Some indications of a head or brain injury are obvious and require emergency medical attention. In other cases, the indications of a serious injury may not appear for hours, days, or weeks.
Immediate Head Injury or Brain Injury Symptoms
Seek emergency medical care immediately if any of the following conditions are present:
- Severe or uncontrollable bleeding
- Laceration (tear) of the skin or scalp
- Penetration or fracture of the skull or facial bones
- Swelling
- Clear or bloody fluid draining from the ears, nose, or mouth
- Stiff neck or paralysis of arm(s) or leg(s)
- Loss of consciousness (blackout)
- Confusion, dizziness, or drowsiness
- Blurred vision or slurred speech
- Convulsions or seizures
- Severe headache or vomiting
- Bruising of the face
- Loss of sight, hearing, taste, or smell
- Low breathing rate
- Drop in blood pressure
- Dilated (wide) pupils
- Any other condition that suggests medical attention is required
Delayed Head Injury or Brain Injury Symptoms
If any of the following symptoms develop after a person experiences a head injury, obtain medical attention as soon as possible:
- Any of the symptoms above that occur later
- Being unusually irritable or restless
- Loss of coordination or clumsiness
- Becoming unusually drowsy or difficult to awaken
- Unusual behavior or change in personality
Should the Injured Person be Prevented from Falling Asleep?
The frequently repeated advice not to let someone with a head injury fall asleep may be rooted in medical fact, but is ultimately not practical advice.
Particularly with small children, if the stress and crying over an injury leads to the child being exhausted and falling asleep on the way to the doctor, it can be beneficial. After the child has rested briefly and calmed down, the doctor can more accurately assess any potential brain trauma.
The source of this advice against letting someone fall asleep after a head injury possibly relates to injuries that cause bleeding within the skull. Initially, the head-injured person seems to recover from the blow. But as the internal bleeding slowly accumulates and intracranial pressure rises, the person later becomes more and more disoriented, lethargic, and eventually comatose. To the surviving family, it seems everything would have been OK if they could have kept their loved one from ”falling sleep.” The fact is that only a neurosurgeon would be able to keep someone with such a serious head injury from entering a coma, and then only if seen immediately.
So if someone is showing increasing signs of confusion or mental or physical distress following a head injury, get immediate emergency medical attention. Attempting to keep the person “awake” is probably not productive.
On the other hand, if someone who has experienced a head injury does not have an abnormally enlarged pupil or pupils, and is not showing signs of confusion or mental or physical distress, sleep and rest may be a good prescription for recovery.
Additional Information
For more information on first aid for head wounds, visit the U.S. National Library of Medicine’s Medline Plus Head Injury information page.
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