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 (686)

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 head on a low ceiling today and a lot of blood came out of my nose, like a lot, I’m a teenager and I’ve had headaches since I hit my head. I accidentally bumped it slightly again and my nose started bleeding again should I go to the hospital?

Hello, when I was 4-6 yrs old? I've been bumped so hard at the back of my head on the rock because my friends were pushing me in the swing and after that we did not go to see a doctor and I have a aunt whos job is a nurse so shes the one who assist about what happend. And after 2 yrs I used to lived in my grandmas house far way from our house I used to lived there and there was this moment that I and my friends were catching some grasshoppers in the grassy area but suddenly one of my friends (younger brother of my friend) threw a glass bottle on my right head and of course I collapsed and just woke up with many people around me pulling off the glass in my head and they didnt bring me to the hospital it was just a self care. So I have been hit 2 times without seeing a doctor.Since when I was 10-12 years old I was been diagnosed with ADHD depression or ADHD bipolar or just depression or just bipolar. But now that I am 14 yrs I have a schizoprenia idunno what type. My question: Is this because of my childhood head injury?But I dont have like a PTSD I dont do flash back memories about what happend I just dont care.

I am 71 years old I was cleaning the bathroom and felt unbalance and I fell down and hit The back of my head and my back. My neck and back hurts and I feel upset stomach and headaches more on the left side . should I be worried?

I hit my head a cuple of minuutes ago and I feel reely dizzy

Couple of weeks ago my 3 year old head butted me in the temple felt dizzy at the time been getting headaches on and off been told by the doc yesterday I suffer with anxiety not sure what to do because I’m thinking all sorts

Few nights ago I fell and hit the back of my head on driveway. Had a huge headache, took ibuprofen and had a huge massive bump on head. Slept that night just fine and by morning the bump disappeared as if it was never there and now the spot is sore. I have headaches since but no other symptoms or unusual behavior. Should this be concerning especially with the bump on the back top on the head disappearing so quickly?

I had the hiccups and decided to hold my breath. I got dizzy so I grabbed onto the cat tree and told myself to lower to my knees. Next thing I know I’m waking up on the tile with my head aching but also numb. I’m at work and continued my shift after. My head hurts to touch and is swollen. Should I go in?

I am 32 years old and I was hanging something up in my sons room and I fell off the chair I hit The back of my head and my back The next day now I am sore my neck hurts my back and I feels a little weird little headaches here and there should I be worried

About 4 hours ago I was lying on my floor and my phone was on charge on my nightstand. I hit the charger cord and my phone fell down and hit my left ear. Ever since then I’ve had a massive headache and my ear and jaw hurt on that side. I’m not sure what I should do or if it’s even serious.

Hello Dr. Bazarian,

I fell on April 3. 2020. I was riding my bike, I lost oxygen, passed out, and fell to the ground. I hit concrete, asphalt, a curbing. My joints are still hurting and burning. Because of the COVID-19, I did not see the ER until April 10,2020.

I have most of the symptoms except for seizures. I tried to get up off the ground for 15 minutes, but my legs kept shaking, weak, and giving out. My memory is bad. I had bruises going up my spine, head, and down the entire right side. I cried..Help me.

It is now May 17, 2020, I still hurt really bad. I have been crying in my sleep. I don't know what to do. :C

My doctors do not want to see me until the COVID-19 is over. I am in intense pain. I have reduced sleep due to the pain. My head hurts a lot. I have moderate brain damage due to my parents.

Please help me.

Hi I’m sorry for the trauma your are experiencing after the incident. Have you been able to get help ?

My hitted my head hard with a big plastic mayonnaise jar last night...on the side of my head...
Now I fill slightly headache and this coldness inside my head... should I go or not

I just hit my head on the thing thats right beloe the window and it reely herts

My desk chair slid off the wooden mat on wood floor, slid out from under me and I fell off chair, landed on my bottom and slightly (?) hit the back of my head on the wood floor. I was on the phone, got up and ok. Very slight headache.

I fall from my bed 1 arm high and I hit my head left side when I get up this morning that I hit so hard that I loss consciousness for a second and fell like vomiting in a second, how did I know if I need to see a doctor

i fell on the floor while cleaning and hit my forehead. got an injury and went to hospital immediately, did some stitches and bought pain killer and antibiotics. i have headache that have never experienced before. and tears keep coming from my eyes. kindly advice

okay so I put my phone to charge and I picked my head up and hit my head on the bed frame. It hurted that night and stopped. It felt good the next day but at night the back of my head felt hot and was hurting. Now today it started to hurt in the back and feels hot. Can somebody please let me know what this is ?

Saturday, April 25 mid-morning I was showering lost my balance and fell on the curb of the tub next to it is the toilet and I think I hit my head twice. On the edge of the tub I hit the side of my head between my jaw and eye, then on the back of my head on the toilet, I was all twisted between the tub and toilet. Few hours later felt a ringing in my ear took Advil very painful. Today April 26 have different symptoms, dizzy, ringing in my right ear not the left where it hurts, my jaw looks flattened it’s different from my right side, it hurts like I just did a root canal my upper lip got swelling, I can get up to go to the bathroom with a little difficulty lost only once the balance, my body and I have a headache. Not vomiting or loss of consciousness. It does bother me my jaw and on between my eyes. Should I go to the Emergency Hospital?

If you get hit in the head with a Croquet mallet at an early age, let’s say 8 years old...do you think it will damage your brain? Obviously it won’t cause death but I only ask bc I feel like my brain has a hard time making choices. I often wonder if it was in part the mallet to my melon.

I fainted whilst trying to get glass out of my husbands foot and as I fainted (I was sat down) I fell back and hit my head on the wall. Spoke to 111 and they said as long as I wasn’t unconscious I Don’t need to go hospital but I have a banging headache

This happen at work on Thursday as I was cleaning the racks and I was doing the lower rack and thought I was out from under there as I got up and boom hit back of my head, oh boy starting to get headache 30 minutes later and did report to safety committee and he said will do this twm as I was getting ready to leave my shift.
Is this somthing I should have taking this serious to see dr.so today is sat bump is still there and a little headache.
Should I put ice pack on ?
Now wondering when Monday comes should I report that I need to see dr have my head cat scan.

Hi I knocked my left ear and side of head 3 weeks ago and still experiencing pain in my ear and left temple when I lay on my side (left and right)? When I initially bashed it i experienced head pain and numb face for a day followed by a bit of vertigo which is off and on ? What should I do ?

I fell backwards & hit a counter top in a camper 3 weeks ago & lacerated my head.
Woke up the next afternoon & vomited later that day until bedtime. I couldn't keep food down.
Fast forward to present, I have vertigo like symptoms when I look left or right quickly. Not stumbling but definitely not right.

I assume I do have a concussion & am waiting for time to pass and symptoms go away?

I’m 22, and out of anger I hit both sides of my temples about 4 or 5 times with my hands open. I got a headache immediately and when I woke up in the morning it was gone but it’s been coming and going. It’ll be 3 nights tonight. I just feel weird but idk if it’s because I’m just panicking myself and stressing out about this. The headache is extremely minor and it’s mainly pressure in my temples and behind my eyes. No other symptoms so idk if I should get checked out, I really don’t want to bc of this COVID stuff. :/

My 4 year old kicked my temple and I’ll because I have anxiety I’m so paranoid that somethings going to be wrong I have a very slight headache

Same! I'm 30 and I got overly upset and I feel so silly now but I did the same! It been about 2 weeks for me and I still feel my scalp is bruised

I’m literally here for the exact same reason . . . I got so frustrated with myself last night that I lost it and started hitting the right side of my head. It hurt a little at the time but now the next day, I have a headache and that side of my head is sore to touch. I know it’s nothing and just stress worrying. That was so stupid lmao next time I’ll punch myself in the leg or stomach or something

I had a mental breakdown about a week ago and hit my forehead as hard as I could against the floor several times-idk how many times it was but definitely more than 5. I lost consciousness several times afterwards and since then I've been having random extreme dizziness and balance problems. Before I hit my head I was having severe migraine but afterwards they have completely disappeared, just having the dizziness worse than I've ever felt. When I lay on my right side I get even more dizziness. I don't have health insurance and I already have a hospital bill from 2 different hospitals from 2 days before...

I woke up last night to go to the bathroom and when I got out of bed and started to walk, I kept walking/falling to the right against the wall until I got to the bathroom. By that time I was not falling to the side any more. I had a mild headache afterwards. What could have caused this?

Hi! I was hoovering the stairs today. I was knelt down and leaning down and using the tube part of the hoover to do the stairs as they are carpeted. I had earphones in as well. Before I know it, the hoover has fallen down the stairs and landed on the back of my head. It hit me so hard I felt it in the front of my skull. It was a Henry hoover, which apparently weighs 6.6kg (according to Google). I have a headache and feel sick if I stand for too long. It is 10pm now and this happened at about 3pm. It still hurts. Should I go to the hospital? Or call 111? I feel fine other than my headache, eyes hurting, and sometimes feeling sick. I don't want to waste anyone's time which is why I am asking here.

Are you okay now

Be Aware off your surroundings at all times... Hoovering with Herbert on the stairs may give you a sense of pride, cleanliness and accomplishment
But you must always be mindful
Given the right height a sucker that size could Cause a cerebral hemmorage Go to the doc. Get checked out.

hello, not a medical expert here but you should really go check it out since you feel sick! otherwise, call a medical expert and explain your symptoms!

Are you okay now?

Helllo I’m 17 and I got punched right behind my ear and ever since I’ve got a lump that’s causing me all sorts of pain in my face and neck

I was laying down asleep on the couch and my husband and son were playing with a cellphone. My son dropped the cellphone and it hits the side of my head, immediately causing me to have a headache, knot on head, got dizzy when I tried to get up to get ice.

I got dizzy and had to sit down. When I put ice on my head, it hurts worse. My head hurts, hurts around my eyes. Should I go to ER or just wait to see if it gets worse?? I think its just a mild concussion

About a year ago I fell in the shower loss consciousness and had amnesia for the first 20 mins. I never went to the hospital but I had really painful headaches on the sides of my head and sometimes behind my eyes like six months after and now I’m starting to get them again. Is that related.

I I was walking across the garage floor and it was wet. I slipped and my feet came out from underneath of me, I fell back and hit my head very hard on the concrete floor. I managed to get up and come inside to get help and ice, I remember everything, I Have 2 cuts on my head. I remember everything, didn’t get nauseated, but my head hurts extremely bad. Should I go to ER?

I did the same thing but in my bathroom after trying to clear so a leak 3 days ago, almost no pain, now just a dull this, but took my wife to the neurologist at our local hospital, I mentioned it in passing to her and she was convinced I needed a CT scan, but they are so expensive. I am going to put it off for a day or two as I have very little pain I don't know if I will do it or not

I tripped and hit my head on a brick sidewalk about 3 days ago. It did cut a small gash right on my eyebrow next to the temple. Today it hurts more than the other two days. It hurts when I jar or turn my head. Do I need to see a doctor or just let it along? I’m 71.

I have iced the back of my head, no headache yet. I got up and I remembered what happened and walked into the house.

i fell on a concert walkway and hit my head at the back. At first there was a bit of swelling, I found it hard to move my head as it hurt my neck

Did you go to the hospital?

I was shoveling dirt out of the bed of a truck (planting bulbs so had truck load of dirt) somehow I slipped backwards and fell out it the truck hitting the back of my head. I was sore and banged up, drove my son to his allergy dr but felt like I was in a daze. Went on through the night, slept ok but now every time I stand I get dizzy and all feels foggy or hazy around me. I am 46yrs old and have RA. I dont want to go to the hospital with Coronavirus but I’m not sure what to do.

Please call your doctor or nurses and explain what happened. I understand the fear of wanting to go in right now but they will be able to advise you over phone what is the best plan now

You should report that to the hospital which may now be offering free telemedicine services and can try to examine you that way. They will let you know if you should come in although it already sounds like you should. The info above would support that.

I was being dumb and was in the shower holding my breath until I suddenly passed out and fell off of my walk in shower and hit my head really hard on my wood floor, after a few minutes I woke up in a complete headache and I decided not to go to the hospital but now I’m having second thoughts..

So Iam a 24 y/0. I was rollerblading and rolled a crack and landed on my butt elbow and quickly bounced the back of my head on the asphalt. It did hurt but I did not go unconscious. I hopped up fast didn't want to freak everyone out and have had a horrible headache since then and it's been hours since it happened and the back of my ear/temple hurts and also my neck by shoulder blades and head hurt. Should I take a bc and go to bed or go to er. It's been 6 hours

Call your doctor or nurses if you havent already they can advise best course of action over the phone.

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