Head Injury After a Fall: When to Seek Medical Attention

A bump on the head that is hot, swollen, and tender after a fall warrants medical evaluation. While many minor head bumps resolve uneventfully, these signs can indicate more serious injury.

Red Flags – Seek Emergency Care Immediately

• Loss of consciousness (even briefly).
• Persistent or worsening headache.
• Repeated vomiting.
• Confusion, disorientation, memory loss.
• Slurred speech, difficulty understanding.
• Weakness, numbness, or clumsiness in limbs.
• Seizure or convulsions.
• Unequal pupil size.
• Clear fluid or blood from ears/nose.
• Inability to wake up or stay awake.
• Severe neck pain/stiffness.

Urgent Evaluation (Same Day)

• Swelling that is large, boggy, or expanding.
• Significant tenderness, heat, or redness over the bump.
• On blood thinners (warfarin, DOACs, aspirin) or bleeding disorder.
• Age >65 or <2 years.
• High-energy mechanism (fall from height, car ejection, assault).

Home Care While Awaiting/Mild Cases

1. Cold Compress: Ice pack wrapped in cloth, 15–20 min every 1–2 hours for first 24–48 hrs. Reduces swelling/pain.
2. Elevation: Head of bed elevated 30°.
3. Pain Relief: Acetaminophen (Tylenol) preferred. Avoid NSAIDs (ibuprofen, naproxen) initially if any concern for intracranial bleeding (they impair platelet function).
4. Observation: Responsible adult should monitor for 24 hrs, waking every 2–3 hrs initially to check arousal.
5. Rest: Physical and cognitive rest (limit screens, reading, decision-making).

Follow-Up

Even if initially cleared, return if symptoms develop over days: persistent headache, concentration issues, mood changes, sleep disturbance, dizziness (post-concussion syndrome).

When in doubt, get checked out. A normal CT scan rules out bleed but not concussion. Clinical assessment is paramount.