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 March 28, 2019.

Comments (819)

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.

Hello Doctor,

I suddenly have a small round (diameter is fine sized) bump right in front of my right temple. It is raised about a quarter inch. I have not hit my head, been better or otherwise injured. My Doctor never sees me it is always his P. A. The hospital here is useless. What can should I do?

Can I asked u question bout my seizures in 2014 cause my head injured that time my mother hitting in head couple times with her vest then I had bump on head was sore off I didn't go to hospital that time bump when way then I had seizures coming never stop

hit the head to the floor by side , what could be done?? It was about 6 hours ago and I put an ice bag on that and slept , there is nothing bad till now but I think to use the ice bag again may postpone the signals awearness ,what do you think?? The possible time to reach to emergency is 2-3 hours more .

Today I hit my head not very hard against my table and felt dizzy for two seconds but now I feel fine should I be worried??

My daughter blow a wood bat on top of my head accidently,now it is headache and tightenees in my head what should I do?

Please I just slipped and fell on a tiled cereamic floor,with the back of my head hitting mini slab on the floor, for some seconds my whole body was numb,my kids tried helping me up but I couldn't move,till I was able to move. But all through I was concious. What do I do? Do I need a CT scan? Am so afraid. Please help

Go to the doctor

I would go to the hospital or urgent care or at least call your doctor to see if they want you to get scanned.

I fell backwards yesterday and hit the back of my head badly straight away I got a splitting headache I ears started hurting and today I have a splitting headache and my neck is sore headache is really sore when I cough
Should I go to hospital?

Very informative article. Thank you!

Thank you so much! God bless

Thank you so much. My head feels swollen and my pcp said he thought I had a concussion. It will take time to heal. Maybe a bruised brain. I am having blurred vision and a really bad headache today. This happened about 2 months ago, I felll and hit it very hard on the bathtub. I know it will take awhile to heal.
I don't really want to go if there's nothing they can do .with Covid19 and all. I am so sorry I know you are working major hours and I really appreciate this God Bless You !❤️

Lat night, I vaguely remember slipping on a plastic bag, and the side of my head hurt so badly, and I only could keep conscious for less than a minute
My roommate walked into my room ,when I didn't answer the door, or say anything. He shook me, and I came to. Now, I have aa large painful lump between the top of my jaw and my temple. Can something still go wrong?

My daughter who is 35, hit her forehead on at the top of here forehead, hard enough she developed 2 black eyes over two weeks ago. She was feeling okay until 7 days ago.
Now she has nausea and is dizzy for the last last week. I told her I was taking her to emergency.

That’s quite a long “explanation” for people seeking a response. I’m not certain that there are many people preemptively seeking medical advice, gauging the seriousness, of hitting one's temple. Generally, people are seeking information because an event just occurred and don’t want to over/under-react. Yes yes, of course, “call your doctor/911, ask a consulting nurse, we aren’t liable, etc.” we get it. Smh, lol. It’s kinda like Googling a recipe and getting three-page articles... We don’t need to know your family history of Thanksgiving traditions. We’re simply requesting a “to the point” answer regarding a pumpkin pie recipe. Thanks for the info though.

Kind of like your comment. If you're in such a hurry that you can't read and you're using the internet to assess what's otherwise common sense, then maybe spend less time writing a novel about how you hate reading articles that you seek out and go see a doctor.

My cat knocked an alarm clock on to the top left side where the temple and top of the skull meet from a height of 2 feet I felt dizzy for about 45 minutes after and now I feel fine I have a small bump on my head does it require medical attention

I got drunk last night and slipped down some stairs and smacked my head on the concrete step. I didn't lose consciousness or feel dizzy after the fact. I woke up this morning with a big knot where i hit. It's sore to touch but other than that i feel normal. Should i see the Dr?

Last night I was very intoxicated and I fell down the stairs in the trailer and hit my head on my temple on my head and got a cut almost enough to need stitches and was bleeding a lot I got a band aid put on it and went to bed There’s a lot of swelling on the part I hit my head and it’s very swollen and hurts when I yawn or chew anything but I feel completely fine but I’m wondering if I should go to the hospital just in case?

How are you feel now? Did you go get checked? I feel off a step down into my room and slammed my head in the same spot. No bleeding but same issue. Plus a nice shiner on my eye on the opposite side of my head. I did it 3/25. It's now 3/29. I feel okay but it still sucks to chew and such.

yesturday last night me and my sisters were messing around and she was pushing against the door so i poked my head through while pushing against her on the other side and i lost my footing and she ended up slamming it on my head (behind my right ear) my other hand was covering my left ear when she pushed it close but i have a mild headache and i can feel behind my right ear is way different than my left. it feels like there is air/liquid coming out of my ear but there isn't anything coming out. atm i feel like passing out and i have told my guardian about my ear already but it just got worse. what should i do?

I was in the shower washing my hair when I started feeling out of breath, and dizzy so I opened the shower door and next thing you know, I woke up on the bathroom floor, I don’t know how long I was passed out for. My vision was really blurry and I couldn’t see. Took me 5/10 mins to be able to see clearly. My whole right side of my body is pretty bruised up and I have a bump on my head that’s very painful. I don’t know if I should go hospital or not. I have had headaches and problems with balance and have felt very weak and sick.

I'm 3 months out from my head injury. I hit the back of my head on a concrete wall last November 27, 2020. The first few days was really tough for me. I almost have those concussion symptoms like headaches, random light dizziness, nausea, a sudden balance problem. Currently, I'm still suffering with head pressure and tightness especially whenever i touch my hair or press my scalf, it feels sensitive to touch especially at the occipital area (where I hit my head). Also my head feels tight and sensitive as it touches to my pillow whenever I lay down to bed. What should I do with this?

You may have a mild concussion. I recommend you consult with your doctor.

I too hit due to faint

I and another member was being pulled in a kayaks on the snow behind a four wheeler. Mine tipped I fell out and the other kayak came straight into the left side of my head by my temple. Tip of the kayak made full contact. Didn’t lose consciousness, just instant pain and ringing, almost felt like my head was in a vice “pressure”. Since incident to 9 hours later I still have a headache. Hurts to bite down/chew. Dizzy when I stand after lying down. Nausea. Swelling on my head. No major bruising. Should I go to the ER? Thank you

I hope you saw your doctor. I hope you are feeling better they need to do an MRI!

Fell on the ice today. Hit the upper left backside of my head. I was told I blacked out for 1 minute. I was dizzy and disoriented afterwards. But now I feel fine. Huge bump on head and it hurts to touch. Should I go to hospital in the morning? There’s a snowstorm. I’m 54 years old.

This same thing happened to me last night walking in downtown Austin slipped on black ice and hit my head in the same spot! I’m 33 I fell asleep and my elbows and head are a bit sore. But I woke up this morning! So I think that’s a good sign!

Tell my daughter Krista hello if you see her.. She performs with her band Krista Van Liew. I hope you are feeling better! My daughter sent me pics of that horrible snowstorm!. Don’t go out unless you are wearing boots designed for ice!

I was a nurse some years back. Worked in different areas and I liked it, well, loved it.
One afternoon close to the time to head out to my shift, I was walking in the back yard, with my mom and I slipped and fell hitting my left temple, with a sharp cement corner, "from the foundation of the house". I didn't lose consciousness but I felt faint like. But not unconscious. So I was in a dilemma. Do I go to work or should I go to the ER. Well, I went to work. My temple hurt and I felt a bit dizzy. So I went ready to work, but told the shift supervisor about the fall and that I wanted to be checked out. But she said " as soon as your finished here you can go" So I worked my shift. Calling my super several times telling her I did not feel good. She had me finished my shift, at 11 pm, and then she told me to go to the E. R. I was treated right away and evaluated with a CT scan. Thank God there was no bleed and the next day I was fine. But what if I had a slow bleed? Or a big one? Well, I know, that if I had had trouble, I would have Sued the hospital adm. Please don't take head injuries lightly.

Your supervisor made the wrong call. You do not need permission. Remember, you are not a prisoner. This woman should have a write up and disciplined. I’m sorry you and others have to put up with bullies. I, too, had even a judge who bullied me. I’m so happy I’m retired.

So every night I take medication to fall asleep but there are times where I apparently wake up and go to the bathroom but I wake up during some what I feel is some strange hour and I end up with my head tilted on the door jam but I don't remember hitting my head or even hurting myself. I take blood thinners so I'm just worried about it and want to make sure before I go to sleep again. I know you cannot give real medical advice but I think I would love to know and if I may be ok. Thank you!

It’s literally like no one read in bold print that this man cannot give medical advice. See the symptoms above to help you determine if you should go to the hospital, call an advice line, or go to urgent care. You have options available to you and when in doubt, seek medical care.

I had my head pounded into concrete last year and 3 months ago I had my head bashed with a hammer about 5 times i some times can’t think or feel like I can do anything n get lost in thought how do I know if I’m ok

You're lucky to be alive omg....I would get it checked out for sure.

You possibly could have brain damage. Consult your dr

Dude you are very lucky to be alive.

Hit my head on the side eye hurting and blurry

I was punched in the temple with a hard solid blow. I idmeditly got the worse headache ever. On the way to hospital....I started throwing up. They had to put a drain tube in my scalp and did brain surgery following more. I had a sevire brain bleed. Was that from then punch in temple?

Any trauma to the head could be the cause of a brain bleed. I'm glad you are alive.

I fell back works I was on the second step fell on my back hit my back and the back of my head on the front door later on I was shacking all over I have slept most of the day as I feel very unsteady on my feet I was going to ring the doctor but I felt so ill I have left it today I am75yrs

My daughter hit her head in the morning and she had to have a head wash in the evening she was alright but by night she is complaining of a headache and nausea. Is this bad and should I take her to a hospital

Call 911

I hit my head on a bench when went to stand up but I had a hat on

Fell on ice and cracked my head ambulance crew stopped blood and said I should be ok but still feeling dizzy 5 days later

Whoa! How can someone that has no equipment to evaluate you r brain, tell you " you should be fine"? Please go to a Doctor and get help. Tell them your symptoms. Line now!

I just fell and hit back of my head on concrete y jaw and nec, hurt snou, I go to hospital

I've hit my head 15 times in a year. I'm okay. Hitting my head on the wall due to not enough sleep.

I had to take care of three people all at once with no help.

I'm lucky to still be here.

i fell off my skateboard the the other day and hit my head on concrete. and i hadn’t been to the hospital but my neck i cant move it. its weak

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