When you fall or hit your head, you may get a large bump on the head that can look serious. But a scalp hematoma, or goose egg, is usually not a sign of brain damage.
However, some head injuries are serious. Brain injuries can occur even when there’s no visible bump or bleeding. It’s important to stay aware of the signs of a serious brain injury, including confusion, vomiting, dizziness, and other signs.
Here’s what you need to know about treating a bump to the head and when to seek medical care.
What Is a Hematoma?
A hematoma is a swelling due to bleeding outside or inside the skull.
A scalp hematoma (often called a goose egg)
This is when blood collects between the skull and the scalp. If you had a bump on the forehead after hitting your head, you’ve had a scalp hematoma.
This is usually not a serious injury.
A subdural hematoma
In rare cases, a head injury can cause a subdural hematoma. This is when blood collects between the brain and the brain’s outer layer (called the dura). This type of hematoma can cause severe damage, especially without early treatment.
Subdural hematomas aren’t likely to occur from a minor bump to the head. They’re much more likely to result from a serious injury like a car crash or fall from an elevated surface.
However, subdural hematomas are possible, even from seemingly minor head injuries, in people who:
- Are elderly.
- Have consumed moderate to heavy levels of alcohol over a long-term period.
- Take a blood-thinning medication.
Because the hematoma occurs within the skull, there’s no visible bump or goose egg on the forehead or elsewhere.
An epidural hematoma
This is when blood collects between the dura (the protective layer around the brain) and the inside of the skull.
Epidural hematoma is more common in adolescents and young adults (aged 20 to 30) and rare in adults above 60. Because of natural changes in the dura, epidural hematoma becomes less common as people age.
People who have epidural hematoma often experience a bad head injury that causes them to lose consciousness. They may feel fine after waking up, for several minutes or even hours, before showing severe symptoms of a brain injury. (See symptoms list below.)
How to Treat a Mild Bump to the Head at Home
You can treat a goose egg by applying an ice pack wrapped in cloth to the area for up to 20 minutes. To reduce swelling, repeat this after an hour and throughout the first day or two.
You may only need to apply ice once for a small goose egg on the head. Healing time ranges from hours to days, depending on the goose egg size. However, you should see a doctor if the goose egg doesn’t get smaller within the first day.
Keep in mind that symptoms of a brain injury or concussion could take a few hours to develop. If you had a severe blow to the head, you should rest for the first 24 hours after a head injury. Have someone stay with you to monitor your symptoms.
You should also avoid alcohol after a brain injury. That’s because alcohol thins the blood and increases the risk of bleeding.
When to Go to the Emergency Department After a Bump to the Head
If you or someone you know shows symptoms of a serious head injury, seek emergency care right away.
A serious head injury includes a subdural hematoma, an epidural hematoma, a skull fracture, bleeding or bruising in the brain, or a severe concussion.
Symptoms of a serious head injury include:
- A headache that is severe or doesn’t go away.
- A loss of consciousness.
- A seizure.
- Blood or watery fluid coming from the nose or ears.
- Bruising around the eyes or behind the ears. (This could mean a skull fracture.)
- Confusion.
- Difficulty with balance or walking.
- Dizziness that doesn’t go away within a minute after the injury.
- Double vision or other vision problems.
- Feeling very sleepy.
- Pupils that are unequal in size.
- Slurred speech.
- Vomiting more than once or nausea that doesn’t go away.
An emergency doctor may perform an exam to check your mental and physical health. For example, they may ask questions to test your thinking. They may also ask you to balance on one leg, follow an object with your eyes, and do other tasks to assess brain function.
If the doctor thinks you might have a serious injury, they will order an imaging test, such as a CT or MRI scan. A scan will show a skull fracture as well as any hematomas or bleeding within the skull.
If you have bleeding in the skull or a skull fracture, you may need emergency surgery.
When to See a Doctor for a Mild Brain Injury
Even if you don’t have signs of a serious brain injury, you may still need to visit a family doctor or walk-in clinic after a bump to the head.
You could have a concussion. This is when an injury to the head injures the brain’s nerve fibers. This can affect how your brain works, but the effects are usually temporary.
A concussion’s symptoms may not start immediately; they may begin days or weeks after the injury. They may include:
- Difficulty focusing or retaining new information.
- Fatigue.
- Foggy thinking.
- Mild dizziness or balance problems.
- Mood changes, such as sadness, irritability, or anxiety.
- Ringing in the ears.
- Sensitivity to light or noise.
- Sleeping more or less than usual.
- Slow reaction times.
If your doctor suspects a concussion, they’ll ask about your symptoms. They may ask you questions to assess your thinking. They’ll also check your eyesight, balance, and reflexes.
Most younger people recover from a concussion in two to three weeks, according to the Brain Injury Association of America.
However, in some cases, recovering from a concussion can take months. With severe concussions, people may have symptoms even years after the injury.
A severe concussion is more likely to happen to a person who has had one or more blows to the head in the past.
Your doctor will advise you about what activities to avoid and for how long based on the severity of your concussion. Your doctor can also refer you to a concussion expert to help you recover mentally and physically.
Rest is usually adequate to treat a concussion. However, additional treatments can include physical, occupational, and cognitive therapy.