When Can We Stop Worrying After a Hit on the Head?

Question: 

About a month ago, my wife tripped while hiking and hit her head. We went to our Emergency Department and they did a CT scan, which was “clean.” Other than an occasional headache, my wife feels fine. Is there a time when we can stop worrying?

Answer: 

The CT scan that was done in the Emergency Department is helpful because it showed there was no bleed in your wife’s head (hemorrhage) that would require surgery. That being said, most of the time after a concussion — or mild brain injury — a CT scan does not show any evidence of injury and yet some people may continue to have symptoms related to the concussion. The injury to the brain in a concussion is generally to the neurons and axons that are microscopic and therefore not seen on CT scan. Symptoms can be broken down into four categories:

  • Cognitive issues, including memory and concentration
  • Sleep issues, including too much or too little sleep, drowsiness, and difficulty falling asleep
  • Physical issues, including headaches, decreased balance, dizziness, impaired vision, fatigue, nausea/vomiting, and sensitivity to light and noise
  • Emotional issues, including irritability, sadness, and nervousness

Many symptoms from mild traumatic brain injuries resolve themselves with some time and rest and it seems this is the case with your wife. However, if her headaches do not continue to improve, if they are limiting your her function, or if they worsen, it would be appropriate to take her for a re-evaluation by your physician.

 

Posted on BrainLine January 19, 2010

Brian Greenwald

Dr. Brian Greenwald is medical director of Center for Head Injuries and the associate medical director of JFK Johnson Rehabilitation Institute. He is a clinical associate professor in the Department of Physical Medicine and Rehabilitation at UMDNJ-Robert Wood Johnson Medical School.

Comments

About a month ago i was at the lake and my jet ski tipped over n hit my head it was not hard but hard enough that i was sick and head ache for 4 days felt great but head was still sore. month later and now more head aches over my eye is black n blue light hurts my eye and real moody dont sleep..what should i do

Hi, I hit my head in a bike fall and started having bad headaches Neurologist said I had migraines and recommended migraine medication. I was afraid to take the medication but after months migraines I finally went to a chiropractor and I was shocked at how effective it was. 6 months later and I have only had one headache. Try a chiropractor and acupuncture - I did both and it helped me a great deal.

I missed a step in the room in motel in Mexicoand hit my forehead pretty hard. I had a bump which later went down but had swelling above my eye briow It is still sore to the touch and have a black eye which started the next day. That was Saturday and I came home Tuesday. This is Wednesday and it seems to be getting better everyday except the black or purple eye has spread some. I'm not having any symptoms so should I go to the doctor after this long

Doesn't really answer the question.

If you had a mild concussion and in the middle of healing you pass out and hit your head should you be worrreid of SIS?

A couple months back .I hit my head on concret. And a month later I started having bad headaches .I went and saw the doctor .they put me on meds for the headaches. But they are not working. They did a ct scan on my head. But the headaches are getting worse. All I want to do is cry.
I hit my head lst night in a fall, Seem okay but today I suffer mostly from neck and upper back which tells me I must have whiplash. I went to see a chiropractor this morning and i feel a lot better, he checked things out and seems I hurt my neck in the fall also. couple of advils help also. I'll se in a couple more days. Should I be worried?

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