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"?
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.
About the author: Jeffrey Bazarian, MD
Dr. Bazarian is an emergency physician with a strong research interest in traumatic brain injury. He is associate professor of Emergency Medicine, Neurology, and Neurosurgery at the Center for Neural Development and Disease, University of Rochester Medical Center.
Comments (686)
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.
Anders Nelson replied on Permalink
If you haven't already, I strongly recommend you visit an ER, or urgent care.
Heike replied on Permalink
About a couple weeks ago, I got up, then felt a little dizzy but not to the extent of passing out when all of a sudden I blacked out, fell down against a wall that now has a big dent in it, soon after that had a siezure/convulsions my friend said, he almost called 911 because the way I was laying looked as though I had broken my neck but after a few minutes I came too, was super confused, my head felt fine, only the next day did I experience a pretty bad headache, ever since then I have had neck pains that shoot to my shoulders but not sure if it’s related. Should I still after all this time go get it checked out just in case? I’m guessing if there is question I probably should?
Jenn replied on Permalink
Hi. I had a severe car accident and a severe concussion a month ago. I'm still dizzy and when I stand for more than 5 minutes I get like a haze and feel ready to pass out. It's been like this only since the accident. I went to the hospital last week and they said since my CT scan a month ago showed no bleeding that what I'm feeling is normal. Now I had a previous accident and in 2009 John Hopkins found that I have 2 pinched occipital nerves.
Is what I'm feeling, in fact, normal? Or should I go back to the hospital?
Nicole replied on Permalink
hi if i were you i would go back to the hospital for a checkup just incase its not normal
Anthony replied on Permalink
I was a passenger in a car wreck -- broken clavicle, broken ribs and a couple other things. The doctor released me knowing there could be other complications. I've never had a concussion but it has been really hard to concentrate and I've been getting really dizzy (to the point I lose balance and the room spins super fast). I was thinking it was from the pain of my body, along with my two broken ribs but it's been 4 days since the wreck and it's still happening. There is no clear head injury but I did break an airbag with my face and then fall 30-40 feet, maybe more in the car. I had to of hit my head on the back of the seat too. I've been really confused since. It's not the easiest to move.
I have got a doctor's appointment in 6 hrs. Should I just go? I think this article just made my decision.
Juju replied on Permalink
Thrown backward into telephone post hitting the back of my head. Just barely dazed but back of head was hurting badly and I was sure there was blood. None there and got up to finish with horse. I had a huge lump and it felt hard at first then squishy. Obviously painful for a while but lump went squishy that night and only had a little mark and bruise on small hard lump. All seemed fine except weird pain when pressure is applied there. Year and a half later the back of my head still feels like it will crack open if pushed on or laying back of head on pillow. Pain goes away when pressure is removed. I am one of the lucky souls that has suffered depression and anxiety for years so that means doctors think you are imagining things or just plain crazy. Anyhow I was just wondering if any of you might know what's up with my head lol.
EbottyG replied on Permalink
I think I'm going through a similar experience to yours... loss of memory, confusion, depression, anxiety, headache, stiff neck and so on. And now my eyes are in pain, the back of my head feels like it's on fire and it's swelling. The pain is becoming more and more consistent and worse.
I'm from a poor background and I'm scared of the high cost of dealing with head problems. This fear has gone on for over 12yrs since when I hit my head back in the primary school on a concrete wall while playing football. I have never told anyone about it. Please help me. What should I do? I feel like it too late now.
Debbie replied on Permalink
Yes, go and get checked out. if you put it off you might talk yourself right out of it and then you'll probably always wonder. But I pray the Lord heals you I'm going through a similar thing right now too.
Tammy solano replied on Permalink
Against what I know to be safe. My daughter on her bike and me on skates no helmet It started to rain and stopped quickly. My wheel hit something on the sidewalk that launched me off my feet straight down into the cement where I heard my head smack the sidewalk like the sound of a bowling ball. From there I slid on my face and stopped. I told my 6 year old I needed help. My husband wasn't far, he rushed over. We called 911 EMT's showed up but I didnt go to the hospital. I now regret that decision. I immediatly had a large lump on the right side of my forehead. I felt pressure behind my right eye for days. I have had memory loss, difficulty driving, vision loss, not to mention I just feel different and no one seems to believe me or understand how serious this could be. Results of a recent CAT scan were normal. I don't know what to do at this point?
Christina replied on Permalink
I hit the side of my head beside my eye on cement drive way still hurts to touch should I be looked at
Joyce replied on Permalink
I just fell down 2 steps on my camper st the beach...I landed flat on my back but took the blunt of the fall on the back of my head. I didn't loose consciousness etc, not sick on my stomach , no know and only a very mild pain coming and going in the back of my left eye. Although I hit the hard ground we do have an outside rug there ...I don't know what to do, concerned now about a blood clot?
Hi replied on Permalink
Hi. My daughter is 6. Today she just hit her head so hard that she was vomiting. It has been an hour and she is playing like normal again. Should I be worried and take her in?
Catherine replied on Permalink
I'm 34. I fell about an hour ago and hit my face on the floor. I'm alone at home and had a hard time getting up. My body feels tingly like I passed out. I feel weak and can't seem to coordinate my left hand to do simple things like text, type, scratch my right arm... I don't think I lost consciousness. Is this serious enough to go to the hospital?
Jacob replied on Permalink
YES!!! I am also going right now, I hit my head a week ago and I have been having worsening migraine headaches since then.
Cindy replied on Permalink
Omg yes please call a friend family member or ambulance to get you to the er
Lisa replied on Permalink
I hope you are doing ok and went to get looked at by a doctor!! That sounds like some frightening symptoms :(
Mr. Doctorman replied on Permalink
Yes
Jacqueline Watson replied on Permalink
At the age of nineteen, I had a fall and hit my head on my carpeted floor, my husband said that my eyes rolled back and they rushed me to the hospital. I don't remember getting off the floor, getting help into the car, Nothing! My husband said my eyes were glazed looking and I was talking out of my head. He said they gave me a sedative to sleep. I stayed in the hospital for a week. Was this a mild concussion?
Christy hashly replied on Permalink
ok so I'm in middle school and play basketball and I was running backwards and hit heads with another girl and had a head ace after wards that whole day I just kinda felt confused or like in a daze kinda.and I have this feeling like I need to throw up bit I dont.then today we had a school assembly and we were in these bubble balls and I flew and my head bounced really hard. and now I have another head ace and still feel like I need to throw up. my sister said I might have a mild concussion but I'm not sure?
Anonomouse replied on Permalink
I'm not a doctor, unless u count watching my obsession for Grey's anatomy enough XD. Talk to your mom/ dad/ guardian about this, I would talk to your doctor if you can though. It could be pretty bad if you have a concussion!
S(nd) replied on Permalink
This is hard for me...
Is it too late?
My sister hit her head when she was 2 or 3 years old, she fell down multiple (10-15) times from the bed, yes I know this is insane, one day she started bleeding. Now, My mother, she didn't want to go to the doctor I insisted that she should, but didn't.
Now she's 7 years old, in the 2nd grade and has problems in her school (learning, socializing, etc.), I don't know if it's because of what happened.
Now we live in a country where English is like the third( second for some people) Language, and our main Language is H.
And the language isn't hard but she has problems learning.
What to do?
Yuzu replied on Permalink
A couple of years ago I had fainted and I woke up on the floor not knowing what happened. As soon as I got up, all I knew was that I was clutching my head in pain for a couple of minutes before the severity of the pain subsided. I had another blackout and hit my head on the wall around a year or two ago but both times when i hit my head I never went to get it checked out.
I noticed that ever since then, I've become more forgetful and up until now, I'm still having a lot of head pain.
I was wondering is it too late to ask for some kind of head scan as it has been years now since that happened? I just want to know what's causing these problems.
Anonymous replied on Permalink
You need to get an EEG and a CT scan especially since this is the second time you have had these scary episodes. then at least doctor will at least have a baseline of your normal brain function and makeup to compare with if and when this happens again. at best doctor will be able to diagnose your problem.
Bethany replied on Permalink
I was hit in the head with a soft ball several months ago, it did not render me unconscious but it did leave a nasty cut on my head that bleed A LOT. Now months later every time I lay on my back or on my left side I get very dizzy like I'm going to pass out. How long is this going to last?
Anna replied on Permalink
I was in a car accident 8 months ago. I have PCS and am struggling hard with the emotional and physical symptoms. I don't feel like myself anymore. I'm easily set off. I'm angry most of the time. My headaches have been consistent since the accident. I feel completely disconnected from my family and the world around me. I lose the desire to eat, and interact with people. I have 0 energy most of the time and it's harder to get motivated now. If I have social interactions I suffer for days later with symptoms. I've had an extremely bad headache for 15 days straight with no relief. This is a nightmare. I feel like the old me died and something else took my body. I struggle with decision making and day to day schedules. I can barely function properly. I feel so alone, even with help.
Chenoa replied on Permalink
I hate to hear you're going through this. I know this may sound strange, but I feel it could save your life so I thought I'd go for it. Please ask the dr to check your thyroid levels. Many people develop thyroid/autoimmune disorders after trauma (I developed graves disease after a miscarriage and other environmental stressors at the time). Please just give it a shot. A lot of what you described sounds like what I was feeling like. The only reason I realized what was wrong was because I developed a goiter. Not everybody gets goiter. Once again I am so very sorry you're so sick. Even if it's not the case I know how it feels to be imprisoned in a sickly body. Bless you.
Stephane replied on Permalink
I feel the same.
When I was little, I hit my head twice on some metal in the playground, I forgot how it exactly happened I was in the 8 grade or something, all my skills in math and etc. fluctuated. like I was "good" in algebra, after that day, nothing was the same.
I never went to the doctor, although I told my parent (mother) she said it was nothing important. Now I can barely remember things, and I couldn't (could but didn't due to fear of being mocked at) communicate (Somehow I started stuttering).
I can't concentrate in school, some words that I know, I forget them, basic math skills (8*5, 4*7, 9*3, etc.) are sort of "hard" for me without calculating for 4 or so minutes.
I'm losing myself, I need help, what should I do?
BlytheLamb replied on Permalink
I don’t know what PCS is. I do know what PTSD is, though, and you’ve got a hella case of PTSD going, Anna. In my opinion, at least. The place you describe is very familiar to me, and I’d not wish it on anyone. I’m sorry you’re having to experience it too, Anna. I want you to know though that it’s not a permanent forever thing - it feels like it but it’s not. The old you will return, I promise. For me it was after several years. I literally woke up one morning and something felt different, it’s like I knew I’d turned the corner or something. I can’t explain it but it felt good and it’s just got better from there. The best tip i can give you, Anna, is to stop fighting it. Stop mourning the person on you used to be....stop thinking and analysing and trying to fix it... The panic which summers away under all of those things only serves to re-catastrophise your days, which in turn pulls the scabs of the initial emotional scars which began with the ‘really big scary thing’ which tore a hole in the one thing which we need to be unthinkingly, contentedly ourselves: ambiant self-control - be it in thought, action, emotion, whatever.
So just tell yourself you’re ok with whatever comes, that this you isn’t as bad as some other people you’ve met over the years, and that you’re going to give in to whatever this new you demands - short temperedness, unsociability, insomnia....whatever. Just make peace with it. Because the sooner you do the sooner you’ll find the new you suddenly gone and the old you gloriously returned. Try it out, even though it seems counterintuitive. Really, what have you got to lose?
Best wishes,
B
Jennifer replied on Permalink
Anna,was it? Hello my twin! ! Though you may feel like an alien on another planet, for not being able to relate to even one of the endless human beings around you... This is temporary. This is also amazing to see, because though I feel for your situation, I realize how NOT alone I am,now. .. because of your own misfortune. ..
it's been 17 years since my accident and I hope you get this because I need to help you, as much as a stranger or Any other can
Please feel free to text or call me, anytime!! Help can be very helpful, if help Is what your looking for. . Helping others, helps the healer as well ;) 603)722-9873
Anonymous replied on Permalink
How would you describe "old me" and the "something else" that took over your body?
Gloria martin replied on Permalink
I fell any hit the back of my head on a cement floor with thin carpet on it about 3 wks ago. The knot has just about gone but once in a while i get a pain there. What should i do?
Elizabeth replied on Permalink
I've encountered two concussions in less than 3 months. The first happened in June 2017 from banging my head accidentally on my night stand and the second was Sept2017 in a bad car accident. After the car accident the hospital had me stay over night for observation and I went home the next day. That happened a week and a half ago but I've been feeling very off, shakey, and now I'm having little fevers what should I do I see a neurologist in 3 days but I just don't feel right.
Robin replied on Permalink
Had a stroke 2014 emergency brain surgery.lefy with blurred vision vertigo memory loss incontinence dizziness nausea on and off headaches not approved for disability cant work or drive help no insurance.
Val replied on Permalink
I tripped and hit my head in 2013. There was no bruising or swelling; just a small trickle of blood over my eye for a few seconds as my steel framed glasses bent out of shape! I got a lift home. I was on my own. A little while later I started with dizziness and vomiting & couldnt stand up. I managed to phone for an ambulance. I had concussion. A cat scan showed i was ok but had displaced or broken little hairs in my ear that control balance. I was in hospital 4 days. As I said; i had no swelling or bruising. I cant even see a scar. Damage can go, in, rather than look a mess on the outside! Get checked out if you bang head!!
Yvonne replied on Permalink
I had an accident about a week and a half ago that caused me to hit my head hard in three different locations on the head. Once on each side of head close to ear and one on left side of forehead. The swelling has gone down a lot. But I still have small bumps and a lot of pain when touched. During the incident I felt very dizzy and nearly passed out. I could not get up without feeling this way. After a full day I am able to walk carefully and go about my day. But everyday I get dizzy if I look down for a long period of time, yawn, stretch, blow my nose, or anything to bring tension To my head. Including lifting things. Is it time I take myself to see a doctor? Do you think it is serious?
Sheyla replied on Permalink
You should go to the hospital
Brittany replied on Permalink
I was sent home from the ICU with a known subdural hematoma which grew so huge at home, I ended up having not 1 craniotomy, but 3 to repair the damage. My questions are: A) is it normal to be sent home with a small acute subdural hematoma? B) No one diagnosed a brain injury, head injury, or said anything of the sort to my family even with every symptom of a TBI after and before the surgeries. It was cause by a MVA, the hospital knew, don't they have to report a TBI or at least tell you so you can get treatment? Thank you.
Anonymous replied on Permalink
Just hit the back of my head hard on a doornob standing up and feeling mild symptoms of sudden fatigue and dizziness.
How can you tell everyone to go to the hospital when the average cat scan costs $1200 and the chances of brain injury needing medical attention are 1/1000?
Emergency visits cost that and more.
By the time the the hospital gets around to diagnosing you after waiting in line it might be too late anyway.
That plus the whole hospital ordeal sounds like a nightmare causing anxiety and stress plus unnecessary exposure to hospital super bacteria and a radiation dump to your brain - all of which together probably take more days off your life on average than waiting it out. -
Maybe if you're a millionaire it's worth it for mild symptoms. Just don't hit your head.
Anonymous replied on Permalink
TamraP43 replied on Permalink
I hit the back of my head back in the year of 2016 on an small steal bridge in a park , i went under it walk to the other end thought i had a clearence and could stand back up and when I did I wacked it really hard. they did a cat scan they said oh it's just a mild concussion .Now back in the year of 2017 i was having pseudo seizures the later that year they said oh it's just anxieties. Then around October 2017 they were saying I'm having panic attacks. Now January 2018 I'm getting weak at times i feel faint i feel like im forcing myself to breath , I can't seem to remember anything anymore. I can't even remember things that happened 2 hours before, I get confused a lot. My mind goes blank. My vision has gotten worse it scares me. But im afraid of the hospital because the ER gave me the wrong medicine in my I V . However I am going to a Neurologist and talk to him about everything that has been going on. Get a cat scan and MRI done. Because I want to get to the bottom of this and find out what's wrong. Then if i need brain surgery I want it done at the Cleveland Clinic I have heard nothing but excellent news about that place!
Sonja Thews replied on Permalink
I fell last June, hit my head on the concrete, temporally lost consciousness but the Mayo Hospital said I was fine. Now I can't even remember how to cook a meal or to get to the grocery store. Something had to be overlooked. Written by a friend, Alvin
michellem replied on Permalink
So sorry for your family's loss.
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Gem replied on Permalink
Yo, wondering if this reply is a bit late, but I would say you should get it checked out somewhere. If you can, try to find a doctor(although I suggest you find insurance first, even if it's cheap)so that they can more thoroughly examine your condition. Head injuries aren't necessarily to be taken lightly so if you feel like your injury hasn't recovered, get to a doctor as soon as possible and get treatment.
Anonymous replied on Permalink
Your Life and Health is Priceless.... please go to the hospital and let them examine you......Let them bill you ....aleast YOU Will Be ALIVE to make arrangements to PAY
Anonymous replied on Permalink
My 2 year old sister hit her head when she fell off the trampoline from about 1-3 feet. I'm wondering if this would cause any brain damage?
Anonymous replied on Permalink
I hit my head last month on a table at school and my head was hurting. I just sucked it up and went about my day. A few hours later my headache got extremely bad. The school called my mom and I passed out in the car, then my neck became stiff. When I got to the hospital they tried talking to me but my words where slurred and the hospital gave me ibuprofen. They sent me home and the next day my headaches got worse and I was throwing up so my mom scheduled an appointment with my PCP where they told me I could have a concussion so I was referred to a head first clinic where they specialized in injuries to the head and i took an impact test. My balance and my vision was off and my test score was really low. I was put on rest for another week. On one of my "rest days" I was passed out and I hit my head again. On Monday I had my checkup with my concussion doctor where I re-took the impact test and i scored worse. My balance was off and worst of all my blood pressure was 136/88 and I'm 14. That same day I was scheduled to see a neurologist where they did a CT scan and it's been 1 month and no recovery I'm currently waiting on my results and have to return tomorrow.
Anonymous replied on Permalink
Thanks. Your words of advice and clear explanation helped me make a decision. Blessings!
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