A blow to the head or a severe twist to your neck can be scary. Usually, the injury is not severe, although sometimes there can be a brain injury such as concussion, bleeding on the brain, or cracks to the skull.
Head and neck injuries are a common reason for visiting the emergency department. It is important for the health care provider to examine you for a possible concussion or another injury. The health care provider may order a CT (computerized tomography) scan of the brain to make sure you do not have a fractured skull or a serious brain injury. But most of the time these scans are not needed. Here’s why:
Often, CT scans aren’t necessary.
CT scans can show if there is swelling or bleeding in the brain or a fracture in the skull. If you have signs of a serious injury, a CT scan is usually the best first test to diagnose it. Your health care provider will look for specific signs of a more serious problem. These include:
- Weakness on one side of your face or body
- Trouble speaking, hearing, or swallowing
- Reduced vision
- Seizures
- Repeated vomiting
- Severe headache
- One pupil larger than the other
- Fluid or blood from an ear or nose
- Tenderness over the skull
- Being on a blood thinner
Health care providers follow guidelines that recommend performing CT scans only for patients who are at higher risk for skull fractures or bleeding in the brain. Most people with head injuries do not have either of these problems, and simple concussions do not show up on a CT scan.
If you do not have any of these signs, research shows your risk of a serious injury needing surgery or leading to serious complications is less than 1 in 7000, and a CT scan is unlikely to be helpful.
A thorough examination by a health care provider is the most important step to rule out a serious injury. Your health care provider will examine you for a possible concussion or more serious injuries. If you are able to walk and talk normally, the chance of you having a serious injury needing surgery or special treatment is very low.