Refer to a specialist if the person has persistent or worsening clinical features related to the initial head injury, such as vomiting, headaches, or new-onset focal neurological signs, which may indicate a possible complication NICE NG232.
Referral is indicated if there are persistent non-specific symptoms for more than 3 months after head injury, or concerns about the severity or nature of symptoms, including cognitive, emotional, or behavioural difficulties NICE CKS.
Immediate referral to a hospital emergency department is necessary if there is evidence of ongoing or worsening clinical features, such as persistent vomiting, severe headaches, or new focal neurological signs NICE CKS.
Referral should also be considered if there are signs of a developing neurological condition, such as a brain tumour, or if persistent or new-onset focal neurological signs are present, warranting specialist assessment NICE CKS.