When to Go to the Hospital

Question: 

People like Natasha Richardson and others 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!

Posted on BrainLine April 8, 2009

Jeffrey Bazarian

Dr. Bazarian is an emergency physician with a strong research interest in traumatic brain injury. He is associate professor of Emergency Medicine, Neurology, and Neurosurgery at the Center for Neural Development and Disease, University of Rochester Medical Center.

Comments

Hi! So I'm 11 and just today I hit the top of my head on the playground. I experienced severe headaches throughout the day, also I heard that sleepiness is a symptom as well. I've also had a little bit of nausea and dizziness. Should I go to the doctor?

Probably because the way you describe it it sounds like the pressure is the blood pushing up against your brain.

If you still have a headache or any nausea, then you probably have a concussion. Not an old one, a new one. I just fell on ice last night as well and hit my head. I have a mild concussion currently. And I've had 7 or 8 previous concussions.

I recommend going to see your primary care and just tell them you fell, hit your head. And ask, do you think I have a concussion? Yes, there is a test to determine if you have one or not. Not every concussion is the same.

Good Luck!

I got hit on the top of my head with a pry bar traveling very fast and attached to heavy equipment. Thankfully I was wearing a hard hat and it took the brunt. I have been nauseous but not vomiting, dizzy, hard time thinking normally, blurred vision, headaches and I find it hard to open both my eyes. I saw a dr. who sent me home with a prescription for alive. My pain in neck and shoulders is increasing and pressure on my head also hurts. The dr. did not give me a cat scan because he said he did not think I was bleeding and there was a radiation risk with the scan. Should I go back???

I fell last night on ice. It happened so fast I couldn't brace myself. I fell back and hit the back of my head. I had alot of aches and pains and a headache and nausia. I felt a little like I was watching tv. Sort of disconnected. I didn't loose consciousness but my vision got dim/dark for a minute. I woke up at 3 am this morning and had no balance at all. Went back to sllep til 6am and I'm not so off balance but something is different for sure. Other then the pain in my back and neck.
I have been in a auto accident where someone hit me head on almost 10 yrs ago and I did loose consciousness briefly then. I was dx with a mild TBI then. Could this just be my old symptoms being aggrrivated?

Go to your local welfare office, you may be eligible for health care insurance. You will need a parent since your under 18 . Bring all your ID, birth certificate, SS card, bill with address from your residence. Hopefully you are eligible and can start treatment. Family doc first . Good luck hope it works out for you.

I fell last June, hit my head on the concrete, temporally lost consciousness but the Mayo Hospital said I was fine. Now I can't even remember how to cook a meal or to get to the grocery store. Something had to be overlooked. Written by a friend, Alvin

I hit the back of my head back in the year of 2016 on an small steal bridge in a park , i went under it walk to the other end thought i had a clearence and could stand back up and when I did I wacked it really hard. they did a cat scan they said oh it's just a mild concussion .Now back in the year of 2017 i was having pseudo seizures the later that year they said oh it's just anxieties. Then around October 2017 they were saying I'm having panic attacks. Now January 2018 I'm getting weak at times i feel faint i feel like im forcing myself to breath , I can't seem to remember anything anymore. I can't even remember things that happened 2 hours before, I get confused a lot. My mind goes blank. My vision has gotten worse it scares me. But im afraid of the hospital because the ER gave me the wrong medicine in my I V . However I am going to a Neurologist and talk to him about everything that has been going on. Get a cat scan and MRI done. Because I want to get to the bottom of this and find out what's wrong. Then if i need brain surgery I want it done at the Cleveland Clinic I have heard nothing but excellent news about that place!

Ok, I'm 15 and yesterday I hit the side of my head on the car door and have had headaches since. Today, I was laying down and I told my mom to hand me my phone and she ended up dropping it on the side of my head I hit yesterday. My mom tells me I'm worrying too much and we don't have insurance. Advice?

I was snowboarding and going about 30 to 35 mph. Hit a real wet patch of snow under a lift tower that made my board stop dead in it tracks. It pitched me right on to my head. I hit a patch af man made snow that was rock hard. I woke up sliding on my back pretty fast. I was able to self arrest before I hit a tree head first. I had a helmet on which I think saved my life. It’s been 3 days and I have a head ache and everything is kind of fuzzy. I was lucky enough to bump into a Dr at the midway lodge 3 minutes after it happened. He said I was ok, but to go right home. Should I get a CT scan or do I need to just rest for a few more days

Hi last night I was swinging on an underground car park sign and it snapped out of the roof and I landed on the back of my head from a reasonable hight I was paralyzed for around 60 to 90 seconds and could hear people but couldn't talk or move I went to the hospital MRI scan said that I was fine although I'm suffering from pins and needles all over from my shoulders to my head and was wondering if this is at all normal and if it will stop... Thanks for your help!!!

Definitely go to doctor again and demand a second opinion.

Not an expert but think you should go back to the hospital to check.

a few day ago, I managed to hit my head on the wooden corner of the night stand when I rolled over in bed and bashed the outer corner of my eyebrow pretty hard...l didn't get a concussion or a black eyed, but had only a minor bump that was barely noticeable that I put a cold pack on.... however, my neck and back feels stiff, my left eye seemed a little blood shot, and I've been spacey minded... however, I just came back from a week
long vacation of sleeping on a somewhat uncomfortable bed, and it's normal for me to get jet lag and be exhausted from traveling. However, I wasn't sure whether the vacation, head bashing, or combination of both factors to be able to distinguish which factor had more of an effect on me to explain the reason behind stiff muscles and fog. I'm still glazed, stiff, and just worried if the head bash might be serious since I thought I had felt something that got in my eye at one point. I haven't barfed or anything but I did burp and got a slight taste of the meal in my throat. and I'm not sure my mind is playing tricks on me for slight small changes I noticed in my vision at times as well during breif moments for my hearing...and not sure but it seemed as if I felt as if my head was somewhat tender...and tasks are taking longer since I kinda daze out so...gonna end it here. thanks

I fell Saturday and it was snowy i went down to feed my hog and went down a small hill and it happend so quick that i hit the back of my head hard on the ground i woke up next day an my body was sore and and today my neck is tender i didnt go to doctor but i was wondering how long it would take to heal

Almost 17 or 18 days ago I hit the forehead on the wall and at the same time when I bend some yellow fluid came out of my nose in a small quantity.. after that day I went to the hospital and my doc ask me to collect that fluid if it comes again and meet him and gave me antibiotics.. but that didn't happen again. After 5days I met him and he said that I am fine.. there is no need of CT scan.. and now I am not feeling well. Some sort of little heaviness in my head and I can't even sleep because I have anxiety issues.. should I go to doctor again or am I fine?

So I was in a bad car accident 10 years ago and suffered a tbi. The other day I was punched in the back and side of the head over 50 times. I haven't thrown up but just wondering what to do. It was the lower back of the head if that helps at all. Thank you for ur help

I hit the base of the back of my head hard on the left side. Got a headache and felt the br uising hours later not at the time. Now 3am and up with a worse headache. Started in forehead and now sort of everywhere and a bit off balance. Should i see a doctor or wait and see

I hit back of my head to the wall last night and my ears are ringing from them, it haven't stopped since. Should I see a neuro-specialist or a hearing specialist?

My husband hit his head at work.. for two days he talked about that same tingle feeling and said he just didn't feel right. 11 days ago I came home from work to find him on our floor having a seizure and unresponsive... He never felt a bad headache only that tingle and couldn't concentrate. He just kept saying he didn't feel right... from the seizure that they believe came from a blow to his head caused more damage and after returning to the ER learned he had 2 spots of bleeding that the nuerosugen believes was an initial bleed and caused a seizure and banged his head causing a more recent bleed... they kept him in a coma for 5 days... and continued to drain the blood for another 8 days. His kidney had shut down and he was in arrest when I found him. Don't wait! Never wait! It's better to be safe then sorry!! Always when in doubt... GO....
My advice... if you EVER hit your head harder then a knock.... GO
My husband Never showed any outside trauma... No bump or bruise... But if we had just gone it could have been a simple treat... but due to a slow bleed turned into almost death... with Tramatic Brain injury it's not over after being released from the hospital... it's been a week now and he still doesn't act himself, he gets angry very easy almost abusive, He was washing my car with toothpaste while i was in the store two days ago, he has hallucinations... because I found him so we don't know the extent of damage from how long he was in the seizure.... the only safety is in prevention and early detection... GO!!!

If you haven't already, I strongly recommend you visit an ER, or urgent care.

This morning I was rear-ended on the freeway, and when I got hit my head went forward then smacked into my head rest. Initially it hurt then it stopped, but now the back of my head hurts and I’ve had a headache since 4pm. I took tylenol but it didn’t help. Should I go to the ER tonight just to check if anything is wrong?

About a couple weeks ago, I got up, then felt a little dizzy but not to the extent of passing out when all of a sudden I blacked out, fell down against a wall that now has a big dent in it, soon after that had a siezure/convulsions my friend said, he almost called 911 because the way I was laying looked as though I had broken my neck but after a few minutes I came too, was super confused, my head felt fine, only the next day did I experience a pretty bad headache, ever since then I have had neck pains that shoot to my shoulders but not sure if it’s related. Should I still after all this time go get it checked out just in case? I’m guessing if there is question I probably should?

Hi. I had a severe car accident and a severe concussion a month ago. I'm still dizzy and when I stand for more than 5 minutes I get like a haze and feel ready to pass out. It's been like this only since the accident. I went to the hospital last week and they said since my CT scan a month ago showed no bleeding that what I'm feeling is normal. Now I had a previous accident and in 2009 John Hopkins found that I have 2 pinched occipital nerves.

Is what I'm feeling, in fact, normal? Or should I go back to the hospital?

I was a passenger in a car wreck -- broken clavicle, broken ribs and a couple other things. The doctor released me knowing there could be other complications. I've never had a concussion but it has been really hard to concentrate and I've been getting really dizzy (to the point I lose balance and the room spins super fast). I was thinking it was from the pain of my body, along with my two broken ribs but it's been 4 days since the wreck and it's still happening. There is no clear head injury but I did break an airbag with my face and then fall 30-40 feet, maybe more in the car. I had to of hit my head on the back of the seat too. I've been really confused since. It's not the easiest to move.

I have got a doctor's appointment in 6 hrs. Should I just go? I think this article just made my decision.

Thrown backward into telephone post hitting the back of my head. Just barely dazed but back of head was hurting badly and I was sure there was blood. None there and got up to finish with horse. I had a huge lump and it felt hard at first then squishy. Obviously painful for a while but lump went squishy that night and only had a little mark and bruise on small hard lump. All seemed fine except weird pain when pressure is applied there. Year and a half later the back of my head still feels like it will crack open if pushed on or laying back of head on pillow. Pain goes away when pressure is removed. I am one of the lucky souls that has suffered depression and anxiety for years so that means doctors think you are imagining things or just plain crazy. Anyhow I was just wondering if any of you might know what's up with my head lol.

YES!!! I am also going right now, I hit my head a week ago and I have been having worsening migraine headaches since then.

Against what I know to be safe. My daughter on her bike and me on skates no helmet It started to rain and stopped quickly. My wheel hit something on the sidewalk that launched me off my feet straight down into the cement where I heard my head smack the sidewalk like the sound of a bowling ball. From there I slid on my face and stopped. I told my 6 year old I needed help. My husband wasn't far, he rushed over. We called 911 EMT's showed up but I didnt go to the hospital. I now regret that decision. I immediatly had a large lump on the right side of my forehead. I felt pressure behind my right eye for days. I have had memory loss, difficulty driving, vision loss, not to mention I just feel different and no one seems to believe me or understand how serious this could be. Results of a recent CAT scan were normal. I don't know what to do at this point?

I hit the side of my head beside my eye on cement drive way still hurts to touch should I be looked at

I just fell down 2 steps on my camper st the beach...I landed flat on my back but took the blunt of the fall on the back of my head. I didn't loose consciousness etc, not sick on my stomach , no know and only a very mild pain coming and going in the back of my left eye. Although I hit the hard ground we do have an outside rug there ...I don't know what to do, concerned now about a blood clot?

Omg yes please call a friend family member or ambulance to get you to the er

I hope you are doing ok and went to get looked at by a doctor!! That sounds like some frightening symptoms :(

Yes

Hi. My daughter is 6. Today she just hit her head so hard that she was vomiting. It has been an hour and she is playing like normal again. Should I be worried and take her in?

I'm 34. I fell about an hour ago and hit my face on the floor. I'm alone at home and had a hard time getting up. My body feels tingly like I passed out. I feel weak and can't seem to coordinate my left hand to do simple things like text, type, scratch my right arm... I don't think I lost consciousness. Is this serious enough to go to the hospital?

At the age of nineteen, I had a fall and hit my head on my carpeted floor, my husband said that my eyes rolled back and they rushed me to the hospital. I don't remember getting off the floor, getting help into the car, Nothing! My husband said my eyes were glazed looking and I was talking out of my head. He said they gave me a sedative to sleep. I stayed in the hospital for a week. Was this a mild concussion?

You need to get an EEG and a CT scan especially since this is the second time you have had these scary episodes. then at least doctor will at least have a baseline of your normal brain function and makeup to compare with if and when this happens again. at best doctor will be able to diagnose your problem.

I'm not a doctor, unless u count watching my obsession for Grey's anatomy enough XD. Talk to your mom/ dad/ guardian about this, I would talk to your doctor if you can though. It could be pretty bad if you have a concussion!

ok so I'm in middle school and play basketball and I was running backwards and hit heads with another girl and had a head ace after wards that whole day I just kinda felt confused or like in a daze kinda.and I have this feeling like I need to throw up bit I dont.then today we had a school assembly and we were in these bubble balls and I flew and my head bounced really hard. and now I have another head ace and still feel like I need to throw up. my sister said I might have a mild concussion but I'm not sure?

I hate to hear you're going through this. I know this may sound strange, but I feel it could save your life so I thought I'd go for it. Please ask the dr to check your thyroid levels. Many people develop thyroid/autoimmune disorders after trauma (I developed graves disease after a miscarriage and other environmental stressors at the time). Please just give it a shot. A lot of what you described sounds like what I was feeling like. The only reason I realized what was wrong was because I developed a goiter. Not everybody gets goiter. Once again I am so very sorry you're so sick. Even if it's not the case I know how it feels to be imprisoned in a sickly body. Bless you.

This is hard for me...
Is it too late?
My sister hit her head when she was 2 or 3 years old, she fell down multiple (10-15) times from the bed, yes I know this is insane, one day she started bleeding. Now, My mother, she didn't want to go to the doctor I insisted that she should, but didn't.

Now she's 7 years old, in the 2nd grade and has problems in her school (learning, socializing, etc.), I don't know if it's because of what happened.

Now we live in a country where English is like the third( second for some people) Language, and our main Language is H.
And the language isn't hard but she has problems learning.
What to do?

I feel the same.
When I was little, I hit my head twice on some metal in the playground, I forgot how it exactly happened I was in the 8 grade or something, all my skills in math and etc. fluctuated. like I was "good" in algebra, after that day, nothing was the same.

I never went to the doctor, although I told my parent (mother) she said it was nothing important. Now I can barely remember things, and I couldn't (could but didn't due to fear of being mocked at) communicate (Somehow I started stuttering).

I can't concentrate in school, some words that I know, I forget them, basic math skills (8*5, 4*7, 9*3, etc.) are sort of "hard" for me without calculating for 4 or so minutes.
I'm losing myself, I need help, what should I do?

I don’t know what PCS is. I do know what PTSD is, though, and you’ve got a hella case of PTSD going, Anna. In my opinion, at least. The place you describe is very familiar to me, and I’d not wish it on anyone. I’m sorry you’re having to experience it too, Anna. I want you to know though that it’s not a permanent forever thing - it feels like it but it’s not. The old you will return, I promise. For me it was after several years. I literally woke up one morning and something felt different, it’s like I knew I’d turned the corner or something. I can’t explain it but it felt good and it’s just got better from there. The best tip i can give you, Anna, is to stop fighting it. Stop mourning the person on you used to be....stop thinking and analysing and trying to fix it... The panic which summers away under all of those things only serves to re-catastrophise your days, which in turn pulls the scabs of the initial emotional scars which began with the ‘really big scary thing’ which tore a hole in the one thing which we need to be unthinkingly, contentedly ourselves: ambiant self-control - be it in thought, action, emotion, whatever.
So just tell yourself you’re ok with whatever comes, that this you isn’t as bad as some other people you’ve met over the years, and that you’re going to give in to whatever this new you demands - short temperedness, unsociability, insomnia....whatever. Just make peace with it. Because the sooner you do the sooner you’ll find the new you suddenly gone and the old you gloriously returned. Try it out, even though it seems counterintuitive. Really, what have you got to lose?
Best wishes,
B

Anna,was it? Hello my twin! ! Though you may feel like an alien on another planet, for not being able to relate to even one of the endless human beings around you... This is temporary. This is also amazing to see, because though I feel for your situation, I realize how NOT alone I am,now. .. because of your own misfortune. ..
it's been 17 years since my accident and I hope you get this because I need to help you, as much as a stranger or Any other can
Please feel free to text or call me, anytime!! Help can be very helpful, if help Is what your looking for. . Helping others, helps the healer as well ;) 603)722-9873

Yo, wondering if this reply is a bit late, but I would say you should get it checked out somewhere. If you can, try to find a doctor(although I suggest you find insurance first, even if it's cheap)so that they can more thoroughly examine your condition. Head injuries aren't necessarily to be taken lightly so if you feel like your injury hasn't recovered, get to a doctor as soon as possible and get treatment.

A couple of years ago I had fainted and I woke up on the floor not knowing what happened. As soon as I got up, all I knew was that I was clutching my head in pain for a couple of minutes before the severity of the pain subsided. I had another blackout and hit my head on the wall around a year or two ago but both times when i hit my head I never went to get it checked out.

I noticed that ever since then, I've become more forgetful and up until now, I'm still having a lot of head pain.

I was wondering is it too late to ask for some kind of head scan as it has been years now since that happened? I just want to know what's causing these problems.

Anita, Did you get the CT scan? Similar situation happened to me. Deciding if I should go.

I was hit in the head with a soft ball several months ago, it did not render me unconscious but it did leave a nasty cut on my head that bleed A LOT. Now months later every time I lay on my back or on my left side I get very dizzy like I'm going to pass out. How long is this going to last?

How would you describe "old me" and the "something else" that took over your body?

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