Mild head injury and concussion: when to get help and how to recover

The NHS says most head injuries are not serious. Headway, the brain injury charity, describes concussion as a type of head injury in which the brain shakes back and forth inside the skull, causing mild damage. It is commonly caused by falls, road crashes, assaults and sports accidents.

Headway says most concussions result in no long-term damage, but they can cause temporary disruption to brain function lasting for at least a number of weeks. The NHS describes concussion as a temporary brain injury that can last a few weeks.

Headway also notes that only around 10% of reported concussions involve loss of consciousness, so it is important not to rely on a lack of loss of consciousness as a sign that all is well.

The NHS says to call 999 if someone has hit their head and shows any of the following. Do not drive yourself to A&E; the 999 call handler will advise.

• Has been knocked out and has not woken up, or cannot stay awake or keep their eyes open.

• Has a fit (seizure).

• Has fallen from a height of more than 1 metre or 5 stairs, or hit their head at high speed such as in a road accident.

• Has problems with vision or hearing, or a black eye without having hit the eye.

• Has clear fluid coming from the ears or nose, bleeding from the ears, or bruising behind the ears.

• Has new numbness or weakness, or problems with walking, balance, understanding, speaking or writing.

• Has a head wound with something inside it, a dent in the head, or a bruise, swelling or large cut and is under 1 year old.

• Their behaviour has changed, such as being more irritable or distracted.

The NHS advises getting help from NHS 111 if you or someone else have recently had a head injury and are being sick (vomiting), feel dizzy, have a condition that thins your blood or take blood-thinning medicine, were drinking alcohol or taking drugs at the time of the injury, or have any other symptoms you are worried about. It says to call 111 if you need advice for a child under 5 years old.

Headway adds a list of warning signs in the days after concussion that should lead to the nearest emergency department, including increasing disorientation, new deafness in one or both ears, blurred or double vision, any weakness in the arms or legs, inability to be woken, any vomiting, any fits, drowsiness when you would normally be wide awake, and a severe headache not relieved by painkillers such as paracetamol.

The NHS says you might have symptoms for up to 2 weeks after a head injury. Its advice for minor head injuries, including those sent home from hospital, is below.

• Hold an ice pack, or a bag of frozen peas wrapped in a tea towel, to the area regularly for short periods in the first few days to bring down swelling.

• Rest and avoid stress; you or your child do not need to stay awake if you are tired.

• Take painkillers such as paracetamol for headaches.

• Make sure an adult stays with you or your child for at least the first 24 hours.

• Do not go back to work or school until you feel better, do not drive until you feel fully recovered, and do not play contact sports for at least 3 weeks.

• Do not take drugs, drink alcohol until you feel better, or take sleeping pills unless a doctor advises it.

Headway describes post-concussion syndrome as the range of symptoms that continue to occur after a concussion, including headaches, dizziness, nausea, impaired concentration, memory problems, extreme tiredness, intolerance to light and noise, irritability, sleep disturbance, and feeling anxious or depressed.

In many cases these resolve within days or weeks, though problems can persist for months and still resolve eventually. Headway says it is sensible to see your GP if you have these symptoms for more than about two weeks after the injury, or if they are severe and not getting better, and that you may be referred to a head injury specialist such as a neurologist or neuropsychologist.

Headway adds that these symptoms often happen even when there is no damage to the brain, and that the fear of having a brain injury can be distressing and delay recovery.

Headway says there is no single treatment for concussion, but with appropriate medical care, plenty of rest and specialist support where needed most people make a good recovery. It suggests warning relatives and employers about the possible effects, not rushing back to work, keeping stress to a minimum in the short term and avoiding alcohol.

The NHS says to see a GP if you are not sure it is safe to drive or return to work, school or sports after a head injury.

Head injuries are assessed through NHS 111, emergency departments and urgent treatment centres. Most people are sent home with advice. A GP can review lingering symptoms and refer on if needed.

The warning signs in this guide apply wherever you are being seen, and the NHS advice on when to call 999 or NHS 111 is the same whichever service you use.