Head Injuries: When to Seek Medical Attention After a Bump

The back of the head was hit but did not swell?

I was originally standing with my back against a column (which is much wider than my head).
Suddenly, my friend rushed over, and I leaned back, hitting the column with significant force, causing immediate headache and tears.
There was no swelling, and I didn't apply ice.
After resting, I felt much better, but I continued to experience sudden sharp pains.
The next day, it seemed like there was no major issue, but by the third day, I felt a bit dizzy and heavy-headed, with some discomfort in the back of my head (without pressing on it).
Is this a sign of internal bleeding? Do I need to see a doctor for an X-ray? What should I do regardless of the outcome?

Wo de tou, 10~19 year old female. Ask Date: 2016/06/11

Dr. Shi Guozheng reply Orthopedics

A head injury is considered to be a serious concussion if there is loss of consciousness, severe pain, vomiting, or weakness in the limbs.
If none of these symptoms are present, resting for a few days is usually sufficient for recovery.
However, it is important to monitor for up to three months, as some individuals may experience chronic bleeding, which can present symptoms.
Currently, no examination is necessary; however, if symptoms do arise, it is essential to seek medical attention immediately.

Reply Date: 2016/06/11

More Info

When it comes to head injuries, understanding the signs and symptoms that warrant medical attention is crucial for ensuring your safety and well-being. Based on your description of the incident, it sounds like you experienced a significant impact to your head, which can lead to various complications, including concussions or intracranial bleeding.
Firstly, it's important to note that even if you did not experience immediate symptoms such as swelling or bruising, the brain can still be affected by a forceful impact. Symptoms like headaches, dizziness, and a feeling of heaviness in the head can indicate that something more serious may be occurring. The fact that you felt intense pain immediately after the impact and have since experienced intermittent pain and dizziness suggests that you should seek medical evaluation.

In general, the following symptoms after a head injury should prompt you to seek medical attention:
1. Persistent or worsening headache: If your headache does not improve or worsens over time, this could be a sign of increased intracranial pressure or bleeding.

2. Dizziness or balance issues: Feeling dizzy or off-balance can indicate a concussion or other brain injury.

3. Nausea or vomiting: These symptoms can be associated with increased pressure in the skull or other complications.

4. Confusion or difficulty concentrating: If you find it hard to think clearly or remember things, this could be a sign of a concussion.

5. Changes in vision or hearing: Blurred vision, ringing in the ears, or other sensory changes should be evaluated.

6. Loss of consciousness: Even a brief loss of consciousness is a red flag that requires immediate medical attention.

Given that you experienced a significant impact and are now feeling symptoms like dizziness and a strange sensation in the back of your head, it is advisable to see a healthcare professional. They may recommend imaging studies such as a CT scan or MRI to rule out any serious conditions like intracranial hemorrhage or skull fractures.
In terms of treatment, if a concussion is diagnosed, the typical management involves physical and cognitive rest. This means avoiding activities that require concentration, such as reading or using screens, as well as physical exertion. Gradual return to normal activities is usually recommended, but only under the guidance of a healthcare provider.

In conclusion, while you may feel that your symptoms are manageable, the potential risks associated with head injuries necessitate a cautious approach. It's better to err on the side of caution and seek medical evaluation to ensure that there are no underlying issues that could lead to more serious complications down the line. Remember, your health and safety should always come first.

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