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 (849)

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.

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

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.

I fell tues evening while attempting to catch one of my dogs who had gotten out of my fenced yard. I had him by his collar with one hand and the mail and a flashlight in the other. He was apprehensive and pulling and the closer we got to the car the harder he pulled and somehow my feet got tangled with his and i lost my balance abd fell. My face hit the wheel and by the time i got back inside the house i had a knot on my forehead and my head was hurting. I put ice on it which took the swelling down some. The next day (Wed.) there was still a little swelling and some soreness and a headache. By Thursday the rest of my body ( Neck, Back and Shoulder were feeling the aftereffects. As of today ( Friday) my forehead and the top of my head are stiil very sore to the touch

I fell today I didn't hit my head but did jar it pretty good. I hit hard and solid. I don't think I passed out but everything is foggy. My neck is stiff. My ears are ringing. I feel like my sinuses feel swollen and have been running clear ever since. I've been kinda dazed and nauseous since it happened and my head and neck and ears hurt

I fell today landed hard And solid on my back. Didn't hit my head but did jar it pretty bad. I've been dazed and confused today. My nose started running afterwards and now I fill like my sinuses are swollen. My neck is stiff and I feel very nauseous. Hurts to move my eyes and my ears are ringing

I had an electric scooter accident may 27th it is now June 2nd, I have had a severe head ache since & have bouts of confusion & some balance issues. Right after the accident I had trouble putting sentences together or mispronounced words. Should I go get checked.. I hit my face so hard on the sidewalk my entire face was numb & now my neck is stiff buts been a week, so I don't know what to do..

Approximately 72 hours ago or under, I feel over and banged my head on the bath tub. I had been intoxicated with a friend. The floor was slippy and to avoid stepping on her dog I slipped and fell. I was quite sick the next day but unsure if this was a hangover...I also forgot I had fell until a day later when I realised my head hurt and had a small lump. I've been to work in-between but also taken 2 days off to rest, I don't know if I should still visit the hospital? I still don't feel right, but I am slowly feeling much better?

I'm 70years old for some reason I don't sleep well and have fallen off the side of the bed / our bed sits about 3 feet off the floor, I have fell asleep in a matter of seconds ,I have fallen asleep ldont understand
Why. I have also fallen asleep on the tolet needlessly it has become a problem I have hit my head on the floor each time this time a knot has come up .
It's scaring me should I go to the hospital ???

48 hours ago I passed out and fell backwards hitting the back of my head on asphalt. Thriving neck pain and headache since. If I’m okay otherwise do I go to the ER?

I just bump my temp of my head on a sun viser of the car it is just sore

Was leaning off my bed to reach my charger and I misjudged the distance and fell off the bed, knocked the left, side of my head, towards the back where my neck joins my skull. It's been 2 days and I'm experiencing nausea and now a pain at the top right side of my head. It gets worse when I lie down. I can't even find a comfortable way to lie down because of this pain. Is this normal?

GO TO THE HOSPITAL. No ma’am that is not normal, especially if you hit your head.

last night i hit my temple on a door and i didn’t get dizzy or nauseous and remained conscious but i woke up this morning and it’s sore with a headache. i get headaches every day so i’m not sure if it’s a normal headache or from hitting my head. i have no bump or swelling . it’s just painful when i blink or clench my jaw. should i be worried about it !

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?

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