When Can We Stop Worrying After a Hit on the Head?

Question: 

About a month ago, my wife tripped while hiking and hit her head. We went to our Emergency Department and they did a CT scan, which was “clean.” Other than an occasional headache, my wife feels fine. Is there a time when we can stop worrying?

Answer: 

The CT scan that was done in the Emergency Department is helpful because it showed there was no bleed in your wife’s head (hemorrhage) that would require surgery. That being said, most of the time after a concussion — or mild brain injury — a CT scan does not show any evidence of injury and yet some people may continue to have symptoms related to the concussion. The injury to the brain in a concussion is generally to the neurons and axons that are microscopic and therefore not seen on CT scan. Symptoms can be broken down into four categories:

  • Cognitive issues, including memory and concentration
  • Sleep issues, including too much or too little sleep, drowsiness, and difficulty falling asleep
  • Physical issues, including headaches, decreased balance, dizziness, impaired vision, fatigue, nausea/vomiting, and sensitivity to light and noise
  • Emotional issues, including irritability, sadness, and nervousness

Many symptoms from mild traumatic brain injuries resolve themselves with some time and rest and it seems this is the case with your wife. However, if her headaches do not continue to improve, if they are limiting your her function, or if they worsen, it would be appropriate to take her for a re-evaluation by your physician.

 

Posted on BrainLine January 19, 2010. Reviewed July 26, 2018.

Brian Greenwald

Dr. Brian Greenwald is medical director of Center for Head Injuries and the associate medical director of JFK Johnson Rehabilitation Institute. He is a clinical associate professor in the Department of Physical Medicine and Rehabilitation at UMDNJ-Robert Wood Johnson Medical School.

Comments (32)

I hit my head about 6 months ago I was running and tripped hit it on some broken up concrete steps. The E.R did a C.T while I was there said everything was good but sense then I've kind of went mental, I go from really happy,depressed, extremely depressed,completely hopeless, to I just don't care I think it I say it ,to really quiet and stay to myself. I have anxiety attacks now. My headaches have gotten to where they are at least every other day I take my meds it'll go away for about an hour then come back and they get bad I just have to go lay down. It's starting to get some sort of bump where I hit it at. I've been put in the mental home once sense it happened and have been to where I probably should have been sent back . I've been to a couple different Dr's I'll tell them everything they just either brush it off or say you probably just have a concussion and that's it. I need to no do I need to just leave it alone because it's a concussion and I'm just still healing or do I need to go throw a hissy fit til someone takes me seriously? Also before all of this I was quiet and sweet never spoke up about anything just kind of stayed in the back so I'm a completely different person

I fell and hit my head from a 10ft drop on to concrete in my barn 10 months ago and still do not remember anything about the accident except some time in the hospita l- I am a miracle story. However in regards to headaches and migraines I went to my chiropractor very early on and found that the fall caused my neck, especially the very top axis vertebrae, to be out of whack. Now no headaches or migraines!

Hi! I'm a 24 year old maIe and think that I may be dealing with post concussion syndrome. I took up boxing as a way to push the limits of my physical capabilities. I got punched in the back right side of my head while wearing protective headgear and gloves back in April of 2018. I have never suffered any memory loss or severe issues regarding the blow, but 4 days after the hit I have had ongoing problems to this day. It began with what felt like a pain in the area I got hit and I gave it some time before I went and saw two physicians. They said that the symptoms were nothing serious as I didn't suffer from cognitive issues or sensitivity to light/noise. Fast forward to the present, 9/8/2018, and my symptoms have changed slightly, but nothing seems to have gotten worse. I've had weeks where I have been occasionally dizzy and the pain in the back right side of my head comes and goes as it used to be constant, but now I find myself suffering from headaches in the front of my head. I would describe it as the type of headache you'd get from staring at a screen too long. I also deal with what feels like worse vision, but that is hard to tell because I already wear glasses and my eyes continuously get worse regardless. I can't seem to do any sort of physical activity without getting a throbbing head and even the slightest activity will give me a pounding heart rate. Alongside these symptoms, I've experienced a serious of mental health issues such as depression and anxiety. Anytime I'm forgetful about something I instantly relate it to this head injury and the impact it's had on my life. I can't help but feel as though I may be living with some brain tumor and that scares me. My insurance is terrible and I really can't bring myself to spend money on what could potentially be an inconclusive test. I have spent so much time on the internet researching for answers and I've spent the last couple months at the chiropractor hoping that my neck was the cause for all of the issues and I don't feel like I've seen any improvement.
Thank you to anybody who takes the time to read and reply to my post.

I am 17 years old. I play competitive ice hockey. Over three months ago I was blindsided in practice. The girl lost an edge and flew into the back of my ankles, I fell back, hit my tailbone, then wiped and hit my head very hard. I got up sat up, then felt extremely sick, then was sick to my stomach, with extreme neck pain, back pain and head pain.

Since then I have had headaches every day. I have yet to go a day without one (I have been keeping track in a booklet) this is my 4th diagnosed concussion. I had two a few years ago and I had one in January-February 2018. None of them have been this bad. I hit my head twice between Feb-May which I didn’t worry about. However, this one has taken a toll on me. I missed a month of school in May - June, failing classes because I couldn’t attend.

This summer I have done nothing at all. I haven’t hungout with friends because I tried and it’s just not fun for me. I’m tired all the time, the noise, lights bother me which doesn’t help. I started this summer working part time a few days a week, which eventually my parents forced me to quit because my pain was getting intolerable. I babysit a few times however even then I still get bad headaches. Some headaches are sharp pains, some are tingling in my head, some are throbbing, some are stabbing pain, some are swelling feeling. I also get a burning sensation in my head. I get tingling in my right hand and ringing in my ears. I go to physio three times a week where I get acupuncture & current for the past two months. I go to the doctors once a week and social workers and therapists at least once a week.

I’ve been suffering with depression and anxiety lately. I’ve had some major panic attacks which are extremly scary. I'm on tons of medications to try to help - sleep, anxiety, depression, headaches. I have tried everything they have told me. I have taken the medications.  I am sleeping well now, I’m doing physio, I limit tv, phone, I try to be physical (walking). I even cut my hair to relieve pressure, I was just refered to a neurologist to possibly get scans on my head and neck to see if there is something else going on such as a nerve being pinched. I’ve also been refered to a pain clinic and a laser therapy.

My family just wants me to make all these decisions & putting so much pressure on me. I tell them to stop but they find another way to bring it up. Or when I have attacks they just make fun of me and it’s the worst feeling in the world. They don’t understand it. Everyone says "oh I understand" or "it’ll get better" but how do they know? I don’t think they know what it’s like to have constant headaches for months nonstop, or fighting mental health all by myself.

It’s gettig really hard to stay positive and hope for better. I am extremely afraid to hit my head again now. At first, I was afraid even to walk stairs because I got light headed and thought I would fall and hit my head and die. I was also scared to go swimming still kinda am without a floaty or life jacket and I’m scared to jump in as well. I know I could hit my head doing anything but it’s terrifying. Everyone wants me to go back to playing hockey but I keep getting panic attacks just looking at the ice. I can’t breathe and I’m shaking and crying. I’m most scared of hitting my head on the ice again. I think I’m most scared of hitting my head because of the pain it’s caused me.

It’s changed me. I’m not the same bright, positive girl anymore. I’m emotional and exhausted. I don’t want to go any longer being in pain having constant headaches daily. I am just so frustrated and fed up with feeling this way, does it ever get better? How do you deal with the anxiety and depression and panic attacks? Do you have any suggestions.?

Hey Kirst,

I can't offer much insight to you as I too am suffering from ongoing issues like yours. In your last paragraph you state how you don't feel like the same person anymore and you seriously sum up the struggle of what it's like to deal with these issues. I just want you to know that my issue has also given me a lot of anxiety,depression, and panic attacks. I haven't told anybody at my work and everybody thinks I'm fine everyday, but the reality is that I'm suffering from what I call an "invisible injury". I've tried explaining it to friends and family and they seem to understand in the moment, but always forget because I'm always trying to tough it out and act "normal". It's been a troublesome journey for me as I've been dealing with my problems for 4 months now, but there's always comfort in knowing that somebody else has something similar going on with them. I've contemplated joining a support group of MTBI sufferers in order to help battle my mental health. I hope you too find the answers that you're looking for. Thanks for taking the time to share your story.

This is a lot to experience and I’m certainly praying that things get better soon. You’re very intelligent & I’m sure your future is still bright. I can relate to the panic attacks and those do get better. I’m just not sure which course you should take regarding returning to hockey. I think you should get your medical issues resolved first. You can’t rush this, it’ll take some time. I’m hoping the neurologist will be instrumental in resolving your symptoms. I pray your support system can understand what you’re going through and be there for you.

I hit my head about three weeks ago, got a CT scan, and there was nothing, the MD there said that my slight nausea and imbalance came from my neck muscles tightening on impact. I just hit my head again about a half hour ago, somewhat bumped it lightly on my car’s metal surface, and I haven’t fainted or puked so far, but should I get checked out again? I feel very scared...

I work for a moving company anyways I was helping unload a truck when a vacuum came off the top and smacked me hard on the top and side of my head. I got knocked out and have been having really bad headaches and pain . I had to keep working cause I’m away from home, we travel a lot. I’ll be home in a couple days and this happened like 2 days ago and my headaches and pressure are just as severe as the first day. Should I see a doctor ?

YESSSSSSS!!!!!!

Yes, see a doctor. It's your head & brain, which happen to be pretty important, right! My advice here is; better safe than sorry.

Omg yes

yes go to a doctors

Yes go see a doctor

I hit my head on a low hanging tree that fell, it hit the top of my head. I have been having an extremely painful headache about 4 hours after. Should I do something?

thank
you .

I hit my head about a month ago but there is still a lump it dosent hurt as much as it did when it happened but if i put hard pressure it does
What should I do?

I hate to be captain obvious here but chances are good, Lilu, that the injury has not fully healed yet. If it is sore, kinda like a bruise feels when you push on it, then, well, don't push on it. Wait until it is fully healed to resume pushing on it. Hope that helps

What if you were hit numerous times in the head, sometimes really bad?

What if you were hit in the head many times? Or if I was? Sometimes really bad? Humm...Where the blows to the head all at once or over a period of time? What is considered to be "really bad"? How many times were you struck? Who or what hit you?

About a month ago i was at the lake and my jet ski tipped over n hit my head it was not hard but hard enough that i was sick and head ache for 4 days felt great but head was still sore. month later and now more head aches over my eye is black n blue light hurts my eye and real moody dont sleep..what should i do

You sir should really really go to the doctors

Yup. I second that

I missed a step in the room in motel in Mexicoand hit my forehead pretty hard. I had a bump which later went down but had swelling above my eye briow It is still sore to the touch and have a black eye which started the next day. That was Saturday and I came home Tuesday. This is Wednesday and it seems to be getting better everyday except the black or purple eye has spread some. I'm not having any symptoms so should I go to the doctor after this long

Doesn't really answer the question.

If you had a mild concussion and in the middle of healing you pass out and hit your head should you be worrreid of SIS?

A couple months back .I hit my head on concret. And a month later I started having bad headaches .I went and saw the doctor .they put me on meds for the headaches. But they are not working. They did a ct scan on my head. But the headaches are getting worse. All I want to do is cry.

Hi, I hit my head in a bike fall and started having bad headaches Neurologist said I had migraines and recommended migraine medication. I was afraid to take the medication but after months migraines I finally went to a chiropractor and I was shocked at how effective it was. 6 months later and I have only had one headache. Try a chiropractor and acupuncture - I did both and it helped me a great deal.

I hit my head lst night in a fall, Seem okay but today I suffer mostly from neck and upper back which tells me I must have whiplash. I went to see a chiropractor this morning and i feel a lot better, he checked things out and seems I hurt my neck in the fall also. couple of advils help also. I'll se in a couple more days. Should I be worried?

This Nov. 6, it will be 15 years since my accident of being hit by a car while walking across the street. They diagnosed me with a mild concussion that night and sent me home from the hospital. The next day I woke up unable to speak 3 letter words, migranes, trouble processing thoughts, and much more. It has lead to a life long learning about my new Normal and a grieving of my old self.

A mild brain injury is nothing to ignore. If it does not go away, do not let them make you think you are crazy. You are not! I know you have lost confidence in yourself because I did too. If you have a friend or relative who can go to the doctors appointments with you, take them. It helps.