The signs and symptoms of a head injury vary depending on the severity of the injury and whether the injury is internal or external. External symptoms may appear worse because they often involve a great deal of blood loss, but are typically less severe than internal symptoms. In addition, external head injuries may indicate internal injuries. External symptoms may include:

• Bleeding from the head
  
• Lump or welt at the site of the injury
  
• Pain
  
• Bruising

Sometimes it is obvious that a person has sustained an internal injury. For instance, if someone experiences a loss of consciousness following a head injury, no matter how brief, it is an indication that the brain has been affected in some way. In many cases, internal injuries can be mild and the signs and symptoms are temporary. The signs and symptoms of internal head injuries may include:

• Headache
  
• Short-term confusion
  
• Dizziness or lightheadedness
  
• Nausea
  
• Feelings of irritability or lethargy
  
• Blurred vision
  
• Ringing in the ears (tinnitus)
  
• Memory loss
  
• Bad taste in mouth
  
• Fatigue

In some cases, the brain may be injured more severely. However, the true extent of brain injury may not be apparent for days or sometimes weeks after the head injury. Signs and symptoms of severe or traumatic brain injury include:

• Headache that gets worse over time or does not go away
  
• Sustained nausea or vomiting
  
• Seizures
  

  

• Inability to wake from sleep
  
• Unusual eye movements
  
• Dilation of one or both pupils of the eyes
  
• Slurred speech
  
• Weakness or numbness in the extremities
  
• Loss of coordination
  
• Cerebrospinal fluid draining from the nose or mouth

Most symptoms of head injury, both external and internal, are temporary. However, in cases of severe head trauma, complications can arise that may be permanent. Some people may experience the following permanent symptoms after severe head trauma:

• Personality changes
  
• Problems with speech and language
  
• Seizure disorder (epilepsy)
  
• Loss of one or more of the senses
  
• Paralysis
  
• Coma

People who sustain or live with someone who has sustained a head injury should remain vigilant for the signs and symptoms of severe internal injury. If any of the symptoms of severe head injury occur, emergency services (911) should be contacted.