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 (532)

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 hit my forehead off of the wall days ago and only now about 4 days after have developed a hard lump under my eye, as well as a black eye that’s only getting worse. I know the blood is draining from the egg on my head I’m more worried about the hard lump?

So today at the gym I accidentally dropped a 95 lbs weight in my head right above my left eye. It instantly welped up. I feel okay now it’s been a bout 2 hours. I have a bit of pain In My eye and of course a headache. Should I go in or is it safe to wait. I’m also a nanny of a 8 month old so I only have 3 days to decide before I go back to work On Monday.

I lost my balance and hit the back of my head on a cast iron fireplace tool yesterday. I have a bump on that side of my head, a headache and I feel a bit “fuzzy brained”. Now I have a new bump on the opposite side of my head that really hurts. Should I be concerned? I am the main caregiver of my disabled husband and kids - and the only driver!

hi, I was punched in the head and after a week when i press on a spot on the side of my head it hurts alot. I got a CAT scan and they found nothing wrong at the time and it's been a week and I still feel pain and headache.

Hello, recently today I was ice skating and fell backwards and hit the back of my head hard against the ice floor, I felt my head throbbing and it hurts my neck to move my head around. Later that night I began getting minor headaches for short periods of time that leave and come back. Would you suggest going to the doctor?

So I was being stupid and jumped on my bed in a hurry to lay down with my phone in my hand, and it landed on my left temple. I didn’t have any headaches, vertigo or any of the symptoms listed above. I also noticed that when I bit down, just messing around to relive the pain on my temple it started to hurt even worse. I don’t know if it means anything, all I know is it was hurting for a while; and now the pain is gone.

Hi today at work i hit my head on the corner of the microwave and I started bleeding and was dizzy and got a headache and I still have the headache and the dizziness. I also have virtigo so should I see my doc

yes, you probably should

my neck has been hurting for 3 days should i go to the hospital?

So I slide and feel down my steps tonight, I hit my neck on the steps and I'm pretty certain I broke my tailbone. I didn't pass out, puke, or anything like that but my neck is pretty sore. It mainly just hurts when I move my head but there are no Mark's or swelling is it safe to wait and see if it gets better/worse tomorrow and then go to the dr?

If a person fell 25ft above and hit his head landing on a concrete sidewalk, would that be fatal? or is there a chance of survival?

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?

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 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 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?

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 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 !

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?

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

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 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

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.

I was running across my room when I slipped on water and fell backwards and hit the floor so hard it was heard all over the house. It hurt for a bit but then I couldn’t press the back of my head because it would hurt I don’t have any headaches or dizziness. Should I go to the doctor please answer quickly. Oh and the slightest spin makes me very very dizzy

Yes, yes...and YES!!
Always have a head injury checked out, if you experience any symptoms (headache, pain, dizziness, nausea feeling sick, slurred speech, can't think straight, unusual symptoms or behavior in general.....these are your body saying something is wrong).

I work in a hospital. Last Friday, I hit my head on the corner of the IV monitor. I had a slight headache and If I remember correctly I went to sleep afterwards. Yesterday, out of nowhere my head goes to throbbing on the side I hit my head. Took some tylenol and it feels better but my eye is hurting kind of like its sensitive to the light and when I look at my phone. Could I have a concussion after all this time?

I am 28 years old FM I got into a fight with someone she pulled my hair really hard and twisted my neck and sat on me. My scalp has been hurting me and my neck and head aches a month later I had vaginal prolapse surgery which I had 10 days a go every time I sit or stand I get severe headache and dizziness also feel sick my vision gets blurred i get ringing in my ear I have been told it is a spinal headache I’m not sure if it is connected to the head injury I need advice on what I should do thank you

I am a 15 y/o boy and i was walking the trussles with my little sister and a train had came so i was running i tripped and fell and smacked my head and i didnt loose consciousness but ever since then i have been feeling like in a daze off and on but when i went to the hospital they cleaned the blood put 4 needles in my head to numb my head but no CAT scan should i go in and check it out its almost a month and a half later and when they pulled the staples out and my mon said "i think my son should have a CAT scan done because hee seems very off" and the doctor said "no hes finehe just coming pff of a concussion" like no the concussion should be gone by now and i still feel dazed and like im not myself what do i do??

Get a different doctor's opinion and dont settle for 1 input...u have to live that way for the rest of your life..so take care of yourself and get a second opinion...might unsurprisingly be the best thing

Nope, get a cat scan! It was irresponsible of that doctor not to order a cat scan in the first place! Be insistent, threaten to sue, whatever it takes to get them to give him one.
I would ask for another doctor...always get a 2nd opinion anyway.

About 24 hours ago I fell asleep outside sitting in my lawn chair. I must have dozed off, because the next thing I remember is 'face planting' in the driveway! I only woke up when I hit the pavement. I bloodied both my knees and my nose. I busted my lip and hit my forehead really hard. Less than 24 hours later I look like I have been a couple rounds with Mike Tyson. My whole face hurts, but especially my forehead. I don't have a knot, but when I bend over the pressure causes my head to throb and I have a terrible headache. What should I do. I am a 55 year old woman.

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