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

Brian Greenwald, PhD
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.

Comments (57)

Anonymous replied on

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?

Anonymous replied on

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.

Deb replied on

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.

Anonymous replied on

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?

Anonymous replied on

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.

Kathy replied on

I was at work and I bent down to get something and when I came up I smashed the top of my head on the metal bar the attched to the stairs and I went to the hospital and they said l do have concussion so I have been off work for a week do you think I should be off more time

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