Not every bump needs an operation

Many knocks on the head cause a bruise of the scalp and a short headache, and settle with rest and a check by a doctor. Some hide a bleed inside the skull. The bleed can be small at first and expand over hours, which is why a person who seemed fine can become drowsy later.

Age, blood-thinning medicines, and alcohol make that delay more important. A person on these medicines should be assessed even when the injury looked mild.

Talk to the clinic about this topic

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Go to emergency now

Choose the nearest hospital emergency department, not a booked evening OPD, if any of these are present after a head injury.

  • Blackout, even a brief one, or you cannot remember the injury
  • Vomiting more than once
  • A seizure
  • A headache that is getting worse
  • Confusion, repeated questions, or difficulty waking the person
  • Weakness, unequal pupils, or fluid leaking from the ear or nose
  • A cut that is deep, or a visible dent in the skull

What the hospital usually does

The first scan is usually a CT. It looks for blood, a fracture, and swelling. A neurosurgeon is called when there is a collection of blood that is pressing the brain, a depressed fracture, or swelling that may need pressure to be relieved. Many bleeds are watched in hospital with repeat scans rather than operated on at once.

If an operation is done, it may remove a clot through an opening in the skull. The decision depends on the size of the clot, how sleepy the person is, and whether the clot is arterial or venous. Families should ask what the scan shows in plain words.

Planned review after you are stable

Once a person is awake, safe, and discharged, a neurosurgeon can review the remaining symptoms: headache, memory trouble, or a scan that needs a second look. That visit belongs in the clinic. Dr. Deepak Kumar sees stable head-injury follow-up in Gurgaon. He does not replace an emergency department on the day of a serious injury.