What is a closed head injury? — A closed head injury happens when a person hits their head on a hard surface or when an object hits and hurts the head, but doesn't go through the skull. The most common causes of a closed head injury are falls, sports injuries, and car and bike accidents.

Even though the object doesn't go through the skull, parts of the head can still get damaged. A closed head injury can cause:

●A broken bone of the skull or face (figure 1)

●Brain injury or swelling

●Bleeding in or around the brain

Some closed head injuries are mild. Another word for a mild brain injury is a "concussion."

Closed head injuries can also be severe and life-threatening.

What are the symptoms of a closed head injury? — Symptoms depend on the type of injury a person has and how severe it is. People with a mild closed head injury, such as a bump on the head, might not have any symptoms.

Some people black out or lose consciousness when they get a head injury. If a person does not wake up quickly, or blacks out several minutes or hours after a head injury, this can mean there is bleeding in the brain. The person needs emergency help.

Other symptoms that can happen after a closed head injury are:

●A headache

●Nausea or vomiting

●Swelling, bleeding, or bruising on the scalp

●Dizziness

●Confusion or memory problems

●Feeling tired or sleepy

●Mood or behavior changes

●Trouble walking or talking

●Seizures – Seizures are waves of abnormal electrical activity in the brain. They can make you pass out, or move or behave strangely.

A closed head injury that involves a broken skull or face bone can also cause:

●Bruising around the eyes or behind the ear

●Blood or clear fluid draining from the nose or ear

Symptoms can start right after a closed head injury, or a few hours or days later.

Some people have symptoms that last a short time only. Other people have symptoms that cause long-lasting problems.

Will I need tests? — It depends on your injury and symptoms. Your doctor or nurse will ask about your symptoms and do an exam. They will also ask questions to check your thinking.

If your doctor or nurse thinks you might have a serious injury, they might order an imaging test of your brain, such as a CT or MRI scan. These tests create pictures of your skull and brain.

How is a closed head injury treated? — Treatment depends on your injury and how serious it is.

Usually, mild closed head injuries do not need treatment. But your doctor might recommend that someone watch you for 24 hours after your injury. This person should watch for new symptoms or the symptoms listed above, and make sure that you can wake up at a normal time after you fall asleep.

Severe closed head injuries need to be treated in the hospital. Treatment can include:

●Medicines – Different medicines can help prevent brain swelling, bleeding in the brain, or seizures.

●Surgery – If you have bleeding in or around your brain, or if your brain swells, you might need surgery.

When should I call the doctor or nurse? — After your closed head injury, call your doctor or nurse if:

●Your headache gets worse

●You vomit

●Your thinking or behavior changes

●You can’t walk normally

●You have a seizure

The person watching you should also call the doctor or nurse if they can't wake you up.

When can I play sports or do my usual activities again? — Ask your doctor when you can play sports or do your usual activities again. It will depend on your injury and symptoms.

How can I prevent another closed head injury? — To help prevent another closed head injury, you should wear a helmet when you ride a bike or motorcycle, or when you play sports where you could hit your head. You should also wear a seat belt every time you drive or ride in a car.

More on this topic

Patient education: Head injury in children and adolescents (The Basics)
Patient education: Concussion in adults (The Basics)
Patient education: Skull fractures (The Basics)
Patient education: Headaches in adults (The Basics)
Patient education: Vertigo (a type of dizziness) (The Basics)
Patient education: Seizures (The Basics)
Patient education: Coma (The Basics)

Patient education: Head injury in children and adolescents (Beyond the Basics)
Patient education: Vertigo (Beyond the Basics)
Patient education: Headache causes and diagnosis in adults (Beyond the Basics)
Patient education: Headache in children (Beyond the Basics)
Patient education: Seizures in children (Beyond the Basics)
Patient education: Seizures in adults (Beyond the Basics)