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!

Posted on BrainLine April 8, 2009. Reviewed March 28, 2019.

Comments (455)

I was playing at the park with my kiddos and I was climbing up the side of the playground set and once I reached the top I stood up and as soon as I did I hit the top of my head on a horizontal metal poll that was above my head that I did not notice when climbing. It about knocked me out due to how quickly I stood up. Should I go to the ER? The top of my head feels hot and there is a lump but that's the extent of my injuries so far.

I was playing kabadi then suddenly wen i went for my rider turn tue opponent girl pushed me to the ground n i cud hear the hit on ground... After tat i am now having mild pain on the back of my head after 8 hrs n a small sprain on my neck....... Shud i go to meet the doc???

I was bent over picking up rocks and throwing them behind me up on a bank and one came back down and hit me in the head.I have a bruise on my head and it is tender to touch the side of my head .I still have a little bit of a headache.What should I do?

I had the front of my head against the ground several times yesterday and many hours later I was nauseous dizzy extremely tired could not move very much. Eventually made my way to a bed and slept off and on all night and often on all day I still can’t really walk without feeling very shaky and like I’m gonna fall over if I move too quickly Or turn my head.
My pupils are the same size they dilate fine I don’t think I’ve lost consciousness or had memory lapses I just have a bit of a headache and a lack of balance and I feel Spinny. Is it A necessity for me to get checked out?

i had just hit my head today very hard on my bed , i get very dizzy and everything is slowed down and it’s hard to stand or walk straight . should i go to the hospital ?

Dog ran and his lease caught my legs, threw me up, slammed hard on my back and then my head. Very sore but after 12 hours feeling nauseous. Should I worry?

Hi. If some one could help me. About three years ago my sister was diagnosed with Fibromyalgia She. All ways in pain. So the dr put her on pain meds. But. There. Days. She. Be. Talking whit me. One hour should be fine and the next minute She’ll be mumbling I know. She not over doing pain med. she all ways. Tired And sometimes wants to. Pass out She could be talk. To me and All of a sudden fall sleep But. She is so scard. And dr. Donor know. What going on. Whit her. She went to several doctors But I don’t think not one of them have that a CAT scan on her brain I am worried something bad is going to happen to my sister please help

I was playing knocker ball and hit someone head on full force and have knot on the top of my head I wasn’t feeling good a first but I feel good now I took some medicine but my head sore on one side where the knot is do I go the hospital?

I hit the back my head twice in Nov/Dec of 2018. Once on skates on my wood floor, I hot the back of my head hard and went straight to the fire station to be examined. Not long after, I slipped on the ice outside on a sloped driveway and landed full force on the back of my head. I went to a walk-in clinic when I hit the wood floor and they said I had a mild concussion. No CT scan or Xrays were done. I told my primary doctor as well. I did not seek medical attention the second time but it was a hard hit, scary. My head was tender for several months but I didn’t lose consciousness either time. Now I’m seeing blood when I clean my ears. Should I seek additional medical attention?

My cat vomited and my partner stepped in it and fell
On our hard wood floor and hit his head. No bleeding nor did he lose conscious. He had a bump on the back of his head but says he does not need or want to go to hospital. I have ice in the bump. Anything else I should do?

Two days ago I was jogging with my dog and made a turn too fast and landed on my back, slamming my head full speed on the asphalt.
Since then, I feel fatigued, my neck and upper back hurt and my head feels heavy, it’s a concussion. I’m leaving for a month vacation in India this Friday. My guess is if I go to the hospital the doctor will tell me to rest. I am on chemotherapy as well. Should I still go to the ER ??? I hate going there for no valid reason while people are bleeding and needing urgent care. Thanks for your advice.

I got stuck/poked with a needle last Saturday on my temple area when getting a hair sew in. Now it’s a week later and I think I have a hematoma on my left side of my head it’s sore to the touch, should I go to the hospital is my brain possibly bleeding, or am I just freaking out ?

There's no way that would cause bleeding in the brain! Your skull would protect from that kind of injury. You might have an infection (or even just a tender bruise) from the needle stick, which would explain your discomfort.

bumped my head today got a lil bump on my head no headaches or anything like that should i still go??

Hello, I was in a car accident and totalled my car and my head has been hurting a lot but I didn't think anything of it because it's normal from the whip lash although I did hit my head pretty hard on the head rest. I don't think I was unconscious after the accident but I got home and napped but I still felt some what concious and it swas hard to wake myself back up. Should I be concerned?

So this is kind of embarrassing, but Sat night I had too many drinks..I’m thinking I fell asleep on the toilet and fell forward hitting my head on the cupboard..I remember walking out of the bathroom down the hall and my head hurt, and thats when I noticed a pretty good sized bump on the top of my head..I went to bed and the next morning that area as well as my neck hurt..took some ibuprofen and was ok..last night I was in the shower and blew my nose and noticed a small blood clot..freaked me out and don’t know if it’s a coincidence because my allergies are bad right now or what..I don’t have a headache and haven’t taken ibuprofen since Sunday morning, and my neck feels a little bit better but I’m freaking out..yah it was stupid but now I’m freaking out because my anxiety is bad to begin with..I almost went to the er last night but just went to bed instead and besides the spots hurting where I hit, I don’t have a headache, haven’t vomited, and the slight dizziness I feel could be my allergies too because I’m always in a fog when they’re bad..I don’t know if I should just go and get checked or call my dr..I’m so embarrassed by it and don't really wanna explain the story to anyone, but I can’t get it off my mind and my anxiety is making me super uncomfortable..should I just go and see how things are or call my dr? Don’t really wanna explain it to her either but I don’t know what else to do..

Meg my recommendation is don't drink so much that you aren't in control of your body and mind. I don't think the blood was related to your bump but I'm not a doctor. As a mom I would think your ok just sore and need time to feel better. Be more careful next time ok take care of you.

I had a hit to the back of my head around the right side around the crown part back of the eye and to the side towards the ear. (a heavy crystal vase fell on me ) while I was moving a cabinet. I didn't think to move it at the time as I was only moving it very slightly. Anyway I was very lucky I remained conciousness and only grained a large lump and swelling where it knocked. I got this feeling of blood build up sensation (like I could feel it bleeding inside) It was sore for weeks and still remains sore at times. It was now three weeks ago and I never went to the hospital is it ever too late? I never went as my husband kept reassuring me that I was fine and the headaches and soreness and swelling is all normal I will be fine. Yet I felt that with bang that hard I should just check it but he kept insisting. So I never went, I still don't know as I don't want to one day not wake up because I didn't check it when I should have. Do you think I still should and is it too late?
thanks

my son had a car accident. bloody nose and swollen lip ...that was yesterday,'today he fell twice losing his balance and went to ER. they checked him over said no worry ,,,shouldn’t they have done more testing?

If I got into a fight and they hit my head by my temple several times should I go to the hospital? I been having headaches, pain on my temple, loss of appetite.

Yes

Definitely. Better to be safe than sorry

I hit my head hard enough to bust open above my eyebrow. That was two days ago now I'm not feeling quite myself. I'm super nauseated I have huge headaches and super sleepy. I went to a doctor but they said it'll go away in a couple days but but it just seems to be getting worse and I can't talk to my husband he just thinks it's stupid. What should I do?

56 yrs in otherwise good health female: Yesterday evening I rolled my ankle wearing wedge shoes, causing me to fall backwards in a parking lot, hitting the back of my head on the asphalt, which made a dull thud sound. A young guy helped me up. It hurt but I didn't cry or black out; no broken skin or bleeding. I felt unsteady, shaky, but after sitting in my car a few minutes, went on to the lecture I was headed to. I tracked with the presentation and did not get a significant headache which really surprised me. I took 400mg Ibuprofen just the same. No nausea developed or speech impairment, vision perhaps a bit off, but I thought it may have been the lecture hall lighting.

I iced when I went home 3 hours later, which actually made it hurt. This morning I feel a bit thick-headed, with some "tingling", maybe very slight nausea though not enough to not eat; took 600 mg ibuprofen. I'm moving a little slower- on purpose- and reluctant to make something out of nothing. I'm at work, reading and on the computer. Given these details, should I go be checked out? Thanks for your insight.

I was taking my gazebo down yesterday and a big wind came broke it. The metal rod broke hitting me in the top of the head. Bled a lot, instant headache. 36 hrs later the headache, neck ache still hurting. Should I be concerned?

I was rearranging and top part of my entertainment fell and hit top of my right side of head.. I didn’t go to the hospital.. it’s been two days.. so since yesterday I started to fell weird. Headaches, nauseated.. at time n can’t handle the sounds around me.. like I just want someone to squeeze my head.. I manage my day at work but later n the day it starts to bother me..

I was playing with my brother on the grass with a water gun and I was running towards him not that fast, maybe a faster-paced jog. I slipped because of the water and fell hard on my head in the grass. I just curled up in a ball in tried to wait for the pain to stop. Fast forward to 1 day in the future, my neck feels kinda stiff, uncomfortable, and somewhat slightly painful when I move. Is it normal? Am I just sensitive?

I fell on my side on the grass. Head did hit the grass but after a few mins. I hardly feel the pain. What are symptoms to look for

I have recently hit the back of my head against concrete, I was jumping on top of a bench but lost my balance. I fell on my back, and the back of my head bounced off the concrete hard. I had no bleeding of any sort that I can see or feel, but my left hand, neck, and right leg hurt. Is this enough for me to go to the hospital?

I had a fall from my horse showjumping and found myself outside the ring holding my horse, but cannot remember getting there. someone told the next day that I was out cold for at least 10 mins, but I was allowed to drive home with my horse alone. I now have a heavy headache at the back of my head.I am also type1 diabetic.

I hit my head on a box and went unconscious for just a few seconds and I do have memory of what happened but ever since then I haven't been able to sleep without waking up every hour feeling light headed or that's the only way I can explain it honestly I feel weird. Should I go to the hospital?

Yes. If you've lost consciousness (even momentary) you should definitely get check out by a medical professional!

I was just trying to do a hand stand, which was a really dumb idea but I crashed my head into the floor pretty hard there's a tiny bit of blood. LIKE TINY tiny in my hair. My head feels funny I feel kind of loopy and dizzy but I didn't lose cosciousness. My head hurts too. What should I do?

You should go to your local E R and from there they'll examine you and tell you what to do next.

If you've been feeling lightheaded headed, confused, have had your pupils change size or a headache ever since hitting your head, it's best to see a doctor just to be safe then sorry. As soon as possible. From asking a friend who's in medical school, blood on the surface is okay. If there's a dent it should be checked out. Hope you're good!

I have been blacking out for over two weeks now, I do not drink. My fiancé has to explain to me everyday what happened minutes before or the day before. I can’t remember 90% of the things I have said or done in the last two weeks. Should I go to the ER?

You should have gone to a neurologist awhile ago. Recommendation see if a neurologist can get you in as soon as possible. Would probably be cheaper than going to the ER too.

Can’t believe you actually asked that question! Have you been and what did they say

Yes, definitely go to the E.R. Blacking out with no cause should be looked into and in some situations, can put you in danger. They may have to give you a brain scan. I hope you are okay!

Please respond.

I was in an extreme car accident 6 Yers ago and cut my head open, had bleeding in the brain, I’ve had two bad concussions in the past year and 3 days ago I got another concussion against the bus roof.

Been to two doctors and they both confirm it’s a concussion and worry about my TBI.

I’m on meds and everyone is telling me to get rest and that if I don’t feel better an hour after meds, then I should go to the hospital.

I don’t feel better yet they tell me to sleep it off.

My head is heavy. I'm nauseous. I feel dizzy. I keep having memory loss of the past two days and I can’t sleep.

What do I do?

It sounds like you're getting medical care. For now, rest and follow the doctor's directions. If any activity makes you feel worse, stop! Don't push yourself. Watch your amount of screen-time. Do you have a follow-up appointment with your doc?

I fell from a standing position and hit my head on the tile floor. I did not lose consciousness when I hit the floor but I have no memory of what caused the fall. I was bleeding and had terrible vertigo and head and neck pain so went by ambulance. I had a CAT scan and X-ray- no bleeding. They told my sister I did not have a concussion but I disagree. The Vertigo, constant headaches, sleepiness and shakiness are not my imagination. My sister and I argued over whether or not I had one - I don’t know why. I decided if I was okay then I would take a shower. The vertigo onslaught happened in the shower. I was terrified because I couldn’t get my balance. I tried calling for help but no one heard me. I blacked out and hit my head - again on the floor/side of bathtub. When I came to I freaked out. The Vertigo was still effecting me, I hurt my foot in some way, but I was mostly afraid I’d done real damage to my head, hammering it twice in less than a week. No bleeding this time except where I had apparently bit my lip. My brother-in-law had to get me out of the tub and half-carry me to my bed. He got me ice for my head. No one can take me to the hospital unless I call someone from church. Obviously, I can think and write so I guess I’m okay but the blackouts are scary. I don’t know what to do. Sometimes my family makes me feel like I am too ‘precious’ and navel-gaze too much. They think I should just get on with things and my symptoms will eventually go away. I’m not so sure. I don’t want to be stupid. I don’t know what to do.

Go to the hospital

I was lying on my side when my partner put a pillow over the right side of my head and punched me there. I felt like my brain separated for 2 seconds then the pain hit. Two weeks later, still having headaches. Do I wait it out?

You should definitely go to the E.R. and if you are in an abusive relationship you should let the nurse know. They have recourses and can possibly help you get away from it.

Hello, my mom fell in the grocery store. She hit the whole left side of her body. 2 weeks later. She’s feeling dizzy with a constant headache, nauseous, and has eye pain or her left side. Should she go to the hospital?

I’m sister was in an MVA contusion to left side of head. Diagnosed with concussion at hospital , had clear CT. Week later swelling in right side base few inches behind ear. Pain behind right eye. Swelling went from small swollen bump to area? Is this related?

i got slammed in the head when someone opened the door really hard. It hurt a lot but no bruise right away. i had a stomache ache that day and went straight home and slept. The next day it really hurt and i had a headache. I felt a bit nautious and dizzy but i am unsure if if it was because of that or my stomache. I put ice and it felt better. today i don't have a headache or feel particulary nautious, it also doesn't hurt as much. Should i still go to the doctors?

When in doubt go to hospital. ..its better to be safe then sorry! !!!hope you went!!!and all is well, God bless you!!!

Pages