Who’s most at-risk for complications from head injuries?
TBIs can impact anyone, but some people are at a higher risk than others for severe problems. For example, people with bleeding disorders are at a higher risk for complications, says Dr. Lumba-Brown. People older than 65, who have thinner blood vessels and smaller brains, are also at a higher risk for severe injury.
Those with a condition called osteopenia, which causes people to lose bone mass and increases the risk of skull fractures, are considered high-risk, as well.
Taking blood thinners (including aspirin) is also a major risk factor. “Because blood thinners prevent blood clots from forming, even small cuts or bruises will bleed a lot more,” says Kontos. “Because of that, blood thinners may increase the risk of any bleeding in the brain.”
Lastly, people who might have difficulty explaining their symptoms—young children, people with dementia or memory problems, or patients who suffer from a substance use disorder—are also at a higher risk, says Dr. Chiampas.
When should you go to the doctor after a head injury?
It’s always a good idea to be evaluated by a medical professional after a head injury, even if it’s mild. According to Kontos, concussions can exacerbate existing issues like migraines, motion sickness, and anxiety and mood disorders.
Because head injuries can worsen over time, a doctor’s input can also help you monitor your symptoms and impairments to make sure they aren’t getting worse. Research suggests seeking medical help within one week of a mild head injury—one study published in the Journal of the American Medical Association (JAMA), found that those who sustained a head injury and sought medical attention within a week recovered faster than those who waited longer to seek help.
Moderate and severe TBIs, however, require emergency care right away, says Kontos. If you have any of these “red flag” symptoms after a head injury, call 911 or have someone take you to the emergency department right away:
- Loss of consciousness for any amount of time
- A severe headache
- One pupil that’s larger than another
- Any type of weakness or decreased coordination
- Speech problems
- Confusion or difficulty thinking
- Seizure (shaking or twitching) for any duration
- Drowsiness or inability to wake up
- Repeated nausea or vomiting
Aside from noticeable symptoms, Dr. Lumba-Brown says anyone who is considered high-risk for complications of a head injury should be seen by a medical professional right away. If you sustain a head injury while you’re alone, you should take extra precautions as well, like telling someone else about your head injury or calling your doctor (or scheduling a telemedicine session) to find out if and when you should seek treatment. And if you have uneasiness about sleep following any kind of head injury—even a relatively mild one—it’s in your best interest to chat with a doctor, too. “A medical professional can weigh in as to whether your sleepiness is normal or if it’s representative of a progressing brain injury,” says Dr. Lumba-Brown.
Of course, preventing TBIs in the first place is important, too, says Dr. Lumba-Brown. Preventive measures can include always wearing a seatbelt in a vehicle and a helmet when you’re supposed to (like when riding a bike, skiing, or skateboarding). At home, you can also keep walkways clear, clean up spills when they happen, don’t put loose rugs on the floor, and avoid risky behaviors like standing on chairs and climbing on countertops or ladders—especially when you’re alone.