You have suffered a mild head injury, and the Clinician that has examined you is happy for you to go home. However, it is recommended that you are not alone for the first 48 hours; we recommend another adult to be with you at home, and that you/ they are near a phone to call for help should your condition deteriorate.
Common symptoms of a Head Injury
It is common to experience some of the following symptoms over the first few days after a head injury. They can be unpleasant, but are not usually associated with any long-term or serious conditions:
- Mild headache
- Feeling sick (but not vomiting)
- Lack of appetite
- Difficulty sleeping
- Feeling irritable
- Dizziness or lightheaded
- Difficulty concentrating
- Difficulty remembering things
These symptoms should disappear over the next 2 weeks. If they do not, or you are concerned about how you are feeling, then go to see your GP.
General advice
If you follow this advice, it may relieve some of your symptoms, and help you recover more quickly:
- Take simple pain relief such as Paracetamol for headache
- Drink fluid regularly and eat food; small sips and small light diet if you feel nauseous
- Do not return to your normal school, college or work activity until you feel you have fully recovered
- Try to avoid stressful situations, as this may make your symptoms worse
- Do not drive a motor vehicle, ride a motorbike or bicycle, or operate machinery for the first 24 hours after your injury
- Do not work on a computer or play computer games until you have fully recovered; spending time concentrating on images or text on a screen may make your symptoms worse
- Do not drink alcohol until you are completely recovered, as your ability to tolerate alcohol is reduced after a head injury
- Do not take any drugs such as sleeping pills or tranquilizers until your symptoms have settled, unless your doctor has said you can take them. Speak to your GP if you need further advice
- Do not play contact sports for at least 3 weeks; please speak to your GP before returning to contact sport after a head injury.
Further information about head injuries can be found at:
www.nhs.uk/conditions/head-injury-minor/Pages/ Introduction.aspx
www.patient.co.uk/health/head-injury-instructions
Things to watch out for
Most head injuries do not lead to any serious complications. However, if you experience any of the following symptoms, you must attend an Emergency Department or call 999:
- Unconsciousness or increasing unconsciousness, difficult to wake up
- Any new confusion, not knowing where you are
- Drowsiness that lasts longer than 1 hour, when you would normally be awake
- Any difficulty understanding or speaking
- Any loss of balance or problems walking
- Weakness in one or more arms or legs
- Visual disturbances – blurred vision, loss of vision, floaters
- Very painful headache that is not relieved with painkillers, or worsening after painkillers
- Any vomiting on more than one occasion in a 12-hour period (with at least 30 minutes between episodes)
- Any fits/seizures or collapsing/passing out
- Clear fluid coming from your nose or ears
- Bleeding form one or both of your ears
- New deafness in one or both of your ears
Taking Anti-Coagulant medication after a Head Injury
If you have had a head injury and are taking medication such warfarin or direct anti-coagulants (DOACs) such as rivaroxiban or apixaban, you are at risk of have sudden or delayed bleeding on the brain.
Your doctor will have carried out a risk assessment, weighing up the benefits of continuing your anti-coagulant, with the risk of bleeding, against stopping the anti-coagulant, with the risk of forming blood clots. After one week, the risks associated with head injuries return to normal.
You have been advised to:
○ Continue with your anti-coagulant
○ Stop your anti-coagulant for one week
Long term problems
Most people recover from minor head injuries quickly and with no long-term health problems.
However, please contact your GP if:
- You are still experiencing problems 2 weeks after your accident
- You are concerned about whether you are fit to drive a car or ride a motorbike
- Develop new problems after weeks or months following your accident
Concussion and return to sport
Concussion is when an injury to the head or body transmits forces to the brain causing injury. Symptoms usually occur quickly and are short lived and do not require any treatment. The injury is not structural, so does not show up on any hospital scans and presents more through common symptoms of concussion as described earlier in this leaflet.
Most concussions resolve with simple rest within 7-10 days. Occasionally symptoms can take longer to resolve, so medical attention may be sought. Every case is treated based on individual symptoms.
Rest from all physical, and brain activities for 24-48 hours is recommended. This includes physical activities such as sport or exercise, and activities requiring concentration such as reading, computer games, watching TV, schoolwork or smart phones.
Returning to these activities before symptoms have stopped can cause:
- Prolonged symptoms
- Potential long-term consequences, psychological and brain disorders
- A further concussion – which could lead to severe brain swelling (Second Impact Syndrome) and could be fatal
Return to play – under 19’s
A more conservative, slower approach is taken in adolescents and children due to the brain not being fully developed and the risk of re-injury.
Return to school activities is normally possible after 48 hours after injury, and prolonged time off school is not necessary. Younger people should return to schoolwork before returning to sport.
If symptoms return at any point, then their level of activity should be reduced to a level that does not cause symptoms.
It is recommended that all players of sport, regardless of age, should have 2 weeks rest and be symptoms free before returning to their chosen sport.
Following this, a graded return to play (GRTP) can be followed. In under 19’s there should be 48 hours between stages as a minimum.
Return to play - Over 19’s
The same advice applies, but the GRTP stages can be done every 24 hours, providing there are no increased symptoms.
It is recommended that all players are seen by a doctor prior to returning to full competition, this is usually your GP.
Return to Play (RTP) outline
Most people will make a full and uneventful recovery and will want to return to play as soon as possible. Following a concussion, players, coaches, families, doctors and officials must work together to ensure safe participation in sport.
- All symptoms should have gone before a GRTP is commenced
- Seek advice from people experienced in GRTP and follow it
- Ensure the advice of a healthcare professional is sought appropriately
Further advice surrounding concussion and return to sport can be found at:
www.nhs.uk/conditions/concussion
www.englandrugby.com/my-rugby/players/player-health/ concussion-headcase/resources
www.sportandrecreation.org.uk/policy/research-publications/ concussion-guidelines
www.mihp.co.uk/health/specialist-clinics/#concussion-clinic www.thefa.com
www.englandhockey.co.uk
Concussion forms
It is important that your child’s schoolteachers and coaches are aware that your child has had a concussion.
You can use these slips on the next page to give to them so that they have a record.
Date of Review: October 2023
Date of Next Review: October 2025
Ref No: PI_M_1838 (Rochdale)