When to Go to the Hospital

Question: 

People who've just had their brains jostled may be in no condition to decide if they need medical care. And the people around them may not know that hitting your head can be dangerous even if you don't lose consciousness. How do you know when you should go to the hospital after having "your bell rung"?

Answer: 

Going to the hospital after a head injury can mean the difference between life and death. But how do you know when to go? This can seem like a difficult decision, but let me sum up the answer for you: when in doubt, go to the hospital. Not later. Not tomorrow. Now!

Here's why.

The hospital is the only place that has a CAT scanner that can "look" inside your head and determine if there is any bleeding in your brain. Bleeding in the brain can be life-threatening when there is enough blood in the right spot to press down on the brain and squeeze it. These dangerous forms of bleeding are called epidural and subdural hematomas. Because the brain is trapped inside the skull, slow bleeding can force important parts of the brain against the inside of the skull and through the small hole in the base of the skull called the foramen magnum. These important brain areas, which control breathing and heart rate, stop working when they get squeezed and this is what results in death. With a CAT scan, epidural and subdural hematomas are easily diagnosed. The treatment requires surgery to remove the blood clot. The quicker the surgery, the better the chances for a good outcome.

So, how do you know when to go to the hospital? The decision is easy if you're the one making it for someone else and that person is not responding to you or looks asleep. This is called coma. The risk of a subdural or epidural hematoma in comatose head injured patients is high and you should summon an ambulance immediately!

But what if the head injury doesn't cause a coma? What if the head injury just causes a brief loss of consciousness, brief period of amnesia, or a sensation of feeling dazed? A person who has such an injury — termed concussion or mild traumatic brain injury — can look, and even feel, just fine. The problem is, even though the person looks good on the outside, inside the skull there is a small chance that slow bleeding is taking place. After a concussion, the chances of this happening are not large — about 1 in 1000 — but the only way to diagnose it is with that hospital-based CAT scan.

Here are the symptoms of a concussion that should prompt an immediate trip to the hospital or emergency department.

  • Loss of consciousness, even if only briefly
  • Any period of amnesia, or loss of memory for the event
  • Feeling dazed or confused
  • Headache
  • Vomiting
  • Seizure
  • In addition, for children under 2 years of age, any scalp swelling or abnormality in the way they usually behave.

One word of caution: because any brain injury — even a concussion — has the potential to injure the brain, the brain-injured patient may lack the judgment to make an informed decision regarding whether or not to go to the hospital. Family and friends can be instrumental in helping the patient chose a course of action that is best for him or her. And when in doubt, go to the hospital!

When in doubt, go to the hospital!

 

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

Posted on BrainLine April 8, 2009. Reviewed March 28, 2019.

Comments (481)

Amanda, you need to see a neurologist.

HI my daughter got hit by a car walking down the road 2 weeks ago. They said she had a contusion on outer left side and seen nothing else. But ever since then she has been very aggressive, crying, and having emotional issues. Could something else be going on that was maybe not seen during the emergency?

Fredia, you need to take her to a neurologist.

I hit the back of my head on a metal bed frame falling onto the bed from standing up 5 days ago, and immediately after it I don’t remember what happened, then I couldn’t move my head until the morning. Since then I’ve had a consistent headache, dizziness, sensitivity to light, drowsiness, and confusion. I went to hospital 2 days ago and they just said to take panadol and nurofen daily and to come back if it doesn’t get better, or gets worse, or the dizziness gets worse or if my balance gets worse or if I get nauseous l, or anything else that could be related. Yesterday I noticed all new things coming up in addition to everything before. I’m very worried and think I should get a scan because I normally have a lot of pain in my body and stuff going on anyway that could be affecting it, and all my friends think I should go back, but my dad doesn’t seem that worried and is saying that it’s normal. What should I do?

Go to a hospital, they can do a CAT scan to look for bleeding in the brain. If in doubt go to the hospital.

I agree, that sounds serious.

These are signs of a concussion. Go back to the hospital.

I was playing ice hockey(still do) about a year ago. I got tripped up and flew about 5-6 feet across the ice while flying about 4 feet off the ground and went head first into the boards. The impact was on the top/back portion of my head(my back was facing the ice and I was going backwards into the boards). Upon impact my head snapped forward(whiplash) I blacked out and remember coming to laying face down on the ice holding my head and the red whistling. At that point I knew I was playing hockey but was a little confused what was going on in the game and knew I had blacked out(not the first time I’ve been knocked unconscious). I ended up sitting out for a little and then went back in to play(I know it was stupid and I was being stubborn). I’ve never gone to a doctor any time I’ve been concussed(yes I know it was a concussion and yes I know I’m stupid for not going). I believe my head has gotten a little messed up, as I forget things I’m talking about and I have developed a slight stutter at times. A perfect example is this post I’m writing right now, I honestly forgot the what I’m commenting on and just know it’s about hitting my head and getting concussions but other than that I don’t even know if I’m commenting on the same “theme” everyone else is. I just know i messed up by not going to a doctor, now I have a completely different injury to my throat/neck and will be seeing a doctor very soon and won’t make the same mistakes again.

You should go to the hospital ASAP before it gets worse. I hope your okay, this sounds scarey.

hi . Today I hit my head in the sport class . My friend had knocked it with the basket ball so hard . I am ok but I fell like my brain is moving , is it normal?

A few weeks ago I fell and the right side of my head bounced off the concrete floor, getting headaches I went to the doctors and was told I had a concussion as I had lost consiousness for a few minutes. Now I am having a problem with vertigo and concussion, plus when I lay on the side where I hit my head I get severe pain on the top of my head and at the back of my ear, plus I get really dizzy and feel sick. I sleep most of the day now, should I worry? I am over 65 years old

Get checked out please.

This is a really interesting chain of messages, in many ways I feel less alone with my own concerns. Please bear with the following, by nature, I'm a worrier and this is ruining my life.

A number of years ago, I walked into a pillar; I was looking the other way whilst walking, looking for someone, then turned around and bang! I was a bit dazed, and the point of contact was on the forehead, just above my left eyebrow. I went into the pub where I was meeting my friends, and I had a massive goose egg bump, with a small cut, which was bleeding. The bar staff were a bit shocked at the bruise and asked if I needed to go to the hospital, but I said no, I was ok - they just stuck a plaster on. I then had a few drinks with mates, then went home; wakened up the following day and felt pretty much ok.

At the same time, I was going through a pretty difficult time in my life, going through University, broken up with a girlfriend, trying to find myself really. Anyway, I just feel at that time, I lost confidence, experienced a really dry mouth when speaking to people, and seemed to slur my words quite a lot. This is still the case years later, and I keep thinking if this is the result of the head injury - was it totally innocuous, or should I have gone to the hospital? Have I just got generalized anxiety, which is causing the dry mouth, etc?

I know the above may sound pretty minor to others who have posted on here, but this has become an obsession for me and has ruined my life. Am I worrying about nothing ref the bump on the head? Really appreciate feedback on this guys.

If I were you I'd go see a doctor and tell them my concerns. A head injury is a serious thing, it's your head and when we are not at 100%, our bodies will try and protect and heal. I'm offering up a special prayer for you. It sounds like you have a lot going on. Good luck and God bless you.

I fell and hit my forehead three months ago causing concussion. Still off work now suffering from anxiety and depression. Up until then I was perfectly healthy definitely think it was the blow to the head.

I hit the back of my head after falling Straight back from only standing height. I don’t feel sick or dizzy but have a head ache that mostly disappears with paracetamol. But I do have a bruise feeling on the area where I hit my head-do you think I’m fine and it should just go away?

I did this exact same thing and have the same symptoms!

Hi! My boyfriend hit his head (eyebrow part) on the ground so hard in the past -- 8 years ago. He briefly lost his consciousness and had a severe headache. And after that day the pain disappeared. And now he's experiencing an everyday headache (mild & severe) and sometimes dizziness. I'm so worried about his condition. Do we need to see a neurologist to check his head? How much does it cost?

I hit my head 3 nights ago. I have a severe headache that hasn't gone away. My vision gets really blurred when I drive and sometimes at work I lose balance. I hit my head last year in an accident on the left side. When I fell this time I hit my forehead on my hairline. Should I go to the hospital?

definitely go!

Id definitley go to the hospital if i was you.

yes! go to the hospital

Yes!! Now!

I hit the base of my skull around five days ago, I was sleepy, draining mucus, I have loss of memory and for two days I felt in a daze/with slow responses. At this point my husband and I agree I had a concussion. However now I have this straining pain on the side were I hit my head and in my neck. It's as if my heads pulling down that direction. I also have stiffness. Should I go to the hospital it's an old injury now

There is a certain spot on my head that is SORE when I touch it. I have hit my head SO MANY times in the recent past month or so, banged it on the top bunk getting into bed, banged it on the car trying to get something in or out of it, and I even hit my own head when I have a migraine and the pain just doesn't seem to MOVE out of that one location, I thought it was a bruise but it's been hanging around way too long for that, so any one of these might have caused me to possibly have cracked my skull. I do not feel a knot, but when I find that spot that is sore when scratching my head, I seem to feel nauseous until I leave it alone...The nausea & pain stops whenever I leave it alone. I have noticed that I have been extremely ANGRY here of late, but I thought that was due to me being bullied at work and then let go when I was the hardest temp worker they had and expected to stay! I don't have any money to go to the doctor with. Hospital charges an exhorbitant amount of money. $3k just for a bladder infection diagnosis, in and out in less than two hours! Maybe it's just a bump, like in acne, but I cannot seem to be able to find it. I don't want to injure my brain in case it is an indention injury that is not healing! Now I"m lying awake and cannot sleep at the thought of this!

Hi! So I'm 11 and just today I hit the top of my head on the playground. I experienced severe headaches throughout the day, also I heard that sleepiness is a symptom as well. I've also had a little bit of nausea and dizziness. Should I go to the doctor?

I got hit on the top of my head with a pry bar traveling very fast and attached to heavy equipment. Thankfully I was wearing a hard hat and it took the brunt. I have been nauseous but not vomiting, dizzy, hard time thinking normally, blurred vision, headaches and I find it hard to open both my eyes. I saw a dr. who sent me home with a prescription for alive. My pain in neck and shoulders is increasing and pressure on my head also hurts. The dr. did not give me a cat scan because he said he did not think I was bleeding and there was a radiation risk with the scan. Should I go back???

Probably because the way you describe it it sounds like the pressure is the blood pushing up against your brain.

I fell last night on ice. It happened so fast I couldn't brace myself. I fell back and hit the back of my head. I had alot of aches and pains and a headache and nausia. I felt a little like I was watching tv. Sort of disconnected. I didn't loose consciousness but my vision got dim/dark for a minute. I woke up at 3 am this morning and had no balance at all. Went back to sllep til 6am and I'm not so off balance but something is different for sure. Other then the pain in my back and neck.
I have been in a auto accident where someone hit me head on almost 10 yrs ago and I did loose consciousness briefly then. I was dx with a mild TBI then. Could this just be my old symptoms being aggrrivated?

If you still have a headache or any nausea, then you probably have a concussion. Not an old one, a new one. I just fell on ice last night as well and hit my head. I have a mild concussion currently. And I've had 7 or 8 previous concussions.

I recommend going to see your primary care and just tell them you fell, hit your head. And ask, do you think I have a concussion? Yes, there is a test to determine if you have one or not. Not every concussion is the same.

Good Luck!

Ok, I'm 15 and yesterday I hit the side of my head on the car door and have had headaches since. Today, I was laying down and I told my mom to hand me my phone and she ended up dropping it on the side of my head I hit yesterday. My mom tells me I'm worrying too much and we don't have insurance. Advice?

Go to your local welfare office, you may be eligible for health care insurance. You will need a parent since your under 18 . Bring all your ID, birth certificate, SS card, bill with address from your residence. Hopefully you are eligible and can start treatment. Family doc first . Good luck hope it works out for you.

I was snowboarding and going about 30 to 35 mph. Hit a real wet patch of snow under a lift tower that made my board stop dead in it tracks. It pitched me right on to my head. I hit a patch af man made snow that was rock hard. I woke up sliding on my back pretty fast. I was able to self arrest before I hit a tree head first. I had a helmet on which I think saved my life. It’s been 3 days and I have a head ache and everything is kind of fuzzy. I was lucky enough to bump into a Dr at the midway lodge 3 minutes after it happened. He said I was ok, but to go right home. Should I get a CT scan or do I need to just rest for a few more days

Hi last night I was swinging on an underground car park sign and it snapped out of the roof and I landed on the back of my head from a reasonable hight I was paralyzed for around 60 to 90 seconds and could hear people but couldn't talk or move I went to the hospital MRI scan said that I was fine although I'm suffering from pins and needles all over from my shoulders to my head and was wondering if this is at all normal and if it will stop... Thanks for your help!!!

a few day ago, I managed to hit my head on the wooden corner of the night stand when I rolled over in bed and bashed the outer corner of my eyebrow pretty hard...l didn't get a concussion or a black eyed, but had only a minor bump that was barely noticeable that I put a cold pack on.... however, my neck and back feels stiff, my left eye seemed a little blood shot, and I've been spacey minded... however, I just came back from a week
long vacation of sleeping on a somewhat uncomfortable bed, and it's normal for me to get jet lag and be exhausted from traveling. However, I wasn't sure whether the vacation, head bashing, or combination of both factors to be able to distinguish which factor had more of an effect on me to explain the reason behind stiff muscles and fog. I'm still glazed, stiff, and just worried if the head bash might be serious since I thought I had felt something that got in my eye at one point. I haven't barfed or anything but I did burp and got a slight taste of the meal in my throat. and I'm not sure my mind is playing tricks on me for slight small changes I noticed in my vision at times as well during breif moments for my hearing...and not sure but it seemed as if I felt as if my head was somewhat tender...and tasks are taking longer since I kinda daze out so...gonna end it here. thanks

I fell Saturday and it was snowy i went down to feed my hog and went down a small hill and it happend so quick that i hit the back of my head hard on the ground i woke up next day an my body was sore and and today my neck is tender i didnt go to doctor but i was wondering how long it would take to heal

Almost 17 or 18 days ago I hit the forehead on the wall and at the same time when I bend some yellow fluid came out of my nose in a small quantity.. after that day I went to the hospital and my doc ask me to collect that fluid if it comes again and meet him and gave me antibiotics.. but that didn't happen again. After 5days I met him and he said that I am fine.. there is no need of CT scan.. and now I am not feeling well. Some sort of little heaviness in my head and I can't even sleep because I have anxiety issues.. should I go to doctor again or am I fine?

Definitely go to doctor again and demand a second opinion.

Not an expert but think you should go back to the hospital to check.

So I was in a bad car accident 10 years ago and suffered a tbi. The other day I was punched in the back and side of the head over 50 times. I haven't thrown up but just wondering what to do. It was the lower back of the head if that helps at all. Thank you for ur help

I hit the base of the back of my head hard on the left side. Got a headache and felt the br uising hours later not at the time. Now 3am and up with a worse headache. Started in forehead and now sort of everywhere and a bit off balance. Should i see a doctor or wait and see

I hit back of my head to the wall last night and my ears are ringing from them, it haven't stopped since. Should I see a neuro-specialist or a hearing specialist?

My husband hit his head at work.. for two days he talked about that same tingle feeling and said he just didn't feel right. 11 days ago I came home from work to find him on our floor having a seizure and unresponsive... He never felt a bad headache only that tingle and couldn't concentrate. He just kept saying he didn't feel right... from the seizure that they believe came from a blow to his head caused more damage and after returning to the ER learned he had 2 spots of bleeding that the nuerosugen believes was an initial bleed and caused a seizure and banged his head causing a more recent bleed... they kept him in a coma for 5 days... and continued to drain the blood for another 8 days. His kidney had shut down and he was in arrest when I found him. Don't wait! Never wait! It's better to be safe then sorry!! Always when in doubt... GO....
My advice... if you EVER hit your head harder then a knock.... GO
My husband Never showed any outside trauma... No bump or bruise... But if we had just gone it could have been a simple treat... but due to a slow bleed turned into almost death... with Tramatic Brain injury it's not over after being released from the hospital... it's been a week now and he still doesn't act himself, he gets angry very easy almost abusive, He was washing my car with toothpaste while i was in the store two days ago, he has hallucinations... because I found him so we don't know the extent of damage from how long he was in the seizure.... the only safety is in prevention and early detection... GO!!!

This morning I was rear-ended on the freeway, and when I got hit my head went forward then smacked into my head rest. Initially it hurt then it stopped, but now the back of my head hurts and I’ve had a headache since 4pm. I took tylenol but it didn’t help. Should I go to the ER tonight just to check if anything is wrong?

If you haven't already, I strongly recommend you visit an ER, or urgent care.

About a couple weeks ago, I got up, then felt a little dizzy but not to the extent of passing out when all of a sudden I blacked out, fell down against a wall that now has a big dent in it, soon after that had a siezure/convulsions my friend said, he almost called 911 because the way I was laying looked as though I had broken my neck but after a few minutes I came too, was super confused, my head felt fine, only the next day did I experience a pretty bad headache, ever since then I have had neck pains that shoot to my shoulders but not sure if it’s related. Should I still after all this time go get it checked out just in case? I’m guessing if there is question I probably should?

Hi. I had a severe car accident and a severe concussion a month ago. I'm still dizzy and when I stand for more than 5 minutes I get like a haze and feel ready to pass out. It's been like this only since the accident. I went to the hospital last week and they said since my CT scan a month ago showed no bleeding that what I'm feeling is normal. Now I had a previous accident and in 2009 John Hopkins found that I have 2 pinched occipital nerves.

Is what I'm feeling, in fact, normal? Or should I go back to the hospital?

I was a passenger in a car wreck -- broken clavicle, broken ribs and a couple other things. The doctor released me knowing there could be other complications. I've never had a concussion but it has been really hard to concentrate and I've been getting really dizzy (to the point I lose balance and the room spins super fast). I was thinking it was from the pain of my body, along with my two broken ribs but it's been 4 days since the wreck and it's still happening. There is no clear head injury but I did break an airbag with my face and then fall 30-40 feet, maybe more in the car. I had to of hit my head on the back of the seat too. I've been really confused since. It's not the easiest to move.

I have got a doctor's appointment in 6 hrs. Should I just go? I think this article just made my decision.

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