What to do if you hit your head

By Ashley Abramson July 4, 2022 at 2:00 p.m. EDT(iStock)

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Falling and hitting your head can be scary. In the moment, it can be difficult to figure out how serious your injury is, what you should do next and what symptoms might signal a possible emergency.

A blow to the head can cause a traumatic brain injury (TBI), bleeding in the brain, a concussion or a contusion (a bruise on the brain). But quick action can help mitigate some of the most serious potential outcomes. Here is how to assess your personal risk level after a severe head injury, and when you need to call for immediate help.

What’s your risk?

As people age, they may be more likely to fall and hit their head, says Matthew E. Peters, an associate professor of psychiatry at Johns Hopkins Medicine. That’s in part because your strength, balance and reflexes may decline with age, as well as with conditions such as osteoporosis and arthritis.

The risk of a serious head injury is also higher for older adults. One large Israeli study, published in the journal Brain Injury in 2016, found that among all age groups, they were the most likely to be hospitalized with TBI.

“As you age, the brain tends to stiffen and shrink, which means there’s more room inside the skull for it to move around,” Peters says. “That moving can tear blood vessels, which [with age] are more rigid and likely to tear.”

Some medications can also increase the likelihood that a head injury will cause bleeding in the brain. These include blood thinners — commonly prescribed to reduce the risk of a heart attack or stroke — as well as the regular use of aspirin and nonsteroidal anti-inflammatory medications such as ibuprofen, says Matthew Robbins, a neurologist at Weill Cornell Medicine and NewYork-Presbyterian. Frequent or excessive alcohol consumption can raise the risk of bleeding as well, Robbins says, along with the risk of falling in the first place.

Is it an emergency?

The first rule of thumb with a possible head injury: When in doubt, don’t hesitate to seek help.

If you’ve hit your head and are experiencing weakness, numbness, a decrease in coordination, slurred speech, or increased agitation or confusion, call 911 immediately or get someone to call for you. Do the same, Peters advises, if you develop a headache that’s either the worst you’ve ever had or that’s not relieved by acetaminophen. (Consult your doctor before taking an NSAID like ibuprofen after a head injury.) Other red flags include a change in pupil size (the black of your eyes), changes in vision (such as blurriness or double vision), seizures or a loss of consciousness. People who sustain a skull fracture could experience delayed bleeding, which can “progress in very unpredictable ways minutes, hours, or days after a head injury,” Robbins says.

If you’re at a particularly high risk of a serious head injury — for one of the reasons detailed above, for example — you should seek emergency care after hitting your head even if your symptoms seem mild, says Ula Hwang, an emergency medicine doctor at Yale Medicine and professor at Yale’s School of Medicine.

In a non-emergency situation — you hit your head on a cabinet but otherwise feel normal and aren’t on blood thinners, for example — it’s still wise to check in with your doctor. It’s also a good practice to tell a loved one if you’ve hit your head, even if it seems minor, because the effects of some head injuries can escalate in severity over time.

How to prevent falls

Simple adjustments to your home can help prevent injuries, experts say. Here are four tips for a safer space.

• Remove hazards. Keep clutter off the floor and secure any rugs.
• Dress for balance. Wear stable, well-fitting shoes, and use your cane or walker if you need one, Hwang says.
• Customize your space. Add railings to your bathtub, shower and toilet areas, and any stairways in your home.
• If you need more help, Peters suggests checking to see whether your insurance policy covers fall risk assessments, which are completed at home by an occupational or physical therapist.