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 (878)

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 fell from ice 1 maybe 1,5 meter down onto a big wooden 90 degree angle block. On my lower back a bit to the left on on my spine. Hurts a lot but i can move. Worried i may have internal bleeding but im not feeling nauseous or have blood anywhere

i passed out yesterday and hit my forehead on a wall. there is no bump but it feels slightly raised and very sore to touch. i didn't get the chance to put an ice pack on it yet. is it something to be worried about...

I fell 12 days ago and hit my head, hard. I received a huge bump (still have a small bump) on the back of my head, my neck was/is still hurting/ sore. And I am having headaches, everyday. Because it has been 12 days should I still go to the Doctors or emergency to have it checked out?

Sometimes my head hurts in spots and I have weird things happen all of a sudden like the burnt smell and I remember someone saying that’s something to do with medical so I thought I should look it up, I also wonder if my forgetfulness is going to ever stop, and it will return back to normal, and I link the numbness of my right leg to my sciatica nerve that’s been damaged and I have severe tension upside my skull that radiates to frontal lobe on left side of my brain where it feels as a knot is there but I have no knot it’s just very sensitive.

I feel over a banister and landed on my back and hit the back of my hard like it felt like it was split and sounded like a bomb.. I was afair5to touch my head but did and no blood..head hurts and I feel a little out of it..head in a cloud after 2 days kinda cant describ the feeling..should I go in to get extra..plus ribs hurt..

I heard some shocking news from my husband when were in mall in a queue, and i started feeling weird like i want to sit down or lie down..but there was no chairs around so i went to a place whee no one was around leaned back to it but i dont know when i passed out. next thing i know is my husband is next to me asking are you ok?I woke up n walked to a table and sat down when my neck hurted badly..i got some water and ice packs!we dint go to ER ,we went home. next day i went to urgent care.Doc said if you have severe headache, confusion,light headedness go to ER so i am still wondering if catscan would hep. Iam worried now. my right side of head is bit painful and swollen , my neck hurts.i have been icing but i am worried

Good information to know I feel better now that I know more about my injury

Ok, so my boyfriend is constantly hitting himself in his head and face with hard heavy items as well as closed fists. Been doing it for a long time like years. He gets swelling and bruising time to time, even popped blood vessels in his own eye. Now he's got some severe swelling just above his right temple and says it feels like he's getting an ear infection and uncomfortable pulsing if leaning over along with migraine that favors the side that's swollen all the way down into his jaw by his ear. Should I be more concerned about this swelling than previous swelling he's caused himself before that would just go away over time? Or is this swelling more severe considering the location?

I'd be concerned that he's hitting himself in the face in the first place. He must have done kind of brain damage or pressure or even growth on his brain causing this behavior.

i hit my head on a wall i had a headache going away theres a bump its red and a scratch not gonna lie reading this scared me

I think you should get out of that unhealthy and toxic relationship. He hits himself with closed fists? Wtf? He needs he’ll and if you stay, you do too.

i hit my head in metal and I feel dizzy should i go to the docter

I hit my head last Sunday. The area hit tingles. Sometimes I feel it on another area of my head. Is this a blood leak

I didn't pass out.

I had a heavy metal bed frame fall on my head today. My head has a gooseegg. Very tender. Should I go to hospital?

10/15/21
I passed out and hit the back of my head. Went to ER. Cat scan was clear. But BP lower number dropped to 40.
I went home
Now a week later the spot still throbs and I have a slight headache at times. What do I do now?

I fell on concrete and head,back,kneck hurting

I hit my head when i feel upset but now there's a bump on my head for 2 weeks and its pink, i get headaches often since then

I was rearranging my garage I had a suspended bicycle girls Junior bicycle hanging upside down in the rafters on hooks it was about a foot and a half drop it drop it fell onto my head the top of my head my top my head has a small laceration about the size of a K looks like a K it’s continuously bleeding snap that much I would say maybe about a very small paint sample size like a model paint bottle size in about an hour maybe if that means it’s it’s slow down but it just won’t stop bleeding it’s been about 4 1/2 hours now I am just curious what should I do

Depending on the location you could have possibly damaged an artery in your scalp if so you will need medical attention

I was using a electric drill screw driver to put a peace of wood in my cabinet to put a shelf on and I slipped and the wood flew off the drill and hit me on my right side on my forehead above my eye I take blood thinners and I brush very easy but it did not brush it is very sore should be worried

My ex and I had got into it and he hit me in my face with his pistol and I have had a headache ever since and that was 13 days ago . I dont have insurance and I'm scared something is wrong

I was in a little store, 42 hours ago. I didn’t realize there was a step to get out of the store. I tripped and hit my head on an antique hard wood door. I remember the sound it made but don’t remember anything thing that happened after I heard the sound of my head hitting. Next thing I know I’m up and people are dusting me off. I was very confused as I was picking up the things I had bought. My husband who was outside and 2 small shops from where I fell heard the sound of my head hitting the antique hard wood door I have a bad headache, no bumps but my whole right side of my body hurts. Especially my shoulder where the ball socket is and my elbow. I broke my elbow 5 months ago and it feels like I may of fractured it again. Should I seek medical attention?

Do you think something is damaged from inside if being hit hard on head and then pulled hair so hard a few times and your head is hurting alot like it's bleeding

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

Def. because unless you are up to date on ur tetanus shots then I wouldn’t worry as much but most people don’t

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.

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