Headache after a fall or impact

Headache after a fall or impact


Headache after a fall or impact. A head injury usually results from a blow or fall to the head. The damage caused by a blow or fall to the head depends on the force with which this occurs and where this force is applied to the head. Types of damage from a blow or fall to the head include:

  • damage to skin and muscles: the damage can be limited to a bruise and / or wound of the skin and underlying muscles
  • concussion: the brain itself can be damaged. Due to the blow or fall on the head, the brain can temporarily not function optimally, without causing permanent damage. This is called a concussion
  • brain contusion: a more severe blow or fall can cause permanent damage to the brain and is referred to as a brain contusion. In rare cases, a blood vessel may rupture and bleeding may occur in or around the brain
  • fracture in the cranial bone: if the blow or fall was severe, a fracture in the cranial bone may also occur. This creates a risk of bleeding between the skull bone and the brain

Symptoms of a headache after a fall or impact

  • Symptoms of skin and muscle damage

A bruise of the skin and underlying muscles usually results in a bump on the head that can sometimes grow very quickly. Tearing up small blood vessels can cause small bleeding in and under the skin, which you can recognize as bruising after a few days. When the skin itself breaks, abrasions or sometimes deeper wounds can occur. These can bleed profusely. These wounds often cause local, sometimes very annoying, pain. Often you also have nagging headaches throughout the head, which arise in the first hours after the injury.

  • Symptoms of concussion

With a concussion, the brain temporarily does not function optimally. People with a concussion therefore cannot react to their environment immediately after the accident. They can also be unconscious. This unconsciousness usually lasts no more than a few minutes, but should not last longer than 15 minutes. If the unconsciousness lasts longer than fifteen minutes, then there is no longer a concussion but a brain contusion.

Also, someone with a concussion is often temporarily unable to absorb new information. As a result, this person keeps asking the same thing, for example what happened or where he is. He usually continues to do this, even if these questions have already been answered. The answers are then temporarily not absorbed by the brain. The period of not including new information usually lasts a few minutes and should not exceed an hour. When someone is still unable to absorb new information for more than an hour after the accident, we speak of a brain contusion and no longer of a concussion. In retrospect, it often turns out that someone with a concussion no longer knows what happened just before the accident. This information was also not absorbed by the concussion.

After a concussion, headaches are common and slowly increase in the following hours. This is often accompanied by nausea. Bright lights and loud noises can be annoying and make headaches worse. These complaints gradually disappear after a concussion, but can last for several days to weeks.

  • Symptoms of a brain contusion

The symptoms that someone with a brain contusion shows are related to the severity of the brain contusion. With a mild brain contusion, the symptoms are similar to those of a concussion, but they last longer. A person with a brain contusion is unconscious for more than 15 minutes and / or unable to absorb new information for more than an hour.

Often people with a brain contusion are also more confused than people with a concussion. Sometimes they react aggressively to people around them and do not listen. With very severe brain contusions, the person is unconscious during the first hours after the accident. People with a brain contusion also often have more serious head injuries than people with just a concussion, but this is not necessary. Complaints that occur after a brain contusion:

  • headache
  • nausea
  • vomit
  • hypersensitivity to light and sound

These complaints often last longer than after a concussion. Depending on which parts of the brain are damaged, other complaints can also occur. This is also very dependent on the severity of the brain contusion. Complaints that can also occur with mild brain bruises:

  • less able to concentrate
  • tired more quickly

Complaints that can also occur with more serious brain bruises:

  • behavioral changes
  • personality changes
  • loss of life, such as reduced vision or paralysis. This depends on where the brain is damaged
  • Symptoms of bleeding in the skull

When a blood vessel ruptures from a blow or fall to the head, bleeding can occur in the head. This bleeding takes up space within the skull. Because the skull is a closed space, the brain cannot be set aside for this bleeding, but is compressed. As a result, the brain cannot function properly and someone with such bleeding can become confused, slurred or paralyzed, and become unconscious for a few hours to days after the accident. Bleeding from an artery is most dangerous and can occur in the first hours after an accident. The person appears to be clearly conscious at first, but after some time develops an increasing headache and becomes drowsy. Bleeding from a vein is much slower and can still cause symptoms a few days to weeks after an accident,

How do headaches occur?

A blow or fall to the head can damage the skin and shake the brain within the skull. Depending on the severity of the acting force and the place where the force hits the head, various symptoms can develop. Sometimes the brain cells can temporarily not function optimally, such as with a concussion. With a brain contusion, brain cells actually break down. A blood vessel can also rupture, causing a bruise in or just outside the brain that compresses the brain.

Headache after a fall or impact, is it serious and what can you expect?

  • Bruising or wounding of skin and underlying muscles

It may take several weeks for the effects of a bruise or wound to heal. Usually this happens spontaneously. You cannot speed up the recovery yourself. Measures you can take are:

  • keep the area around the wound clean by rinsing it regularly with running water
  • protect the wound against dirt and new damage by sticking a plaster or gauze on it
  • sometimes it is necessary to suture the wound when the wound edges are not close enough together. You can read more about this in the doctordokter.nl folder ‘Suturing’
  • if dirt has entered the wound and you last had a tetanus injection more than ten years ago, it may be wise to get a repeat tetanus shot
  • Concussion

Many people suffer from headaches after a concussion. This headache often worsens in the first hours after the concussion and subsides in the days that follow. In some people, the headaches last for several weeks. Bright lights, noise, and crowds can make headaches worse. If you have a lot of headaches, you can use paracetamol for this. If paracetamol does not help enough, it is wise to discuss with your GP practice whether you can use stronger painkillers.

Certain painkillers should not be used in the first 24 hours after the concussion because they affect blood clotting. After a few days it is wise to reduce the amount of painkillers. On the contrary, taking painkillers daily for more than a few weeks can cause headaches and make you need more and more painkillers. If you are unable to reduce the painkillers, it is also wise to consult with your doctor.

Nausea is also a common complaint after a concussion, sometimes accompanied by vomiting. If you vomit three times or more in the first hours after a concussion, it is wise to contact your GP practice. The nausea and vomiting usually disappear quickly in the first days after the concussion. When the complaints are very severe, you can sometimes temporarily use suppositories against nausea and vomiting. Other common complaints are:

  • fatigue
  • insomnia
  • be easily irritated
  • dizziness
  • problems with concentration and memory
  • can’t stand crowds

If this is bothering you a lot, it may be wise to take a little more rest. Strict bed rest, as was previously prescribed, is no longer necessary. You can listen better to the signals from your body. Increased fatigue or headaches are often a sign that you need to rest. When you feel well, you can gradually return to your daily activities. It is wise to wait before working and exercising until you can do all your activities at home again.

Slight symptoms of fatigue, problems concentrating and being unable to tolerate pressure can persist in the weeks after a concussion and often disappear gradually. Most people no longer suffer from this three to six months after the accident. The complaints are rarely permanent.

  • Brain contusion

The consequences of a brain contusion depend on its severity. You will usually be admitted to hospital with a brain contusion. You will be monitored there very regularly. Often a scan of your head is also made to assess the degree of damage. The neurologist or neurologist’s assistant will check you regularly and determine when you can go home. The recovery after a mild brain contusion is the same as after a concussion. The complaints can be more severe and last longer, but this does not have to be the case.

With a more serious brain contusion, you may suffer from failure symptoms, such as problems with seeing, talking or paralysis. The recovery of these failure symptoms can often be accelerated by therapy, for example physiotherapy or occupational therapy. We will determine which therapy is suitable for you.

With a more serious brain contusion, there may be a change in behavior or character. These changes can be less influenced by therapy, but can have a major impact on the person himself and his immediate environment. Often a (neuro) psychologist is engaged who can guide the patient and his family. He can also use tests to determine the severity of these changes in behavior and character. Memory problems are another problem after a concussion and a psychologist can help with recovery.

  • Bleeding in or outside the brain

Bleeding in the brain takes up space and pushes the brain aside. Some time after the accident, the following symptoms may occur:

  • confusion
  • failure phenomena
  • unconsciousness

Admission to hospital is then always necessary. In the hospital, a scan of the head is made to determine what type of bleeding is involved. Accumulation of blood outside the brain due to a tear in an artery is an additional phenomenon of a fracture of the cranial bone and is a life-threatening situation. You will then have to be operated on quickly by a neurosurgeon. It stops the bleeding and removes the blood, so that the brain is no longer compressed.

After this operation, the patient is nursed in the intensive care unit. Accumulation of blood outside the brain from bleeding into a vein is usually less life-threatening. With a minor bleeding, it is often awaited whether the bleeding itself will stop. Major bleeding also often requires surgery. Bleeding in the brain itself due to tearing of blood vessels there is less easy to operate. These usually have to come to a standstill themselves.

When to go to the doctor with a headache?

You should always contact your GP practice if, after a blow or fall to the head, someone:

  • is unconscious for more than 15 minutes
  • more than one hour after the accident still cannot absorb new information
  • after first being clear, becomes drowsy and confused or unconscious again
  • vomits more than twice
  • indicates that the headache is getting worse
  • are taking blood-thinning medications that require check-ups at the thrombosis service, or have a bleeding disorder and the symptoms of a concussion
  • is younger than 2 or older than 65 and has the symptoms of a concussion
  • has a wound that keeps bleeding
  • has a dirty wound and was last given a tetanus shot more than ten years ago
  • has fallen from a height of more than two meters
  • fallen after an accident in which the speed was more than 10 kilometers per hour for cyclists, 30 kilometers per hour for motorcyclists and 60 kilometers per hour for motorists
  • is not approachable for any other reason, for example due to the influence of alcohol, medicines or drugs

It is also important to contact your doctor if, apart from the above points, you simply do not trust it.

What can you do about a headache yourself?

Head injuries Superficial wounds can be rinsed with lukewarm water to remove the worst dirt. If the wound is very bleeding, you can use a clean ironed dish towel or sterile gauze to press firmly against the wound to stop the bleeding. If the wound edges do not lie against each other or if the wound continues to bleed, it is wise to contact your doctor’s office to have the wound sutured and the bleeding to stop. You can put a washcloth filled with ice cubes on a bump to prevent the bump from getting bigger and to reduce pain.

Concussion You should keep a close eye on a person with a concussion for the first 24 hours after the accident to see if he becomes drowsy or shows signs of a brain contusion. That is why someone must always be present for the first 24 hours. You check the person with a concussion every hour:

  • whether the person is still awake
  • whether the person knows where he is
  • whether the person knows what has happened in the past few hours

Someone with a concussion often feels like going to sleep. You must then wake him up every two hours and ask the above questions. When the person answers the questions correctly, they can go back to sleep. Two hours later, the person should be awakened and asked the same questions. If everything has remained normal after 24 hours, you can stop the check-up. Contact your doctor immediately if:

  • you cannot wake the person with a concussion
  • when he gives no or strange answers to the questions

Brain contusion People with signs of a brain contusion are actually always hospitalized, where they are closely monitored. In case of a mild brain contusion, admission to a nursing ward will take place. A nurse checks the patient every hour. Blood pressure and pulse are measured, a light is looked into the eyes and how the patient responds to questions and commands. A more severe brain contusion requires more intensive check-ups and the patient is usually admitted to a specialized ward or a medium or intensive care unit.

General advice and precautions

Try to avoid head injuries. You can do this by taking a number of precautions, such as:

  • a bicycle helmet for children
  • a cap while riding
  • a helmet while inline skating
  • obey the traffic rules
  • be careful when working at height and use decent equipment
  • seat belts in the car
  • a good car seat for children
  • only allow children to participate in traffic themselves when they are well aware of the traffic rules and can apply them independently

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