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 (671)

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.

I had an accident at work just over a week ago... My workmate and I were having trouble retracting a pump truck from beneath an empty pallet, so I stood on the pallet in the hope that my weight would hold it in place whilst my buddy pulled the pump truck out (we’ve done this before and it works!)... However, this time it didn’t work - he ended up yanking the entire pallet from beneath me - I lost my balance and fell backwards, landed flat on my back and smacked my head on the concrete floor. I felt really sick and dizzy for a minute or two, but then I made myself get up as if nothing had happened. I have felt OK-ish since... I think the back of my head hurts slightly and I might be a bit more forgetful - but I don’t know if I’m imagining it, because of the accident. Should I see a doctor? It’s now nine days since I fell and I’ve survived so far! I’m a 51 year old lady, in good health.

Hi, I've just come across your comment. I would certainly get checked by a Doctor. Hope you feel better soon!

I have been hit on the head by my boyfriend so I'm having pains on my head It is even swollen I can't even swallow the areas around my ears are also swollen

What?! I hope you went to the hospital! That is abuse! I hope you are safe. Do you have any friends or family you could stay with? You should never be with someone who would hit you.

Are you okay? I’m not a doctor, but am concerned. I feel like you should go to a doctor. Your boyfriend should not be hurting you.

I would suggest you get to a Dr. If this from multiple hits damage could be cumulative. I would also suggest getting some counseling, or removing him or yourself from each other in abusive situations. I understand the reasons to stay and that being made to feel like you are nothing is a long term process. Been there done that, got out finally and found that I am really someone I like. No one can put me down now. Hard to do but worth the hassle.

Hello,

My Wifes hatchback supports gave out and the hatch came down on the back of her head pretty hard. No symptoms except she is developing a slight black eye on her right eye 48 hours later. I know getting hit the frontal area of the skull will cause black eyes, but I wasn't aware a blow to the back could. Anything to be concerned about? Thank you!

The top of my eye hurts after i hurt my head and has hurt for 2 days what should i do

Someone rear ended me the 8th and the dr told me I’ve had a concussion. Been vomiting off and on since the accident. I’m very wobbly, can’t focus. Today if I close my eyes or focus it’s worse. And there’s like a vibration (tremble maybe) throughout me. I couldn’t pass the finger to nose drunk test I think he dr. Office Friday but it seems worse now. I go back to the dr. Tomorrow, can I wait or should I go to the Er today?

Of course you should go to the ER! Are you kidding me? Those are serious symptoms!

I hit my right temple on the cushioned frame on the car getting back in the car - it hurts and now have a headache should I go to the walk-in or the ED

I was walking home drunk but have no memory and was found on the floor unconscious. I still have no memory if I hit my head or not but the last few days I’ve been feeling very dizzy and dazed aswell as having a headache and being confused aswell as not being able to concentrate. I did briefly pass out the morning after and woke up very confused and an ambulance was called, my blood pressure is still fine but I’m worried maybe i should of gone to the hospital.

I was rolling down a grass hill and there were these rock stairs and my head hit the rock stairs and my head hurts and I’m dizzy with a headache and my neck hurts also my friends were there and they said they heard a like loud noise when I hit my head so what do I do?!

2 days ago at work I was walking in the warehouse and a Canon D camera -the box was misplaced and fell on my forehead my head moved backwards abruptly. When I press on one left side of my forehead it hurts. I don’t have a bruise or bump but it hurts. Even though my neck moved backwards it doesn’t hurt. Should I go to the clinic tomorrow?

I’m a RN. We have a young person who is a family friend that contacted us for advice. She felt dizzy in her kitchen and before she could sit down on the floor she fell hitting her head hard on a kitchen stool. She had just put something in the microwave so she knows that the conscious seizure she had from the fall lasted 3 1/2 minutes. She didn’t contact us for two days asking for advice. She and her family had determined she has a concussion.
I’m beside myself. She’s in denial that anything could be really badly wrong and even if we pay for the ER visit won’t go. The reason she finally contacted us is because of the residual headache. I need her to understand that she HAS to be seen by a doctor and needs a CT scan at minimum to rule out a bleed.
She claims it isn’t spouse abuse but we know her boyfriend has roughed her up before and he’s not wanting medical involved. We may be able to convince her to go to an urgent care center but he insists he be present at all times. Urgent care won’t have the ability to do a scan. Any suggestions? It’s now been three days.

I was fixing a extra bar in wardrobe when the base of it slipped and fell on my nose the top just below my right eye ...medium size bump has appeared in last 20 minutes hurts and throws about 40 percent
When I scrunch it pains a little
Didn't knock me out luckily and didn't get dazed but there is a bump visible
Do I go a and e or wait
Please reply here as I just stumbled on this website

I'm 72 and fell backward and hit the back of my head on a concrete flower urn. I have a dent in the back of my head. No skin break, no headache or any other problems from the fall. Should I be concerned?

I hit my head about 3 days ago with the corner of a fireplace very hard. I’ve already have had 2 concussions from the past and I the right side of my head continues to hurt. I’m not sure what to do and I really don’t want to go to the hospital. What should I do?

I was drunk and don’t remember bumping my head but I woke up with a huge and painful bump and it hasn’t gone away even after 2 days. Is this normal or should I be concerned and go to the hospital? It still hurts when I put pressure on it

Today I was stretching on my bed and I fell off my bed and hit my head on the edge of my bed it hurt at first it still kind of hurts but I don't feel any things else should I get checked out or not

I fell shoveling walks and hit my forehead hard. It still has purple bump and black cheek. Still getting headaches and nausea but had act scan. It's been2 weeks. Do iI the too get it rechecked?

I slipped inside my bathroom and hit my head in the side of the toilet it hits my right lower part of my head near from my ear it gets a small cut that's bleeding and I can't take the pain should I see a doctor now?

I was in the shower earlier today and had dropped something and i went down to pick it up and when i came back up i hit my head on the Lever of the Shower Handle. I didn't lose conscience or had any signs of it. Should I have went to the hospital?

The freezer door swung open banging my 8 year old between his nose and forehead he seems fine and have been acting normal afterwards should i get him checked.

Hi there I’m a 20 year old female and a few days ago I was cooking dinner with my friend at her apartment and I started feeling really strange. I started Feeling very hot like I was overheating, light headed, dizzy, nauseous, and there was this ringing I. My ear. I thought maybe I should step out of the kitchen and sit down on the couch. I tried that but my symptoms were not improving it just felt like they were increasing. My vision started going In and out and along with the ringing everything was sounding muffled. I pretty quickly decided I needed to just step outside and maybe the cold would help me (this was all a matter of like five minutes) I was using her doorknob outside to hold myself up and then everything went black and I felt myself hit the ground but I don’t remember falling. I laid there for a few seconds. I thought that I had been laying on the flat deck part outside her apartment but when I opened my eyes I was actually laying headfirst on my back halfway down her concrete stairway. (she lives on the second floor and her door is right next to the stairs) other than a small dent in my head and some bruises on my arms and legs I feel fine (I don’t have a concussion I don’t think and I’ve yet to have any headaches) the dent is starting to lesson and there’s only a dull ache when I lay on it (I’m assuming it’s bruised from smacking it on the concrete) but I’m still concerned even if I haven’t sustained a serious head injury I have no clue as to why I passed out like that. I’d like to prevent it from happening again. I don’t think the back of my head would be as resilient a second time. Please respond I’m actually a bit worried.

I hit my head on a plastic cup holder (cracked it) and my head still feels a little sore. I’ve had nothing but soreness or a headache. Oh, by the way, I’m 12

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

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