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Why do I have head injury symptoms after a bump to my head?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: July 27, 2025Updated: July 27, 2025

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Key Takeaways

Head injury symptoms—headache, dizziness, nausea, blurred vision—usually come from the brain moving suddenly inside the skull, causing a mild traumatic brain injury (concussion) or bleeding. Symptoms can start right away or emerge up to 72 hours later as swelling increases. Even a short loss of consciousness, any amnesia, or worsening pain means you need urgent medical evaluation because delayed bleeding can become life-threatening.

Could a single hit really cause these symptoms?

Yes. Even a brief, seemingly minor blow can jolt the brain, stretch nerve fibers, and trigger a concussion. Bruising, microscopic bleeding, or swelling inside the skull can explain the headache, fogginess, or balance problems you feel now.

  • The brain can move 2–3 cm inside the skull during impactThat rapid deceleration stretches axons and releases inflammatory chemicals that disrupt normal brain signaling, leading to dizziness and confusion.
  • Loss of consciousness is not required for concussionAbout 90 % of concussions seen in U.S. emergency departments do NOT involve passing out, yet patients still report memory gaps and nausea.
  • Secondary inflammation peaks between 24 and 72 hoursCytokine release and swelling can explain why you felt fine after the hit but woke up the next day with pounding headaches.
  • Even low-speed falls can be dangerous in older adultsPeople over 65 have more fragile bridging veins; ground-level falls account for 50 % of subdural hematomas in this age group.
  • Mild TBIs make up 75 % of the 1.4 million U.S. head injuries each yearThe American Migraine Foundation notes that three-quarters of the roughly 1.4 million annual traumatic brain injuries are classified as “mild,” showing how often a single seemingly minor hit leads to concussion-level damage. (AMF)
  • Subtle symptoms after a minor blow still signal concussion riskCleveland Clinic cautions that any impact causing headache, dizziness, nausea, or feeling “out of it,” even for a moment, indicates a concussion and warrants stopping activity and seeking medical care. (CCF)
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Which head injury symptoms mean you should go to the ER right now?

Some signs point to bleeding, high intracranial pressure, or skull fracture. Waiting at home could allow irreversible damage. As the team at Eureka Health notes, “Timing matters—brain bleeding can double in volume within two hours.”

  • Repeated vomiting is a red flagMore than two episodes triples the likelihood of intracranial hemorrhage in CT studies.
  • Worsening or new severe headache after two hoursEscalating pain suggests expanding hematoma or rising pressure and warrants immediate imaging.
  • One pupil larger than the otherAnisocoria can signal pressure on the third cranial nerve from a subdural bleed.
  • Weakness or numbness in an arm or legFocal neurologic deficits indicate possible contusion or stroke-like injury secondary to trauma.
  • Seizure occurring after the impactPost-traumatic seizures occur in about 5 % of moderate head injuries and often precede discovery of cortical bruising.
  • Loss of consciousness longer than one minute warrants immediate ER careACEP advises that being unconscious for more than 60 seconds after a blow to the head is a sign of moderate-to-severe brain injury that requires rapid imaging and neurologic evaluation. (ACEP)
  • Clear fluid or blood from the nose or ear can signal a basilar skull fractureDignity Health warns that drainage of clear cerebrospinal fluid or bloody discharge following head trauma should prompt an urgent 911 call because it often accompanies skull fracture and internal bleeding. (Dignity)

Why can head injury symptoms appear hours or even days later?

Delayed symptoms puzzle many patients. Sina Hartung, MMSC-BMI explains, “Microscopic tears leak blood slowly, so pressure builds silently until it reaches a tipping point.”

  • Slow venous bleeding fills the subdural spaceBridging vein tears can ooze for 24–48 hours before causing noticeable drowsiness or confusion.
  • Chemical cascades disrupt brain metabolismExcess glutamate and calcium influx impair neurons, causing fatigue and light sensitivity that peak on day two.
  • Sleep after a concussion can mask early warning signsNormal drowsiness makes it harder to detect lethargy from rising intracranial pressure during the first night.
  • Older anticoagulant users face delayed bleedingWarfarin or DOACs increase hematoma risk by 4-fold, often with subtle day-two headaches before rapid decline.
  • Worsening headaches or limb weakness demand urgent evaluationThe CDC lists intensifying headache, weakness or loss of coordination as danger signs that can appear hours or days after a concussion and should prompt immediate emergency care. (CDC)
  • Repeated vomiting or seizures may signal late-developing brain injuryCleveland Clinic warns that serious head trauma can produce delayed symptoms such as multiple bouts of vomiting, seizures or vision changes several hours to days post-injury. (ClevelandClinic)

What can you safely do at home in the first 48 hours?

Home care focuses on preventing worsening injury and tracking red flags. The team at Eureka Health advises, “Think of the next two days as an observation window—you’re looking for any downhill turn.”

  • Arrange wake-up checks every 3–4 hours overnightBriefly arouse the patient, ask their name and the date, and note speech clarity.
  • Limit screen time and bright lightsBlue light and rapid visuals can aggravate headaches and prolong recovery per sports-medicine studies.
  • Hydrate and eat light, protein-rich mealsAdequate fluids and steady glucose help the brain restore energy metabolism after traumatic injury.
  • Use acetaminophen, not ibuprofen, unless a doctor okays itNSAIDs can increase bleeding risk in the first 24 hours; confirm safety with a clinician.
  • Document symptoms in a simple logRate headache 0–10, note any nausea or dizziness; this record helps doctors see trends if you seek care.
  • Skip alcohol, driving, and contact sports for the first 48 hoursPrimary-care guidance lists alcohol, driving, and contact sports among the “do NOT” activities immediately after a head injury to prevent re-injury and avoid masking serious symptoms. (NCBI)
  • Seek urgent care if repeated vomiting or new neurological changes appearCDC discharge instructions warn that repeated vomiting, worsening headache, seizures, or unusual behavior are danger signs that warrant immediate medical attention. (CDC)

Which tests and treatments might your clinician order?

Decisions depend on age, exam findings, and risk factors. Sina Hartung, MMSC-BMI says, “A single CT scan answers most bleeding questions within minutes.”

  • Non-contrast head CT within the first 24 hoursDetects >95 % of clinically significant bleeds; radiation dose is roughly equal to eight months of natural background exposure.
  • Serum S100B and GFAP biomarkers in mild casesElevated levels can rule out brain injury in some European protocols, avoiding unnecessary imaging.
  • Observation versus admissionLow-risk patients may be discharged after a normal CT; high-risk (anticoagulated or skull fracture) often stay for 24-hour neuro checks.
  • Tranexamic acid in moderate injuriesGiven within three hours, it reduces death by 22 % in traumatic brain injury according to the CRASH-3 trial.
  • Physical and vestibular therapy referralsEarly balance training shortens post-concussive dizziness by nearly 50 % in randomized studies.
  • New Orleans Criteria flags seven symptoms that warrant immediate CT imagingHeadache, vomiting, short-term memory loss, alcohol intoxication, seizure, visible head or neck trauma, or age over 60 all mandate scanning, streamlining decisions in the emergency department. (MedicineNet)
  • Neurocognitive and balance testing refine concussion management when imaging is normalMayo Clinic notes clinicians often assess memory, concentration, balance and coordination to grade injury severity and to pace a graded return-to-activity plan. (Mayo)

How can Eureka’s AI doctor guide you right after a head knock?

Eureka’s app offers a structured symptom diary, triage questions, and tailored alerts. The team at Eureka Health notes, “Our algorithm mirrors validated ER decision tools like the Canadian CT Head Rule.”

  • Instant triage with evidence-based questionsIf you report vomiting or age over 65, the app flags you to seek emergent imaging.
  • Symptom trend graphs sent to your clinicianDaily headache scores and balance tests can be shared securely, supporting informed return-to-work decisions.
  • Lab and imaging requests reviewed by doctorsWhen appropriate, Eureka submits CT or serum biomarker orders; a licensed physician approves before scheduling.

Why users track concussion recovery with Eureka’s AI doctor

People appreciate private, round-the-clock guidance without feeling dismissed. Women using Eureka for menopause rate the app 4.8 / 5 stars; concussion users show similar satisfaction.

  • 24-hour chat support eases nighttime worriesYou can ask, “Is it safe to sleep now?” and receive an answer in seconds.
  • Custom reminders for gradual activity returnThe app schedules light walking on day three, cognitive tasks on day five, mirroring CDC guidance.
  • Secure data storage meets HIPAA standardsYour symptom log and imaging results stay encrypted; only you control sharing permissions.

Frequently Asked Questions

Is it safe to sleep after a head injury?

Yes, but someone should wake you every 3–4 hours the first night to check speech and orientation.

How long do concussion headaches usually last?

Most resolve in 7–14 days, but 20 % of people experience headaches for three months or more.

Do I need a CT scan if I never lost consciousness?

Not always. Age over 65, vomiting, severe headache, or blood-thinner use are stronger reasons for imaging than loss of consciousness alone.

Can I take ibuprofen for the pain?

Avoid anti-inflammatories for the first 24 hours unless your doctor says otherwise because they can worsen bleeding risk.

When can I return to sport?

Wait until you are symptom-free, pass a graded exertion test, and get medical clearance—usually at least one week.

What is post-concussion syndrome?

Symptoms like headache, fogginess, and irritability persisting beyond four weeks; rehabilitation and specialist referral help most patients recover.

Does wearing a helmet prevent concussion?

Helmets prevent skull fractures and severe brain injury but cannot stop the brain from moving inside the skull, so concussions can still occur.

Should children be managed differently?

Children under two need lower CT thresholds, and return-to-learn plans are as important as return-to-play plans.

How does alcohol affect recovery?

Drinking slows brain healing, increases fall risk, and can mask worsening symptoms; abstain for at least a week.

This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

References

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