When British actor Natasha Richardson fell and hit her head during a beginner’s skiing lesson in Quebec, Canada in 2009, she didn’t give the mishap a second thought. After reportedly refusing medical attention twice, she gave in when she developed a headache and other worrisome symptoms. Transported to a hospital in Montreal, she was placed in the intensive care unit and pronounced brain dead. With not much left to do for her, her husband, fellow actor Liam Neeson flew her home to New York to be with family and friends. She passed away soon after.
Like Richardson, most of us would probably forgo a trip to the hospital when we accidentally bang our head in a fall or get hit by a hard object. “When we injure our arm or leg, we can see it through a bruise, wound, bump, or fracture,” says Cymbeline B. Perez-Santiago, MD, Chief of the Section of Neurology of the top hospital in the Philippines Makati Medical Center (MakatiMed). “But traumatic brain injury (TBI), or a sudden external force strong enough to move the brain within the skull, isn’t always visible.”
TBI can range from a mild and temporary bruise, wound, or tender bump on the head, to more serious and life-threatening conditions. “A concussion is a mild traumatic brain injury that leaves you feeling dazed and with a headache, neck pain, or changes in vision,” explains Dr. Perez-Santiago. “A contusion refers to bleeding in the brain substance or parenchyma, like a bruise of the brai8 tissue. A skull fracture means you cracked your skull bone, and the sharp broken bones could cut into your brain or an artery, resulting in a pooling of blood that presses against your brain.”
This pooling of blood is known as hematoma, and it can happen instantly upon impact to the head, or after several days and even weeks. Active bleeding can put pressure on the brain. “This puts you at risk for potential brain damage and even death,” adds Dr. Perez-Santiago.
For MakatiMed, no head injury is too minor or insignificant to take to a specialist. “Because some damage caused by a head injury happens over time, it’s still recommended that you see your doctor within a week of the accident. That way, they can request for follow-up imaging tests, check for new symptoms, or gauge whether existing symptoms have worsened or improved,” highlights Dr. Perez-Santiago.
If the head injury is minor: “Sit or lie comfortably with the head slightly elevated. Apply an ice pack on the injured site, and clean any surface wound with water and a wound disinfectant. Give an over-the-counter pain reliever in case of a headache,” says Dr. Perez-Santiago. “A person with a head injury doesn’t necessarily have to stay awake at all times, but make sure he or she can be woken up gently and respond in a normal way.”
If the head injury includes the following symptoms: “Vomiting, headaches and dizziness, double vision, confusion, memory loss, difficulty keeping awake, balance problems, trouble hearing and speaking, and pain that doesn’t go away even after taking a pain reliever are signs of a more serious injury,” notes Dr. Perez-Santiago. “Time is of the essence. Go to the nearest emergency room immediately.”
If the head injury presents symptoms days or weeks after the accident: “See your doctor as soon as possible for persistent headaches and nausea, memory and balance issues, one-sided weakness, disorientation, contusions, and increase in drowsiness,” asserts Dr. Perez-Santiago. “These are red flags that strongly indicate complications following the head injury.”
“Again, after you hit your head, it’s best to see a neurologist who can assess your condition and avert any problems that may arise from what you assumed was a minor accident,” reminds Dr. Perez-Santiago.