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 (645)

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.

A couple of nights ago I passed out and landed halfway down a concrete stairwell. I didn’t roll down them or anything I landed solid where I fell, trouble is though that I hit the back of my head when I fell. The back of my head doesn’t seem cracked open or anything but it does feel a little dented. Hence my concern. I have yet to have any headaches and I feel relatively fine other than a couple of bruises on my arm from the fall. I don’t have a concussion either. Idk what to you think? Should I be worried?

Yesterday I went to close the back window/ tailgate on my SUV, misjudged where my head was and slammed the tailgate on my head really hard. I couldn't believe it! It hurt badly and I got a little dizzy. After sitting in the car a few minutes to make sure I was ok I drove Cross the street and bought some ice to put on my head. I iced it for a few hours off and on and took Tylenol. Today my head is tender and there are indentations where the door hit me. I feel ok otherwise. Is there a chance there could be internal bleeding?

My 2, almosst 3 year old daughter slipped in the tub last night and hit the back of her head on one of our jets in the tub....She hit the soft spot behind her ear and it instantly swelled up and created a small purple/ red lump just behind her ear lobe.
She instantly cried and settled easy after the fact. She hasn't been acting unusual or vomiting. no raccoon eyes or anything of the sorts... we have been trying to ice it. We let her sleep through the night and checked on her periodically through out the night, and she didnt have any issues and woke easily. But the swelling behind her ear has increased....The discoloration has gone, but it just seems more swollen....
Should this be cause for alarm? she is acting completely normal, except complaining that her neck hurts.

yesterday me and my friends were all sitting on my livingroom floor and i have glass sliding doors. i lay down and my head was in line with the glass doors when my dog came and tried to lick my face and scared me, making me react by suddenly moving my head and hitting the temple quite hard against the glass. i felt pretty dizzy the rest of the night and have all of today too. i’ve had a headache on and off for a little but nothing too serious and my temple is really sore to touch but i think it might just be bruised. not sure if it’s serious enough to go to the doctors but i’m worried at the same time?

I hit my head on the steel at work when i hit it it didnt really hurt but now when i feel of where it hit it feels like an indent but at the angle i hit i dont think it could have caused it is this seriois ?

There was a large pane of glass thats 1/2 inches thick. It was put in the back seat of my car. It was long enough it was on my side of car. I jumped in not noticing it and the corner of it hit my head with great force. I couldnt talk it hurt so badly. I developed a headache for 2 days about 4 days after I hit my head. Headaches gone but im left with a finger tip indentation above my left ear. Its been about 7 days since it happened. Should I be seen?

I fell in may getting out of the shower landed on my forehead. Went to er said I had tons if swelling but looked good. 6 months later I have a spotlight above my eye that swells now and again hurts especially to touch and I get a headache. Is it normal to swell up like this that long after an injury?

My son was slammed on his head on a concrete floor.He had a fractured eye and bleeding on brain.He was seen in hospital for 4 or 5 days he cant recall all details but he can barely walk,Should I be concerned?

I was at work today mopping the freezers when I slipped and fell backwards and hit my head very hard . I got sent home because the workers that saw what happened were worried. But I feel perfectly fine . It just hurts a little bit other than that I’m ok .

I was playing with my sister and a metal bar fell off and hit me in the temple and its bleeding

My 1 and 1/2 year baby hit her back head’s lower area on one rack during shopping.. For 2 minutes, she had been crying , after that she is normal.. I didn’t go to the hospital.. bt I am very scared abt it... should I need to take her to the hospital

I was in a car accident 2 days ago. It was a fender-bender, but my airbags deployed, and, among other minor aches and pains, I have a very tender bump just above my ear, and one on my brow bone near my temple. When touched, I get a radiating headache. I’m also experiencing some irritability, light and sound sensitivity, and am always yawning. I was wondering if I should go to a doctor. If I simply have a concussion, I really can’t afford it, as I’m uninsured. Halp!

Is a slight headache a more significant symptom if it's in a different part of the head than the injury was?

This is unhelpful. I hit my head hard maybe once a month. I can't afford to go to the ER once a month.

I walked into a concrete staircase 8 months ago. Initially it was a lot of swelling, which went down after some ice but a couple months after i realise my vision was affected as well as frequent headaches heightened from exposure to light. I'm terrified that something is wrong.

Hi I’m a 38 year old female I have a bump on my head right in the front near my hair line it’s sore to touch and has a cold felling to my head in that area and I’ve not hit or bumped my head at all what could this be

I'm a teenager who recently hit my head on a tree. I hit it after slipping, making contact with the tree at full force. At the moment I hit it, I didn't feel any pain, I only felt the force of the impact. My pupils were even, I have had no headaches in the past week, and my vision is completely normal. It's been a little over a week since then, and this morning I hit my head while entering a car. I am not sure whether it has caused serious damage to my brain, or whether I'm just being over-worried. My parents won't take me to the doctor, because they believe the injuries weren't on a serious level. I notice I'm being more emotional and my mind is quite foggy, will this damage be permanent?

I have a severe headache and I fell and hit my head 2 days ago. Should I go to the hospital?

While at school a girl purposefully punched me and hit my temple. It didnt hurt much at first but now it's hard to close my jaw in anyway and feels like talking is a lot of work. I usually struggle with memory so it's hard to go by that. Should I go to the hospital?

Last night, I hit my head on the bathroom tiles. I often wake up in the middle of the night to go to the bathroom, and I'm usually still kinda half sleeping, but this time I feel like I don't really remember getting up, I just remember waking up in pain after having fallen. It hurts and I have two bumps on either side of my head but I'm otherwise completely fine. I put some ice on my forehead and went back to sleep after. I didnt even think I could have a concussion. And like I said, I'm fine today except the bump on my head. However I also had an aortic dissection 3 years ago so I'm a little freaked out it might be related to my heart. Do you think I should go to hospital? I didn't really think it would be anything, but now talking to coworkers, I'm starting to freak out a little. I'm a 38yo woman.

I fell 5 days ago & hit my head on the ground just above my eyebrow & it still hurts now. I had been drinking alcohol before it happened & about 1/2 an hour later after I hit my head I was sick so then went home to bed. The next morning I woke up with a black eye & it was all swollen as if I had been in a fight. I feel ok but when I move to bend down it hurts more. Should I go to hospital & get checked out?

Yesterday I swung me head back and smashed it of the brick wall behind me by accident and I think I think I went unconscious for a minute and it’s only started to hurt now and me necks stiff should I go to a&e or is it okay

I slipped and fell a week ago and landed on my back and hit my head slightly. I'm still getting headaches and tingling throbbing in lower part of my head is this normal. I'm worried

I had a minor Concussion went to the hospital there’s no bleeding on the brain came home next day balance is way off and I fell again hitting my head. I haven’t gone back to the hospital. It’s been three weeks my head still hurts and still nauseous but everything else is OK should I go back to the hospital

I feel and hit the side of my head above my temper on a coffee table corner. There is a home about the size of a pencil eraser. Other than just a little bleeding and swelling, and being sore to touch, I feel fine. Should I worry or is following the other signs to watch for ok for me?

A closing door slammed on the right, back/side of the head about 5 hours ago. Initially I was dazed but not unconscious. No nausea nor amnesia. Moderate, intermittant headache,a bit of sensitivity on right ear, I am 50 year old male. Sound like it warrants a visit to Dr. tomorrow morning?

Yesterday My boyfriend was carrying me on the front of him and he fell over on some grass , I feel backwards and hit the back of my head really hard, I felt like a cracking sound in the back of my head , I had a excruciating headache after and it’s the next day and I still have it abit along with a stiff neck and I feel very drowsy

Someone picked me up and slammed me today and I hit the back of my head ... I have played football for 2 years and it really hurts to hit your head but I’m a pretty tough young women but I always get over it and I just don’t know what to do ?

I bashed into someone with my head two days ago at a hockey game. I felt dizzy for about 15 mins after and had a slight headache the next day but no other symptoms. Should I see a doctor?

I was at work today and my coworker pulled off the vent from the grill (at mcdonalds) and when he swung it down i happened to bend down to get something and it smacked me on the side of the head, i stayed on my knees after a second to not scream from pain and i got back up and was fine. I feel fine and have, just a tiny bump and a small headache. Its 3am it happened around 11:30pm am i good to sleep or should i go to the hospital

7 days ago, my daughters 110 pd dog yanked me in the street to chase a deer. I went down hard on the asphalt right side upper cheek at eye socket and Lip area took most of the hit. I was dazed, dizzy , nauseated, faint and shaking. Couldn’t stand up for 5-10 minutes. 7 days later it still hurts more than tylonal can treat.
If the eye socket was fractured there isn’t anything they can do, right? The lump above my lip is prob a hematoma ? So my question is , there is a great chance that I’m fine right? I’m 60 years old female. Thank you !

Two weeks ago I fell over and hit my head when intoxicated, I vomited afterwards. No particular headache (apart from a hangover) the next day. I have a dent/divert in my head where I hit it (it bled quite a bit at the time, but the wound was only small and is healed now) - is this normal? Willit heal?

Yesterday I leaned back on my work out bench and hit my head really hard I didn't feel dizzy or feel sick to my stomach I slept fine last night, Today that spot of my head is sore , Not sure if I should get it checked out

Just today four bottles fell on the back of my head from a shelf support breaking. The shelf is in arms reach. I just feel weaker with a little pain. Two glass two plastic.

I fell backwards when I tripped over a cat water fountain and hit the back lower right side of my head and neck. It really hurt, but I did not lose consciousness. I took an Aleve immediately. I am just sore. There is no bump so I know I should not sleep for a good while. What should I do?

I smacked my head standing up straight at work in a big thick metal sign. It hurt very bad when it happened, I got a minor headache shortly after that’s gotten worse. No other symptoms. Should I go to the hospital? I know it probably wasn’t a very severe injury but I have a lot of anxiety and I really don’t want to have a brain bleed and die or anything. I’m a 23 yr old female

when I was in my late teens I kept passing out I would be just standing there then just drop The 1st time it happened I hit my head on the table the second time it happened I was outside in my friends driveway passed out falling backwards crack in the back of my head on the concrete when I woke up I couldn't see So I just went home with help from my friend and went to bed the 3rd time it happened I was at a friends house in his basement getting ready to leave and it happened again passing out hitting the back of my head on the concrete floor never went to the hospital for any of them. I've have had memory and concentration problems later in life. what could be the long-term effects . it seems to be getting worse as I age

You should go to the hospital sounds like very serious injuries it's better to be safe than sorry

Yesterday while me and my brother were joking around, by accident my brother turned around and they both hit their heads but the things is my mom hasn’t been feeling well, she says she has a headache and doesn’t feel well since yesterday and that on her left side of the head where my brother hit doesn’t hurt if not on the opposite side which is the right, should we take her to the hospital or not because I’m getting really worried she says she feels like throwing up and doesn’t really feel normal like a bit confused...., should we take her to the hospital?

I hit my head, sometimes once a week when I am cleaning out the goats as their house is quite low. I banged my head this morning on one of the wood beams. I had a headache for a couple of hours afterwards, nothing too bad but its feeling achy now.
I'm concerned lately how often it has happened. However, I will be building a house for them with lots of head room asap.

I hit my head 2 days ago because someone pushed me into a wall. When I touch it, it still hurts. I was kind of okay that day. I started vomiting, feeling nauseous, and having headaches yesterday’s night and today but these symptoms match with my stomach medications. Should I go get it check out? My mother and friends said it’ll be fine but I’m just very worried something might have happened. The school recommended me to get it check out. Should I do so?

I was hit in the top of my head on Saturday afternoon by a bunch of plastic boxes with shoes inside. I felt a little dazed at first but that subsided. We went out and had a couple of mixed drinks on Sunday I woke up with what felt like a hangover with nausea and dry heaves. Got worse as the day progressed. Today, Monday I’m still no better still nauseous and very tired didn’t go to work had some diarrhea also. It worries because I can normally handle my 3 vodka cranberries. I’m not an everyday drinker, have not had a drink in about 3 weeks or so. Just a little concerned my husband said it can’t be a concussion. Thank you.

When I was sitting down my brothers where fooling around and hit my head super hard I don’t know if I should go to the hospital plz respond back ASAP thank you

I have hit my head twice today, the first one is when I have hit it on the pool floor, I slipped of my lilo, (lol), then the second one is when I came into my hotel room and smacked my temple quite hard on the door, my eyes go a bit blurry at times and I feel a bit sick, I also have anxiety so I could just be thinking about it to much.The first incident happened about 3/4 hours ago and the second one happened 30 odd minutes ago, what should I do? I’m a 12 y/o boy btw

I slipped and feel face first, flat on my face. My nose bled pretty bad,but it’s been 13 hours and have had a headache since. I just woke up dizzy,headache, and nauseated. I don’t feel that anything is broken

Okay same i literally thought i was gonna have a stroke I’m like panicking right now whic is clearly why i am looking up what to do when you bit your head hard lol.

I got hit pretty hard above my temple in a fight. I have a goose egg in the spot of impact. Slight headache and the goose egg is tender to touch the day after. Should I go to the er?

YES! Always tell your parents what you are feeling and go to the hospital if you have ANY dizziness, feeling sick, or headache, especially all those together. And if you have a sudden severe (really bad) headache, then GO TO THE HOSPITAL right away.

So if you have any bleeding or a cut go if you black out or vomit go. If you have a bump bugger than two centimetres don’t be concerned but ask them questions like the date and their birthday after that if they say the wrong answer go to a&e if the bump continues after two weeks or a week then go.

My dad smashed my head of the corner of the fridge it was really swelled like a golf ball and it’s been about a month and a half later and I still get nauseous and headaches

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