avoid alcohol.

Pain-killers
Paracetamol or aspirin can be taken in the usual doses for headache.

Drugs
Avoid sedatives; take no medication unless instructed.

Icepacks
Icepacks can be used over swollen or painful areas of the head.

Rest

• Stay resting in bed for 2 days.
• When you start getting up, return to bed if you feel giddy or get a headache.
• Rest quietly at home and do not return to work or your normal activities until after 7 days.
  
  

  Copyright 1995: John Murtagh, Professor of General Practice
  Monash University, Melbourne, Australia