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 (468)

I smacked my head on the edge of my metal bunk bed really hard, I have a bump and a red spot but I feel fine. I can’t tell if I have a concussion because I hit myself because I was dizzy beforehand but I don’t have any of the other symptoms. I’ve had a concussion before and I don’t feel like I did then. Should I go to the doctor? I haven’t gone because usually the doctors just do a quick superficial look and ask some questions then just send me home like nothing happened and it’s kinda too expensive to just go.

8'9'2019- I was walking out of bedroom, my dog crossed in front of me, I fell into the chair then into the wall and hit the left side of my head. I stayed on all fours for a few moments, asking the Lord to help me. I didnt want to get up and be dizzy. Later that morning I have head aches and neck hurts, went to chiropractor, he cracked my neck. Head ache had let-up. Saturday morning, headache is back. Shall I go in and be checked?

I hit my head and fell out. Went to urgent care . They said I had a concussion . Then a day later I fell and hit my head bad in the tub and I can’t remember how I fell in the tub. I have a big bump on my head it’s now about a week later and it still hurts . The bump is still there . What should I do ?I also forgot to mention I had neck surgery 5 years ago with 18 screws .

My 21 month old granddaughter hit her forehead pretty hard has a big lump it’s her bedtime now they live in NY I’m not near them and I’m concerned if she goes to sleep or has swelling?? Stuff that can’t be seen. I know little one get plenty of lump & bumps maybe you can guid parents what they should do. Thank you

Today I was riding my bike down a hill and lost control of it and hit my head on asphalt and there is nothing but a little knot on it....and it only hurts where the knot is but, my balance fills iffy

I was helping pack up some heavy stage equipment tonight and while someone was lifting a very heavy speaker it toppled and fell directly onto the top of my head. It only hurt for a little bit, and I mostly felt it in my teeth, but the problem is that I can't tell if I've got a concussion or not. I have Chronic Fatigue Syndrome, and so basically I already have pretty bad fatigue and cognitive difficulties, fogginess and such. I have a little bit of pressure where my head was hit, and I now have a headache, are there any other telling symptoms of concussions I could check, since the fatigue and fogginess are already there? I need to know if I should bother going to the hospital.

Two days ago the back of my head was been hitted to the floor.at first,I just feel pain because of the smash but a day later it become worse.when I wake up from the bed I can't lift up my head by itself.As the result I have to use my hands to support my head to lift it up.It is also so painful when I move my neck.just move it a little brings a great pain to my neck especially the back part.i also feel dizzy sometimes.even chewing food,yawning or talking makes my neck felt so pain.it has been 2 days now that I feel pain at my neck.does it mean I had a brain injury or something?

Please, I hope you have been to Accident Emergency Jo pital by now? I have no medical background but you may have at least damaged your neck. You must be assessed by medics ASAP xx

Please respond, I need to know. I
was at work. I was throwing trash away and i was holding up the lid, and it got caught on bags on the other side and it fell and hit my head. Never loss consciousness, I do have a bruise, bump and a cut. Its been hurting bad for almost24 hrs. It is on my forehead. What is normal and when do I worry?

Go to the E.R. to be safe

I have had several headaches over the past month. I now find I have a few small lumps (about the size of a pea) on left hand side very near the top of the head where your skull leaves a small hole/joins. It is also very painful to the touch on left hand side of my head. Do I need to go to hospital or can it wait until Monday?

I about 20 mins ago hit the right top side of my head by accident on my car door and or the part right where I opened the door , I’m a delivery driver and just took the food to the door and when I returned to my car is when I hit my head , I have done the same thing before in the past. Lol Anyhoo , it hurt but not bad enough to cry or anything just kind of hurts not that bad . Should I get it checked out or am I ok? I drove home it was my last delivery. Haven’t vomited, blacked out, no blood where I hit it not coming from anywhere on my body.

A 3 and 1/2 year old had two hard hits on head in a week heard crack as of yet today almost 12 hours since last trauma no symptoms other than hard bump ice applied 3 times what are chances for internal cran
ial bleed?

Why would a 3 1/2 year old have 2 head trauma in one week? Of course you take them directly to the E.R. could have a concussion

I was playing at the park with my kiddos and I was climbing up the side of the playground set and once I reached the top I stood up and as soon as I did I hit the top of my head on a horizontal metal poll that was above my head that I did not notice when climbing. It about knocked me out due to how quickly I stood up. Should I go to the ER? The top of my head feels hot and there is a lump but that's the extent of my injuries so far.

I was playing kabadi then suddenly wen i went for my rider turn tue opponent girl pushed me to the ground n i cud hear the hit on ground... After tat i am now having mild pain on the back of my head after 8 hrs n a small sprain on my neck....... Shud i go to meet the doc???

I was bent over picking up rocks and throwing them behind me up on a bank and one came back down and hit me in the head.I have a bruise on my head and it is tender to touch the side of my head .I still have a little bit of a headache.What should I do?

I had the front of my head against the ground several times yesterday and many hours later I was nauseous dizzy extremely tired could not move very much. Eventually made my way to a bed and slept off and on all night and often on all day I still can’t really walk without feeling very shaky and like I’m gonna fall over if I move too quickly Or turn my head.
My pupils are the same size they dilate fine I don’t think I’ve lost consciousness or had memory lapses I just have a bit of a headache and a lack of balance and I feel Spinny. Is it A necessity for me to get checked out?

i had just hit my head today very hard on my bed , i get very dizzy and everything is slowed down and it’s hard to stand or walk straight . should i go to the hospital ?

Dog ran and his lease caught my legs, threw me up, slammed hard on my back and then my head. Very sore but after 12 hours feeling nauseous. Should I worry?

Hi. If some one could help me. About three years ago my sister was diagnosed with Fibromyalgia She. All ways in pain. So the dr put her on pain meds. But. There. Days. She. Be. Talking whit me. One hour should be fine and the next minute She’ll be mumbling I know. She not over doing pain med. she all ways. Tired And sometimes wants to. Pass out She could be talk. To me and All of a sudden fall sleep But. She is so scard. And dr. Donor know. What going on. Whit her. She went to several doctors But I don’t think not one of them have that a CAT scan on her brain I am worried something bad is going to happen to my sister please help

I was playing knocker ball and hit someone head on full force and have knot on the top of my head I wasn’t feeling good a first but I feel good now I took some medicine but my head sore on one side where the knot is do I go the hospital?

I hit the back my head twice in Nov/Dec of 2018. Once on skates on my wood floor, I hot the back of my head hard and went straight to the fire station to be examined. Not long after, I slipped on the ice outside on a sloped driveway and landed full force on the back of my head. I went to a walk-in clinic when I hit the wood floor and they said I had a mild concussion. No CT scan or Xrays were done. I told my primary doctor as well. I did not seek medical attention the second time but it was a hard hit, scary. My head was tender for several months but I didn’t lose consciousness either time. Now I’m seeing blood when I clean my ears. Should I seek additional medical attention?

My cat vomited and my partner stepped in it and fell
On our hard wood floor and hit his head. No bleeding nor did he lose conscious. He had a bump on the back of his head but says he does not need or want to go to hospital. I have ice in the bump. Anything else I should do?

Two days ago I was jogging with my dog and made a turn too fast and landed on my back, slamming my head full speed on the asphalt.
Since then, I feel fatigued, my neck and upper back hurt and my head feels heavy, it’s a concussion. I’m leaving for a month vacation in India this Friday. My guess is if I go to the hospital the doctor will tell me to rest. I am on chemotherapy as well. Should I still go to the ER ??? I hate going there for no valid reason while people are bleeding and needing urgent care. Thanks for your advice.

I got stuck/poked with a needle last Saturday on my temple area when getting a hair sew in. Now it’s a week later and I think I have a hematoma on my left side of my head it’s sore to the touch, should I go to the hospital is my brain possibly bleeding, or am I just freaking out ?

bumped my head today got a lil bump on my head no headaches or anything like that should i still go??

Hello, I was in a car accident and totalled my car and my head has been hurting a lot but I didn't think anything of it because it's normal from the whip lash although I did hit my head pretty hard on the head rest. I don't think I was unconscious after the accident but I got home and napped but I still felt some what concious and it swas hard to wake myself back up. Should I be concerned?

So this is kind of embarrassing, but Sat night I had too many drinks..I’m thinking I fell asleep on the toilet and fell forward hitting my head on the cupboard..I remember walking out of the bathroom down the hall and my head hurt, and thats when I noticed a pretty good sized bump on the top of my head..I went to bed and the next morning that area as well as my neck hurt..took some ibuprofen and was ok..last night I was in the shower and blew my nose and noticed a small blood clot..freaked me out and don’t know if it’s a coincidence because my allergies are bad right now or what..I don’t have a headache and haven’t taken ibuprofen since Sunday morning, and my neck feels a little bit better but I’m freaking out..yah it was stupid but now I’m freaking out because my anxiety is bad to begin with..I almost went to the er last night but just went to bed instead and besides the spots hurting where I hit, I don’t have a headache, haven’t vomited, and the slight dizziness I feel could be my allergies too because I’m always in a fog when they’re bad..I don’t know if I should just go and get checked or call my dr..I’m so embarrassed by it and don't really wanna explain the story to anyone, but I can’t get it off my mind and my anxiety is making me super uncomfortable..should I just go and see how things are or call my dr? Don’t really wanna explain it to her either but I don’t know what else to do..

I had a hit to the back of my head around the right side around the crown part back of the eye and to the side towards the ear. (a heavy crystal vase fell on me ) while I was moving a cabinet. I didn't think to move it at the time as I was only moving it very slightly. Anyway I was very lucky I remained conciousness and only grained a large lump and swelling where it knocked. I got this feeling of blood build up sensation (like I could feel it bleeding inside) It was sore for weeks and still remains sore at times. It was now three weeks ago and I never went to the hospital is it ever too late? I never went as my husband kept reassuring me that I was fine and the headaches and soreness and swelling is all normal I will be fine. Yet I felt that with bang that hard I should just check it but he kept insisting. So I never went, I still don't know as I don't want to one day not wake up because I didn't check it when I should have. Do you think I still should and is it too late?
thanks

my son had a car accident. bloody nose and swollen lip ...that was yesterday,'today he fell twice losing his balance and went to ER. they checked him over said no worry ,,,shouldn’t they have done more testing?

If I got into a fight and they hit my head by my temple several times should I go to the hospital? I been having headaches, pain on my temple, loss of appetite.

Yes

Definitely. Better to be safe than sorry

I hit my head hard enough to bust open above my eyebrow. That was two days ago now I'm not feeling quite myself. I'm super nauseated I have huge headaches and super sleepy. I went to a doctor but they said it'll go away in a couple days but but it just seems to be getting worse and I can't talk to my husband he just thinks it's stupid. What should I do?

56 yrs in otherwise good health female: Yesterday evening I rolled my ankle wearing wedge shoes, causing me to fall backwards in a parking lot, hitting the back of my head on the asphalt, which made a dull thud sound. A young guy helped me up. It hurt but I didn't cry or black out; no broken skin or bleeding. I felt unsteady, shaky, but after sitting in my car a few minutes, went on to the lecture I was headed to. I tracked with the presentation and did not get a significant headache which really surprised me. I took 400mg Ibuprofen just the same. No nausea developed or speech impairment, vision perhaps a bit off, but I thought it may have been the lecture hall lighting.

I iced when I went home 3 hours later, which actually made it hurt. This morning I feel a bit thick-headed, with some "tingling", maybe very slight nausea though not enough to not eat; took 600 mg ibuprofen. I'm moving a little slower- on purpose- and reluctant to make something out of nothing. I'm at work, reading and on the computer. Given these details, should I go be checked out? Thanks for your insight.

I was taking my gazebo down yesterday and a big wind came broke it. The metal rod broke hitting me in the top of the head. Bled a lot, instant headache. 36 hrs later the headache, neck ache still hurting. Should I be concerned?

I was rearranging and top part of my entertainment fell and hit top of my right side of head.. I didn’t go to the hospital.. it’s been two days.. so since yesterday I started to fell weird. Headaches, nauseated.. at time n can’t handle the sounds around me.. like I just want someone to squeeze my head.. I manage my day at work but later n the day it starts to bother me..

I was playing with my brother on the grass with a water gun and I was running towards him not that fast, maybe a faster-paced jog. I slipped because of the water and fell hard on my head in the grass. I just curled up in a ball in tried to wait for the pain to stop. Fast forward to 1 day in the future, my neck feels kinda stiff, uncomfortable, and somewhat slightly painful when I move. Is it normal? Am I just sensitive?

I fell on my side on the grass. Head did hit the grass but after a few mins. I hardly feel the pain. What are symptoms to look for

I have recently hit the back of my head against concrete, I was jumping on top of a bench but lost my balance. I fell on my back, and the back of my head bounced off the concrete hard. I had no bleeding of any sort that I can see or feel, but my left hand, neck, and right leg hurt. Is this enough for me to go to the hospital?

I had a fall from my horse showjumping and found myself outside the ring holding my horse, but cannot remember getting there. someone told the next day that I was out cold for at least 10 mins, but I was allowed to drive home with my horse alone. I now have a heavy headache at the back of my head.I am also type1 diabetic.

I hit my head on a box and went unconscious for just a few seconds and I do have memory of what happened but ever since then I haven't been able to sleep without waking up every hour feeling light headed or that's the only way I can explain it honestly I feel weird. Should I go to the hospital?

Yes. If you've lost consciousness (even momentary) you should definitely get check out by a medical professional!

I was just trying to do a hand stand, which was a really dumb idea but I crashed my head into the floor pretty hard there's a tiny bit of blood. LIKE TINY tiny in my hair. My head feels funny I feel kind of loopy and dizzy but I didn't lose cosciousness. My head hurts too. What should I do?

You should go to your local E R and from there they'll examine you and tell you what to do next.

If you've been feeling lightheaded headed, confused, have had your pupils change size or a headache ever since hitting your head, it's best to see a doctor just to be safe then sorry. As soon as possible. From asking a friend who's in medical school, blood on the surface is okay. If there's a dent it should be checked out. Hope you're good!

I have been blacking out for over two weeks now, I do not drink. My fiancé has to explain to me everyday what happened minutes before or the day before. I can’t remember 90% of the things I have said or done in the last two weeks. Should I go to the ER?

Do not drive. Do not get up to walk. If you can have your friend hand you the phone and dial 911 immediately. 911 operators are highly trained. They will stay on the phone until the rescue squad arrives.

Emergency Medical Technicians will access you in the ambulance, hook you to monitors and have you stabilized prior to arriving at the EMERGENCY ROOM.

I have seen this on numerous occasions and each person immediately called 911. Don't hesitate. Your next blackout could be your last.

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