Head Injuries: What to Watch for Afterward What are the main causes of head injuries? A serious head injury is most likely to happen to someone who is in a car wreck and isn't wearing a seat belt. Other major causes of head injuries include bicycle or motorcycle wrecks, falls from windows (especially among children who live in the city) and falls around the house (especially among toddlers and the elderly). Are head injuries serious? They can be. Bleeding, tearing of tissues and brain swelling can occur when the brain moves inside the skull at the time of an impact. But most people recover from head injuries and have no lasting effects. See the box below for a list of types of head injuries. Types of head injuries A concussion is a jarring injury to the brain. A person who has a concussion passes out for a short while. The person may feel dazed and may lose vision or balance for a while after the injury. A brain contusion is a bruise of the brain. This means there is some bleeding in the brain, causing swelling. A skull fracture is when the skull cracks. Sometimes the edges of broken skull bones cut into the brain and cause bleeding or other injury. A hematoma is bleeding in the brain that collects and clots, forming a bump. A hematoma may not be apparent for a day or even as long as several weeks. So it's important to tell your doctor if someone with a head injury feels or acts oddly.  Watch out for headaches, listlessness, balance problems or throwing up. How can the doctor tell how bad the damage is? Your doctor will ask about how the injury occurred, about past medical problems, and about vomiting, seizures (fits) or problems breathing after the injury. The injured person may need to stay in the hospital to be watched. Sometimes, special pictures of the brain may be needed to find out more about the damage. What happens after the injury? It's normal to have a headache and nausea, and feel dizzy right after a head injury. Other symptoms include ringing in the ears, neck pain, and feeling anxious, upset, irritable, depressed or tired. The person who has had a head injury may also have problems concentrating, remembering things, putting thoughts together or doing more than one thing at a time. These symptoms usually go away in a few weeks, but may go on for over a year if the injury was severe. Will the head injury cause permanent brain damage? This depends on how bad the injury was and how much damage it did. Most head injuries don't cause permanent damage. What about memory loss? It's common for someone who's had a head injury to forget the events right before, during and right after the accident. Memory of these events may never come back. Following recovery, the ability to learn and remember new things almost always returns. Is it true that the person must be kept awake after the injury? No. If your doctor thinks the person needs to be watched this closely, your doctor will probably put the person in the hospital. Sometimes, doctors will send someone who has had a head injury home if the person with them is reliable enough to watch the injured person closely. In this case, your doctor may ask you to wake the person frequently and ask questions such as "what's your name?" and "where are you?" to make sure everything is okay. Get help if you notice Any symptom that is getting worse, such as headaches, nausea or sleepiness Nausea that doesn't go away Changes in behavior, such as irritability or confusion Dilated pupils (pupils that are bigger than normal) or pupils of different sizes Trouble walking or speaking Drainage of bloody or clear fluids from ears or nose Vomiting Seizures Weakness or numbness in the arms or legs Other Organizations Brain Injury Association of America http://www.biausa.org/ 800-444-6443