Hi Roger
Ive been deeply involved in EMS since its inception - EMT, EMT Instr., Paramedic and Paramed Instr., Ski Patroller, etc. etc. etc.
Truly, Head trauma is the most devastating injury, responsible for much more than half of all trauma fatalities.
The most interesting thing about heqad trauma is that its not always evident immediately after 'impact', sometimes taking a very long time to 'develop', sometimes as long as days or sometimes very rarely weeks after the impact.
The KEY to early assessment is the 'changing/declining level of consciousness, followed by a SLOWING pulse rate.
For adults, anyone who VOMITS shortly after head impact is usually in BIG trouble. Kids commonly vomit after a head smack ... and that may be normal BUT when an adult vomits after a head hit it 99% of the time spells BIG trouble.
The key for any possibility for recovery is DO SOMETHING / GO TO A HOSPITAL if you or those with you experience:
Blurry vision / double vision
Personality changes / irritability
slowing pulse rate (less than 60 per minute is a REAL bad sign)
Unconsciousness for more than 20 seconds.
Repeated or sequential sessions of 'unconsciouness'.
Unequal pupils, one sided weakness are usually 'late state' sign .... the changing level of consciousness usually 'comes first'.
Most of these symptoms and signs may be transient BUT one really needs to be evaluated at an EMERGENCY ROOM to differentiate between a 'concussion' and a true (life threatening) head (brain) injury.
..... and yes, both my wife and I wore helmets when we campaigned our M20 scow ... with dam good reason (besides the boom being held lower than ones head). I wouldnt think of skiing / ski-patrolling as I do without a helmet. Ive seen too damn many fatalities and forever destroyed lives - mostly due to 'head trauma'.
Previously the treatment for head trauma was always 'so-so' ... a big gamble. Ive been associated with several of the leading trauma centers due to my avocation; the 'modern' / new treatments (and understanding) is radically changing the rate of suceessful recovery .... but, you, as a patient, need to be evaluated promptly and not 'waiting around' until you become 'irreversible'.
Hit your head enough to experience any 'changes' or momentary loss of soncsiousness - GET YOUR ASS TO A HOSPITAL.
regards
RichH