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 (794)

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.

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?

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

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

That's whiplash

Fell of a hover board and fell backward hit my head felt fine apply ice should I be worried

Hit my head with a paddleball racquet above my left eye felt fine got a lump which I put ice on. Two days later i m walking sideways like vertigo symptoms or inner ear infection but no pain. Should I be worried?

I fell and hit quite close to my temple , there is a bump there and it does hurt , I do have a head ache , and it hurts to open my mouth .

I slipped in the bath and head butted the wall I didn't feel dizzy or loose consciousness but I do have a headache my forehead is red and bruise as is my nose and I may have a black eye forming. This happened an hour ago

I fell in the tub and I had a big bump on the top front of my head! I feel fine however I feel like a pressing on the spot! Should I be concerned?

I feel like i keep reliving parts of my past like a bad dream what could it be

I slipped and hit my head on a table. I have a hole on my right side of my head by my ear/ hair line. It’s not to small but not to big. It’s not that deep. All the right side of my head and face is hurting now and my ear hurts badly. What do I do

I hit my left side of forehead eye really hard on the edge of door frame I was crying in pain for 10mins then I started getting confused and dazed blurred vision, pain in the left side of head behind eye and pressure or strianing feeling to its been 1half since I did it and I still have a lump and a 20cm long by 5cm wide dent running down my left front lobes to behind my eyebrow did I crack my skull

While snowboarding I fell at mid speed, landed on my bum and the back of my head whipped into the hardened snow. I fell slightly dizzy for only a short moment and resumed without issue. The next day I come to realize that I cannot lift my head off of my pillow. I don't believe it's a brain injury, but I am very concerned about the neck strain and don't want to visit a hospital if I can avoid it.

Messing around and I landed/hit the back of my head doing a backflip off a couch- my spine hurt and the headaches haven’t stopped nor the neck and back pain...

Mh dad jammed his glasses on my temple when we were dightijt, should i go to hospital

Drinking and i fell on my head twice, on the ice road. I didn't get my head checked for injuries.

I hit the top of my head and jammed my neck now I have severe pain vision problems and my neck cracks when I move it a certain way then when it cracks that pain literally makes me sick to my stomach

I was looking in the car boot with my husband. He didn't realize I was there and pulled the lid down. It hit me hard on the top of my head. Should I b concerned?

Maybe if you are unsure then go to the doctor

I felt very groggy and confused yesterday while driving and moving around, later that day while washing my hair I found a really sore spot. A few hours later I brought it up to my boyfriend and he said I had fell back and hit my head on the bathroom cabinet either the night before or two nights before (I am not sure). I thought he was joking because I have no recollection of this but just went with it anyways, I’m a little concerned now though because I am still experiencing grogginess and dizziness today, I don’t want to overreact though if this will heal itself. What is your input?

I just hit the side of my head (temple and jaw) VERY hard on a flag pole. I lost my balance afterwards and was dazed by I don't *think* I lost consciousness. The pain is so severe it hurts to cry. I have epilepsy and a blood clotting disorder, so I am on blood thinners. I don't see or feel any bump on my head though. It's this ER? I'm 38.

I work in the medical field. Today while trying to restrain a mentally challenged patient I was kicked in the temple twice. I have a headache but really that's all. Should I be worried?

So I was hit in the left temple I think 3 days ago..as soon as the situation ended I noticed my temple was swollen and had a lump on it..and I wasn't able to open my mouth more than half way... well it's 3 days later and not much has changed..it's still hurts to touch.its swollen feels lumpy n mouth hurts to open n now chew...do I need to get it checked out at the er

Same situation here

I Have B's severebheacd and become disoriented

I just fell very hard backwards, from a distance, I hit the back of my head on the edge of table hard. I can't get to U.C. until tomorrow. I'm icing top of head and neck after falling sideways. Should I get CAT, or wait to see if feel better tomorrow?

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