Head Injury: First Aid, When to Get a CT Scan & Red Flags

By Dashvanth Healthcare Medical Team · Reviewed by our specialists · East Delhi

Types of Head Injuries

• Concussion: Temporary brain dysfunction without structural damage — most common TBI
• Contusion: Brain bruising at injury or contrecoup site
• Extradural haematoma (EDH): Bleeding between skull and dura — classically lucid interval then rapid deterioration
• Subdural haematoma (SDH): Bleeding between dura and brain — acute (trauma), chronic (elderly on anticoagulants)
• Subarachnoid haemorrhage (SAH): Bleeding in the CSF space — worst headache of life

First Aid After Head Injury

• Call 112 if: unconscious, fitting, vomiting repeatedly, or if a child
• Keep the person still — assume cervical spine injury until proven otherwise
• Do NOT remove any penetrating object
• Do NOT give food or water (may need surgery)
• Monitor consciousness level — use AVPU scale

When Is a CT Scan Needed?

NICE guidelines (Canada/UK Rules):

• Loss of consciousness ≥5 minutes
• Vomiting ≥2 episodes
• Age ≥65 years
• On anticoagulants (warfarin, aspirin, newer agents)
• Amnesia for events >30 minutes
• Dangerous mechanism (pedestrian vs car, fall >1 metre)
• Seizure after injury
• Focal neurological deficit