A headache after a head injury can happen after a fall, a blow, or an accident, but some headaches need urgent medical attention. Call emergency services if the headache gets worse or does not go away, or if it occurs with repeated vomiting, confusion, weakness, seizures, or unusual sleepiness. Even without these warning signs, seek medical advice if a headache develops after a head injury, particularly if symptoms persist or worsen.
When should you call for a headache after a head injury?
The most important factor is whether the headache is accompanied by warning signs or becomes progressively worse. A head injury can affect the brain even when there is no visible wound or obvious damage to the outside of the head. Some serious problems also develop gradually, so feeling relatively well immediately after an accident does not always mean that everything is fine.
According to the US Centers for Disease Control and Prevention (CDC), a headache that gets worse and does not go away is an emergency warning sign following a possible concussion or mild traumatic brain injury.
Call emergency services immediately if any of these signs appear
After a head injury, seek emergency medical care if the injured person experiences any of the following symptoms. Do not wait for every symptom to appear or for the person to become more unwell.
- A headache that becomes increasingly painful or does not go away.
- Repeated vomiting.
- Confusion, unusual behavior, agitation, or difficulty recognizing familiar people or places.
- Loss of consciousness, increasing drowsiness, or difficulty waking up.
- Seizures or convulsions.
- Weakness, numbness, difficulty walking, or loss of coordination.
- Slurred speech, double vision, or one pupil appearing larger than the other.
- Blood or clear fluid coming from the nose or ears after the injury, particularly when a serious head injury is suspected.
These symptoms can indicate a serious injury that needs immediate assessment. The MedlinePlus head injury first-aid guidance also identifies severe headache, repeated vomiting, seizures, unequal pupils, and loss of consciousness as reasons to obtain urgent medical help.
If the person is unconscious, has a seizure, or is difficult to wake, call your local emergency number. In India, dial 112 for emergency assistance. Avoid driving the injured person yourself if their condition is unstable.
When should you contact a doctor without waiting?
Not every headache after a head injury requires an ambulance, but a new headache following an impact should not automatically be dismissed as minor. Contact a healthcare professional promptly for assessment, especially if the headache continues, interferes with normal activities, returns after initially improving, or occurs with dizziness, nausea, light sensitivity, or difficulty concentrating.
Seek prompt medical assessment even if the headache is not getting worse when the injury involved a significant fall, a road traffic accident, or another substantial impact. A clinician can consider how the injury occurred, when the headache began, whether symptoms are changing, and whether additional examination or testing is needed.
People taking blood-thinning medicines or living with a bleeding disorder should seek urgent medical advice after a head injury, even if symptoms seem limited. Older adults may also need a lower threshold for assessment, particularly after a fall. The Mayo Clinic guidance on bleeding inside the skull explains why symptoms such as a persistent headache, vomiting, weakness, or vision changes after a head injury require prompt attention.
Can a headache after hitting your head be normal?
Headaches can occur after a head injury, including with a concussion. A concussion is a type of brain injury that can affect how a person feels, thinks, sleeps, and functions. A headache may occur alongside dizziness, nausea, tiredness, sensitivity to light or noise, or problems with concentration.
According to the CDC's guidance on concussion symptoms, symptoms can appear immediately or take hours or days to become noticeable. Many people improve over time, but the presence of a headache alone cannot establish how serious an injury is. A medical professional can assess the overall pattern of symptoms and the circumstances of the injury.
A headache that seems manageable at first can still require attention if it changes or new symptoms develop. Do not use the ability to walk, talk, or carry on with everyday tasks as proof that a serious injury has been ruled out.
What should you do while waiting for medical help?
If you suspect a serious head injury, arrange emergency assistance rather than trying to manage the headache at home. Keep the injured person as still and comfortable as possible. Avoid unnecessary movement of the head and neck, especially after a fall or a high-impact accident, because a neck injury may also be present.
While waiting for help:
- Stay with the injured person and watch for changes in alertness, breathing, speech, or movement.
- Do not allow the person to drive, return to sports, or undertake activities that could cause another injury.
- If vomiting occurs, protect the airway and follow the emergency dispatcher's instructions. If the person may have a neck injury, avoid unnecessary movement and follow professional guidance.
- Do not give alcohol or recreational drugs.
- Ask a healthcare professional before giving pain medication, particularly if the injury has not been assessed or bleeding is a concern.
The MedlinePlus first-aid guidance for head injuries recommends limiting movement when a serious head or neck injury is suspected and obtaining immediate medical assistance when serious warning signs are present.
What if the headache starts hours or days later?
A delayed headache after a head injury still deserves attention. Symptoms do not always appear immediately, and a person may initially seem well before developing a headache, nausea, confusion, or changes in behavior. A headache that develops later should not automatically be attributed to tiredness, stress, or the original impact without considering the possibility of an injury-related problem.
If the headache is worsening, does not go away, or occurs with any emergency warning sign, seek emergency care immediately. If the headache is new but there are no emergency signs, contact a healthcare professional promptly for advice about the appropriate assessment. Do not wait for symptoms to become severe before seeking help.
How are headaches after a head injury assessed?
A healthcare professional will ask how the injury happened, when the headache began, whether it is changing, and whether there have been symptoms such as vomiting, memory problems, dizziness, or loss of consciousness. They may review existing medical conditions and medicines, including blood thinners, and examine alertness, vision, movement, coordination, and other neurological functions.
Depending on the circumstances and examination findings, the clinician may recommend observation, imaging such as a CT scan, or other assessment. Not everyone with a headache after a head injury needs a scan, but symptoms and examination findings help determine whether one is appropriate.
When is it safe to return to normal activities?
Do not return to contact sports or activities that carry a risk of another head impact while symptoms remain unexplained or recovery is incomplete. If a concussion is suspected or diagnosed, follow the healthcare professional's instructions about returning to work, school, exercise, driving, and sports.
Headaches that persist, worsen, or interfere with sleep, concentration, work, or daily activities should be reviewed by a healthcare professional. Follow-up may be needed to assess recovery and decide whether further evaluation or changes to activity are appropriate.