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 (812)

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 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.

Let me just say this. If there’s bleeding AT ALL you need to go to the docter immediately. And a dent in your skull!! Popped blood vessels!! You need to go to a urgent care and get it scanned immediately!! It’s not normal for it to bleed out when you scratch it. And I don’t know if your in a abusive household or relationship (you don’t specify who hit you) but I think it’s your brother?!! Anyways you need to get help immediately that is not ok at ALL and you need to leave before it gets worse and the next time it happens you need to call 911.

I wish there were replies to some of these comments. I'm not sure if I should go to the ER or not. I stepped on a rake on Sunday and got a huge lump on my forehead. By Tuesday I had a black eye. This is Wednesday and now my eye is swollen and half closed. Throbbing headache that comes and goes. Nausea that comes and goes. Can the hospital do anything to stop this pain or should I just ride it out? I need to run a farm and feed livestock. There is no one else to do it. I can't afford to be at the hospital if it's not life threatening.

I recently went to ship with my hair and noticed that I had a big goose egg and it was split I did not know that I hit my head hard enough to do that but I was feeling weird in my head and I had gotten a nosebleed and never got enough sleep before is there anything else concerned and my head still hurts quite a bit

I’m 68 years old. At night I tripped over a pot plant and fell. I fell on a concrete porch and hit the back of my head. This happened about a week and a half ago. I’ve felt a little light headed when I lie down like slight vertigo. It did not beak the skin and I had a knot and soreness on the left top back of my head. The knot has subsided but my head is still a little sore where I hit it. Do you think I can heal from this?

I fell forward to the left when leaning over to fix a leg cramp in the middle of the night and smacked the top of my head on the bed stand. Little bleeding but stopped quickly. Just a small cut that's healing fine. Now my right shoulder side back muscles are very sore the next day and days later. Are they related? Any movement causes lots of pain in my back.

It just happened, I was cleaning at work and as I was walking out the restroom I hit the hook right on my temple, excruciating pain Immediately I had so hold my head and dance it off... it still hurts I’m wondering should I go to the hospital.

Ok so two weeks ago I went cliff jumping and I had jumped and my brother didn't see me and had jumped on my head I remember everything but I did blackout for a second it hurt really bad to the point I cried it hurt for a least an hour but not as bad. for 3 days I was fine but then at of nowhere I would get a random bad headache where I got hit it would last for 1 min that go away and right now iv been getting a really bad headache that wouldn't go away sometimes it would go away sometimes there not that bad but sometimes they're really bad and every time I get up I get really dizzy and can't see well last about 30 seconds and sometimes out of nowhere my vision would come out of nowhere. I don't know what to do

I'm not a doctor but I would definitely go see one if I were you. Could be a brain injury or could be a nerve issue... it seems that the reoccuring headaches especially after any loss of consciousness is a concern worthy of prompt medical attention.
Hope you feel better soon and all is ok! x

My adult son is on crutches and slipped and fell backwards and his head on concrete. This was about 10 hours ago. He has been up all night afraid to fall asleep. He said he was a little confused at first and keep forgetting things that happened or said earlier. He never put ice on his head either. Should he go to hospital?

I had a 1kg medicine ball dropped directly on top of my head, two months later I have a bunch of large "floaters" appear in my eyes, and the skin over my eye lids has dropped. Plus the headaches have continued. I am 68 years of age. could the blow to the head have caused these issues?

I fell back on a kitchen chair and hit the corner of the Stove.i got a Big Bump on the back of the right side of my head. I had a big Headache all that day. And the bump is tender to the touch and 2 days later it is still tender to the touch even though the Bump has gone down. Should I go to the Doctor ?

I am 16 and a couple days ago I got up from lying down on the couch to go wash the dishes. I got to the sink and I felt dizzy. I blacked out and fell. No one was around me so no one knows what happened. I hit my head on something and there is this giant bump. It’s gone down since the incident but there’s still a small bump. It still hurts if I put pressure on it (like a bruise). I’ve only started getting a small headache yesterday but thought it was because my hair was tied up and was pulling too much. Today it kind of bothers me but not much. Should I be concerned? I don’t want to go to the doctors for nothing and worry everyone.

I feel last night and hit my head hard on a glass 1/4 inch glass shelf to my entertainment. My head didn't bust I don't have a knot. It was hard enough most the stuff sitting on the whole entertainment center got knocked of. No bleeding, no knot, but my head has been pounding since I hit it. Should I go to dr.

I fainted and hit my head on the kitchen bench. I was out for two minutes. My best friend told me that I wasn’t bleeding so I thought I was fine. I stood up and blacked out. I woke up to my best friend hugging me she was crying. I told her I was fine. I fainted the next day and she insisted that I went to the doctor. I did and he told me nothing was wrong but my friend keeps reeling me he’s wrong. Who should I listen to.

Go to hospital immediately

Listen to your friend, I’m a Medical Assistant and I’m telling you this right now. Most doctors don’t care and all they care about is money. Go get a CAT SCAN and inform them on the inc ident. Please listen to your bestfriend.

You go and get checked out a few more times for more opinions. Fainting everytime you stand up isnt normal. Like how do you shower, walk anywhere, wash the dishes?

I’m not a doctor or anything but random fainting spells after a hit to the head doesn’t sound normal. it doesn’t hurt to get a second opinion from another doctor.

Go to the ER NOW as they have a CT Scan and can rule out subdural or epidural hemorrhage that may be causing your blackouts. If you have not had blackouts before the injury I feel they are related to your fall.Feel better soon.

You should listen to your friend. If you have lost consciousness more than once then there is definitely something wrong. Talk to a different doctor or go to the hospital.

Ok so I was on the couch and I went to get up and I flipped of the couch and fell on my neck and my chin like went into my chest and I felt a crack in my neck and now my upper back hurts so I need to go to the doctor or did I break something?

I went down a slide backwards Ano I shouldn’t of but someone else done it and it was okay so I tried it and hit my head multiple times from side to side and then I went flying and bashed the back off my head of the ground my neck then stiffens and I coudlnt move for a few min tires my shoulders hurt and the top of my back hurt it’s been a few hours and I now have a really bad headache what do I do

I hit my head on a low ceiling today and a lot of blood came out of my nose, like a lot, I’m a teenager and I’ve had headaches since I hit my head. I accidentally bumped it slightly again and my nose started bleeding again should I go to the hospital?

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