Brain Injury: When to Go to the Hospital

Ask the Expert: 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 February 22, 2022.

Comments (888)

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.

The other day I was jumped by four people and hit in the face with a maglite and my whole face and head was swollen now the swelling has gone down to my eye and I can hardly see out of my eye the swelling is so big I've had a headache and not much dizziness or vomiting but the swelling is really bad

I hit my head really hard on brick wall and i have a permanent big goose egg 2 years later , should i be worried? when i went into the hospital after it happened they sedated me and didnt check my head.

Today I fell backward and put a bump on my head as big as an egg !! I have no pain ! No confused nothing ! Should I go hospital ?

If someone punched me on both sides of the head and it's been 12 hrs since then will I be ok??

I somehow made a dolly whiplash and slam hardon my head, also caused a laceration of my head that thankfully didn’t needs stitches, but was pretty bloody at first.

about an hour ago my sister and i were play fighting and i tripped while running and hit my forehead really hard on hard tile. the pain was enough to make me cry and i couldnt get up by myself at first so my sister helped me inside. i have an ice pack on my head to bring down the bump but i feel dizzy. im alert and everything just a bit dazed and worried bc i had a little head injury not long ago so idk..

I fell from ice 1 maybe 1,5 meter down onto a big wooden 90 degree angle block. On my lower back a bit to the left on on my spine. Hurts a lot but i can move. Worried i may have internal bleeding but im not feeling nauseous or have blood anywhere

I fell from ice 1 maybe 1,5 meter down onto a big wooden 90 degree angle block. On my lower back a bit to the left on on my spine. Hurts a lot but i can move. Worried i may have internal bleeding but im not feeling nauseous or have blood anywhere

I’m not sure if anyone is going to read this or not or if anyone can even give me some advice. I’ve been having heart palpitations and a sense of dizziness and confusion for a few weeks now. I can’t go to the doctor beacuse my insurance doesn’t kick in until next month and my local er isn’t doing ct scans right now super packed 24/7 beacuse of covid. I’ve been freaking myself out reading all of these articles and even scared to go to sleep, but it feels like i’m always tired and after I wake up I feel better. I went to the er a few months ago for chest pains and he said there’s a very low chance of heart attack or stroke happening. Im not sure what to do im just really afraid of passing out or something bad happening to me.

I’ve heard that hospitals do have funds to cover expenses when a person doesn’t have insurance. Try a different hospital also.

i passed out yesterday and hit my forehead on a wall. there is no bump but it feels slightly raised and very sore to touch. i didn't get the chance to put an ice pack on it yet. is it something to be worried about...

I fell 12 days ago and hit my head, hard. I received a huge bump (still have a small bump) on the back of my head, my neck was/is still hurting/ sore. And I am having headaches, everyday. Because it has been 12 days should I still go to the Doctors or emergency to have it checked out?

Yes, absolutely get a medical evaluation.

Sometimes my head hurts in spots and I have weird things happen all of a sudden like the burnt smell and I remember someone saying that’s something to do with medical so I thought I should look it up, I also wonder if my forgetfulness is going to ever stop, and it will return back to normal, and I link the numbness of my right leg to my sciatica nerve that’s been damaged and I have severe tension upside my skull that radiates to frontal lobe on left side of my brain where it feels as a knot is there but I have no knot it’s just very sensitive.

I feel over a banister and landed on my back and hit the back of my hard like it felt like it was split and sounded like a bomb.. I was afair5to touch my head but did and no blood..head hurts and I feel a little out of it..head in a cloud after 2 days kinda cant describ the feeling..should I go in to get extra..plus ribs hurt..

I heard some shocking news from my husband when were in mall in a queue, and i started feeling weird like i want to sit down or lie down..but there was no chairs around so i went to a place whee no one was around leaned back to it but i dont know when i passed out. next thing i know is my husband is next to me asking are you ok?I woke up n walked to a table and sat down when my neck hurted badly..i got some water and ice packs!we dint go to ER ,we went home. next day i went to urgent care.Doc said if you have severe headache, confusion,light headedness go to ER so i am still wondering if catscan would hep. Iam worried now. my right side of head is bit painful and swollen , my neck hurts.i have been icing but i am worried

Good information to know I feel better now that I know more about my injury

Ok, so my boyfriend is constantly hitting himself in his head and face with hard heavy items as well as closed fists. Been doing it for a long time like years. He gets swelling and bruising time to time, even popped blood vessels in his own eye. Now he's got some severe swelling just above his right temple and says it feels like he's getting an ear infection and uncomfortable pulsing if leaning over along with migraine that favors the side that's swollen all the way down into his jaw by his ear. Should I be more concerned about this swelling than previous swelling he's caused himself before that would just go away over time? Or is this swelling more severe considering the location?

I'd be concerned that he's hitting himself in the face in the first place. He must have done kind of brain damage or pressure or even growth on his brain causing this behavior.

i hit my head on a wall i had a headache going away theres a bump its red and a scratch not gonna lie reading this scared me

I think you should get out of that unhealthy and toxic relationship. He hits himself with closed fists? Wtf? He needs he’ll and if you stay, you do too.

i hit my head in metal and I feel dizzy should i go to the docter

I hit my head last Sunday. The area hit tingles. Sometimes I feel it on another area of my head. Is this a blood leak

I didn't pass out.

I had a heavy metal bed frame fall on my head today. My head has a gooseegg. Very tender. Should I go to hospital?

10/15/21
I passed out and hit the back of my head. Went to ER. Cat scan was clear. But BP lower number dropped to 40.
I went home
Now a week later the spot still throbs and I have a slight headache at times. What do I do now?

I fell on concrete and head,back,kneck hurting

I hit my head when i feel upset but now there's a bump on my head for 2 weeks and its pink, i get headaches often since then

I was rearranging my garage I had a suspended bicycle girls Junior bicycle hanging upside down in the rafters on hooks it was about a foot and a half drop it drop it fell onto my head the top of my head my top my head has a small laceration about the size of a K looks like a K it’s continuously bleeding snap that much I would say maybe about a very small paint sample size like a model paint bottle size in about an hour maybe if that means it’s it’s slow down but it just won’t stop bleeding it’s been about 4 1/2 hours now I am just curious what should I do

Depending on the location you could have possibly damaged an artery in your scalp if so you will need medical attention

I was using a electric drill screw driver to put a peace of wood in my cabinet to put a shelf on and I slipped and the wood flew off the drill and hit me on my right side on my forehead above my eye I take blood thinners and I brush very easy but it did not brush it is very sore should be worried

My ex and I had got into it and he hit me in my face with his pistol and I have had a headache ever since and that was 13 days ago . I dont have insurance and I'm scared something is wrong

I was in a little store, 42 hours ago. I didn’t realize there was a step to get out of the store. I tripped and hit my head on an antique hard wood door. I remember the sound it made but don’t remember anything thing that happened after I heard the sound of my head hitting. Next thing I know I’m up and people are dusting me off. I was very confused as I was picking up the things I had bought. My husband who was outside and 2 small shops from where I fell heard the sound of my head hitting the antique hard wood door I have a bad headache, no bumps but my whole right side of my body hurts. Especially my shoulder where the ball socket is and my elbow. I broke my elbow 5 months ago and it feels like I may of fractured it again. Should I seek medical attention?

Do you think something is damaged from inside if being hit hard on head and then pulled hair so hard a few times and your head is hurting alot like it's bleeding

I am on Xarelto, last night I slipped on mud and hit the concrete hard, no head injury, but I am unable to bend my knee and now the left side of my abdomen where I hit is slightly swollen and feeling pain and nausea, should I be worried?

I fell backwards from a bench bruising my bottom badly and banging the back of my head on a concrete floor. My head is slightly painful to touch. 3 days later I went over on my ankle and fell to the ground again. Head tender to touch, neck tender to touch. Do I need to go to A&E.

i picked up grocery on the floor and banged my right forehead and is a bit swollen should i see doctor

I hit my head two days ago on short closet on top of my head and it still hurts, I'm high risk for covd , I'm needing to know what to do for it?

Hello, this may sound silly. Seven years ago I hit my head in the floor of a bathroom pretty badly, had to had stitches and everything. Apart from that there were no other procedures or studies made to see if I had any internal bleeding. I was a minor at the time so I didn't think much of it, but now I'm a bit concerned.
I don't think I have any symptoms, but should I still go to the doctor and get my brain checked? Or is it too late?

I am 75 years old and I was on the second step of a small latter organizing my kitchen cabinets when I lost my balance and fell to the rise side of my body. I hurt my head. I immediately started putting ice every hour gor 20 minutes. I did not loose consciousness or anything like that. No vomiting either. Should I go to the ER of the hospital? Thanks

Just looking for advise on whether I should seek further medical advise.
I was struck by a metal object just 9ver a month ago, there is a small literally smaller than a pea that is still very painful. Could it be an issue

Def. because unless you are up to date on ur tetanus shots then I wouldn’t worry as much but most people don’t

I feel off my bed and hit my face

So me and my friend where playing around and I tried to skip a rock and I hit her head, and she has a. Little egg on her not lots of bleeding but I can’t seem to find the place where the blood is coming from?? Help please

I fell backwards 10 days ago from trying to climb a 2 meter fence and landed on concrete hitting the back of my head. I went to after hours within 2 hours, but am still suffering from terrible long lasting headaches with occasional dizziness and sometimes blurred vision. Today my headache wont leave. Please help

Please get to a doctor

I fell really hard when rollerblading but I didn't hit my but instantly my right side of my head hurts it's been one day and so far it hurts to laugh and turn my head side to side quickly

I slipped on a toy today and slammed the back of my head on a concrete wall. I have a small bump , my bead feels heavy my neck hurts and I have a head ache. Should I be seen at the hospital?

I hit my head around the temple area on a door. It’s sore right now, what should I do

Did it get better? I’ve done the exact same thing got the worst headache today from it!

I fell of a rope swing and slammed my head on a table (to get up on the swing) And scraped my arm on the wood and I was 3 1/2 feet in the air.

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