Depending on the power of the bang and the location, a brain injury can be anything from a minor bump that goes away in a few days to a severe head injury that leaves the victim lying in a coma for a long time. Most head injuries are closed this means that an observer can’t see any blood, bumps, or bruises, but it doesn’t mean that all those things aren’t occurring inside the skull. You must, therefore, rely on your powers of observation. Look for signs that are similar to any illness: nausea, chills, shock, dizziness, and disorientation.

If a person merely bumps his or her head on, say, a cabinet door or a dresser drawer, chances are it will hurt, but the pain will soon subside. The person might have a headache and even a lump where the bump happened, but there shouldn’t be any other symptoms. An ice compress and some aspirin should do the trick, especially when combined with a small nap (which will stop movement for a while).

If the bump doesn’t subside within 24 hours and/or if the person experiences nausea, chills, dizziness, or a spacey feeling that doesn’t go away, he or she should call the doctor immediately. It’s possible that the victim suffered a more serious concussion.

A concussion can be anything from a temporary loss of consciousness to that bell-like ding a baseball player will hear for 10 minutes after being socked in the head by a hardball. The effects of a concussion can be a one-time-only reaction, or they can be long-lasting, consisting of several reactions occurring over time. The latter is what happens to punch-drunk fighters who become increasingly uncoordinated and eventually become unable to perform in the ring.

If a concussion is suspected, you should always seek medical help. Your physician can determine whether any neurological damage has occurred, and the victim can begin rehabilitation treatment to prevent the damage from increasing. Keep the victim as prone, still, and immobile as possible until you see the doctor.

Skull Fractures

Of course, there are those terrible accidents that do puncture the skull. A bullet or a shard of glass can easily result in a skull fracture and a brain injury. This open head injury puts a person at further risk because of the dangers of infection through the open door. Treat a skull fracture as a medical emergency, not only because of the seriousness of the blow to the head, but also because of the risk of hemorrhaging and infection.

A Mild Head Injury: Five Good Signs

All head injuries should be taken very seriously, but keep in mind that about 75 percent of all such injuries turn out to have only mild consequences, which is good news. Still, we suggest that you seek medical help for any and all suspected head injuries, just to be certain that all is well and to prevent future problems. When a person has a mild head injury, you’ll usually observe the following five conditions:

1. The injured person does not lose consciousness or is out only briefly. He or she may be confused for up to 20 minutes.
2. The person shows only mild physical symptoms of neurological damage, including nausea, dizziness, or blurry vision (which can crop up any time within three months of the accident).
3. The person is treated in the emergency room and is not admitted at all, or is hospitalized for no more than a week. He or she is ordered to rest and restrict activity just long enough for the bruised and jolted brain to heal, and for the results of diagnostic tests to show little damage.
4. After three months, the injured person has few side effects.
5. There is no motor damage, and the injured person’s faculties (the ability to think and solve problems) are intact.

Treating a Mild Head Injury

Sometimes a head injury can start out minor and become serious a few hours later. If a person gets up and dusts him- or herself off, but then goes home and goes right to sleep, it could be a sign of a more serious condition. If you see that a person is sleeping excessively within 24 hours of a head injury, take him or her to the emergency room.

It’s always best to get medical help for any sort of head injury. If a person blacks out, medical attention is imperative even though it can still signal only a minor head injury. Call for an emergency team quickly. While you are waiting for help to arrive, follow these steps:

1. Immobilize the victim as best you can, keeping the person on his or her back in case of possible spinal problems.
2. Avoid giving the victim alcohol, sedatives, or even water.
3. Observe the person for signs of shock and treat accordingly.
4. Keep the victim warm.
5. Use ice on the head to ease the pain.
6. If the victim is unconscious, time the length of the blackout. This will help in determining a diagnosis later.
7. If the injured person is released to your care, watch him or her carefully for at least 48 hours. Make sure no symptoms recur. If they do, bring him or her back to the hospital as soon as possible.

Danger Signs of a Serious Head Injury

Unfortunately, the other 25 percent of head injuries cause moderate to serious damage. If the injured person exhibits any of the following symptoms immediately after an accident, he or she probably has a moderate or serious injury:

• Unconsciousness for 10 minutes or more
• Seizures or convulsions
• Inability to swallow or control elimination
• Paralysis
• Slurred speech
• Loss of memory or confusion that lasts for more than 15 minutes
• Personality change, usually in aggressive, violent ways
• Difficulty breathing
• Pupils of unequal size

If someone around you suffers what appears to be a moderate or serious head injury, first make sure that help is on the way (preferably from a trauma center), and then begin first aid.