I received another email, this one from a lady who often worried that her little girl was not scanned when she fell off a pony at 6-years-old at summer camp and hit her head. She remained conscious after the fall but suffered with bouts of cognitive and physical changes, like memory loss, concentration issues, and dizziness after the fall.
She’s 14 now and the effects of the fall are still ongoing. The mother did nothing except soothe the girl with an ice cream sundae. Now, the mom asks if she should have done more. Here is my answer:
If any of these appear after a fall, a brain scan is appropriate:
- Confusion, slurred speech, or memory loss
- Trouble walking or balancing
- Worsening headache
- Loss of consciousness–even briefly
- Vomiting more than once
- Seizure or convulsions
- Unequal pupil size
- Weakness or numbness
- Vision changes or drowsiness that worsens
- Clear fluid or blood from the nose or ears
People in these specialized groups are more likely to need a scan, even if symptoms seem mild:
1. Children
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Their skulls are still evolving, and symptoms may be hard to detect.
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Vomiting, drowsiness, or abnormal behavior can be signs of a concussion.
2. Older adults over 60
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Falls can cause slow brain bleeds called subdural hematomas that may not show symptoms for days.
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Often prescribed blood thinners which increase the risk of internal bleeding.
3. People on blood thinners or with clotting disorders
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A minor bump can cause critical internal bleeding.
4. People with previous brain injuries like stroke
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The brain is more delicate and may not tolerate new trauma.
Scanning would be accomplished by these machines:
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CT scans can ascertain bleeding, fractures, and swelling fast.Â
- MRI may be used later for more detailed imaging of brain tissue, especially for subtle injuries, especially in mild TBI or constant symptoms persist.
Early detection allows doctors to prevent complications like brain swelling, long-term disability, or ultimately death.Â
Less severe brain injuries might be monitored without scanning if the person is conscious, has no symptoms, and can be observed by someone competent. However, symptoms can develop hours, even days, after an injury, so continued monitoring is important.
If no scan is done, watch for delayed symptoms over the next 48–72 hours, such as:
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Headache that gets worse
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Personality changes
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Nausea or confusion
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Sleepiness or difficulty waking up
If any of these risks appear, seek medical help at once.
Yes, people with head injuries should generally be evaluated and often scanned, but the specific type and urgency depends on the severity and symptoms present.
Any head injury that results in altered consciousness, persistent symptoms, or concerning signs should get prompt medical attention. Emergency room doctors are trained to assess which injuries need scanning or just observation.
Types of head injuries:
If you’re dealing with a head injury, it’s always better to err on the side of caution and seek medical evaluation rather than trying to guess severity on your own.Â
You may have come across the term ABI (Acquired Brain Injury). ABI is an umbrella phrase including both TBIs and Non-TBIs.
- TBIs include:
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- Falls
- Physical assaults
- Motor vehicle accidents
- Sports injuries
- Non-TBIs include:
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- Oxygen deprivation due to a heart attack or stroke
- Aneurysm
- Brain tumor
- Meningitis and other infectious diseases that affect the brain
- Near-drowning
- Strangulation or suffocation
- Hemorrhagic brain injury
To the lady whose daughter fell off a pony and hit her head: Yes, you should have taken her for a scan. But it’s not too late for peace of mind. With time passed, a CT scan or an MRI may show you what you need to know.
