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 (836)

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 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

You're lucky to be alive omg....I would get it checked out for sure.

You possibly could have brain damage. Consult your dr

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 .

Hurt my head 3weks ago feel absolutely fine but still have bump ?

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?

I just had kinda same fall backwards! Hit my head on edge of round table full force! Putting on ice, no symptoms!! Should I go or stay

I fell backwards hit my head hard on the floor in the bathroom I hit my arm and my tailbone is really sore. Not the first time this happens ,I had wet shoes this time

I just fell off of a chair and hit the left top side of my head. There is no bleeding I don’t feel days I don’t feel confused I did not black out. I put ice on it do you think I have to go to the hospital

A mobile phone dropped on the side of my head just above ear .
The corner of the phone hit my head .
I don’t feel concussion or dizzy how ever have a little bump and it is still sore 24 hours later

I was brisk walking and I tripped over my foot fell down and it my head on concrete. I have a huge bump, but I didn’t pass out and I walked back home. Should I go to an urgent care and be checked. Also a slight nose bleed.

8 days ago I hit my head on the concrete
I am having dizzy spells and my head is hurting terribly and I've been stuttering a little bit and having a hard time concentrating on anything the pain is very severe but when I'm worried about is there any way any damaged to my brain.

One week ago while rearranging furniture, I hit the top of my head on my dining room table. The next day, my husband found 2 indentations in my forehead. Since then, I have found a 3rd. All are in the forehead up near my hair line. They are not noticeable to the eye but you can definitely feel the indention. I called and scheduled an appointment with my doctor, but it is not for another 2 weeks. I am not sure if the hitting of my head (directly on top and center of head) is related to the indentions on my forehead or if it was just coincidence my husband saw them. Should I go to the ER instead or wait for my scheduled appointment?

I took an ambien Last night, went to kitchen and fell on my head, I woke up this morning had blood but is not swollen, it seemed to have a cut, I felt dizzy like the room was moving really fast, later in the day felt better, my concern is that it does hurt, and I had blood, should I go to hospital?

Sorry in advance for the long post..

3 months ago i was strangled while being held down on a bed and punched repeatedly in the side of my head.. (i had turned my head 90° just before so I could breath easier as I wasn't face down then). After not being able to breath at all for what felt like 10secs maybe and after the punches stopped, panic set it and i used the last breath i had to scream out to my late brother for some sort of divine help as I started to go unconscious, thankfully he stopped and let go of my neck then. luckily I didn't fully go unconscious but definitely was dazed and it hurt and was hard to gasp for breath.

After a few weeks i developed a small dent in my skull close to where I was punched.. It was super itchy. When I scratched it, it immediately opened at one end and blood came out and was immediately very tender.
Over another couple of weeks it grew in length and began to bleed from the other end after scratching the itch not thinking... I also would feel a cold sensation moving within the dent.

Thinking back I did have bruising and burst blood vessels around my eyes but that would happen each time I've been strangled (thankfully only a few times) so I assumed it was just from that. My vision was a little bit blurry and my eyes felt swollen the next day but i assumed it was from the fight in general as well as alcohol and drugs consumed that night.

My question is... 3 months on, I still have the dent (roughly 4cm long X 1cm wide now), is this a concern?
It will hurt if i rub it or touch it too much but the pain has reduced alot compared to when it first appeared.

I did see my doctor 2 weeks after the dent appeared - 5 weeks or so after the incident occured...he said it's possible I had suffered a fracture and then a type of hematoma but was probably nothing to worry about as I couldn't recall if I had experienced any headaches (which I later did recall having a sudden terrible migraine one day that differed greatly to anything I'd experienced including sharp precise pain that travelled through my skull into my eye.
I hadn't had a migraine for close to a year since ceasing marijuana use)...

Should I get a second opinion or am I being a hypochondriac?

Please get away from whoever is punching your head and strangling you. Strangling is a second degree felony. The person is dangerous. Get away from them. Go to a shelter. Next time you might die.

Pages