Head bump swelling treatment

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head bump swelling treatment home care when to see doctor

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Head Bump with Swelling ("Goose Egg") - What It Is and How to Treat It

A raised, tender lump after a knock to the head is usually a scalp hematoma - bleeding into the soft tissue under the skin, sitting on top of the skull bone. Because the scalp has a rich blood supply but not much room for blood to spread, even small cuts or bruises there swell up quickly and can look alarming, but most are benign - Bailey and Love's Short Practice of Surgery, p. 383; The Essentials of Forensic Medicine and Toxicology.

Home treatment (first 24-48 hours)

Ice immediately: apply a cloth-wrapped ice pack (or bag of frozen peas) for up to 20 minutes at a time, repeated hourly for the first few hours, then a few times a day for 1-2 days. This limits bleeding and swelling.
Simple analgesia: paracetamol for pain. Avoid aspirin, ibuprofen, or other NSAIDs/blood thinners in the first 24-48 hours if there's any chance of a more significant injury, since they can worsen bleeding.
Rest and observation: keep the person quiet and resting for the day; avoid strenuous activity or contact sports until swelling and any symptoms resolve.
Do not press hard or massage the lump - just cool it and let it settle. Most goose eggs shrink over a few days to about a week.
Someone should stay with the person for the first 24 hours to watch for any of the warning signs below, since brain-injury symptoms can take hours to appear even after a seemingly minor knock.

When to seek medical attention (do not just treat at home)

Get evaluated (urgently, or via emergency care) if there is:

Loss of consciousness, even briefly, or a "lucid interval" followed by worsening confusion/drowsiness (this pattern can signal an expanding intracranial bleed)
Persistent or worsening headache despite pain medication
Repeated vomiting (more than one episode)
Drowsiness, confusion, difficulty waking, or behavior/personality change
Visual disturbance, slurred speech, or limb weakness/numbness
Seizure after the injury
Clear fluid or blood leaking from the nose or ears, or bruising around both eyes/behind the ears (possible skull fracture)
The lump keeps growing rather than shrinking after the first day, or the skull feels soft/dented under it
Injury involved a significant mechanism (fall from height, high-speed impact), the person is over 65, or is on blood thinners (aspirin, warfarin, rivaroxaban, etc.) - these raise bleeding risk even with a "minor" bump
In infants: a bulging soft spot, unusual fussiness/sleepiness, or vomiting

These are consistent with the NICE (UK) criteria used clinically to decide who needs a CT scan or hospital observation after a head injury - Bailey and Love's Short Practice of Surgery, p. 383.

Bottom line

A simple bump with a swollen lump and no other symptoms can usually be managed at home with ice, rest, and paracetamol, and should improve within a day or two. Any of the red-flag symptoms above, or a lump that isn't improving, warrants prompt medical evaluation to rule out a skull fracture or intracranial bleed.

This is general information, not a substitute for an in-person medical assessment - if you're currently worried about someone's symptoms, especially in a child, an elderly person, or someone on blood thinners, it's safest to get them checked now rather than wait.

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