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 (837)

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.

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?

I would to make sure that everything is okay... A huge shelf full of food supplies fell on my head today and I’m thinking about going because it hit me pretty hard and even now my head still hurt

You must visit a doctor.One must take headaches seriously if severe

YH go to the hospital bro... you hit your top of your head and blood came out your nose? Even if you couldn't walk at the time call an ambulance if you can or 111 if you live in the UK dunno if this a US website but sprint to the doctor's ... i got a rock thrown at my head when i was like 8-9 "accidentally" by my ex friend and i ran into a brick wall when i was 3 years old playing TAG so now my i get regular headaches and migraines, my ears sometimes goes into episodes of random loud bangs in both ears, like 'bang snaps' sounds, sometimes sounding like a 22 long rifle bullet hitting metal really close to your ear hole but you dont get hit with fragments... once i was sitting on a wall with my friends chillin, ringing started in both my ears, everything went quieter around me and within like 15 seconds my ears were burning and all i could ear was my ears ringing and then i heard a loud like a bullet flying right past my ear snap sound, like i just been flash banged and i just seen white and passed out for like 40 seconds and came to almost dying of lack of oxygen because my friends told me i was struggling to breath while i was out cold i don't know if that was definitely because of previous head injuries but just SEE A DOCTOR NOW!

Yes! Blood = hospital!!! Be safe my friend:)

Im 55..... if there's blood.....GO TO THE ER!!!

Yes, sweetie, you should have gone. Did you go and what was the outcome?

Hello, when I was 4-6 yrs old? I've been bumped so hard at the back of my head on the rock because my friends were pushing me in the swing and after that we did not go to see a doctor and I have a aunt whos job is a nurse so shes the one who assist about what happend. And after 2 yrs I used to lived in my grandmas house far way from our house I used to lived there and there was this moment that I and my friends were catching some grasshoppers in the grassy area but suddenly one of my friends (younger brother of my friend) threw a glass bottle on my right head and of course I collapsed and just woke up with many people around me pulling off the glass in my head and they didnt bring me to the hospital it was just a self care. So I have been hit 2 times without seeing a doctor.Since when I was 10-12 years old I was been diagnosed with ADHD depression or ADHD bipolar or just depression or just bipolar. But now that I am 14 yrs I have a schizoprenia idunno what type. My question: Is this because of my childhood head injury?But I dont have like a PTSD I dont do flash back memories about what happend I just dont care.

I think it's worth your time to get checked by a doctor send get a CT scan of your head.

I am 71 years old I was cleaning the bathroom and felt unbalance and I fell down and hit The back of my head and my back. My neck and back hurts and I feel upset stomach and headaches more on the left side . should I be worried?

I'm not a medical doctor or nurse. But this sounda serious enough to be seen. If u were my Mom id have u in the drs asap.

Yes it sounds very bad and u could have concussion go to ur local go as soon as possible

I hope that you went to the hospital! Are you okay?

On my first shift at work first hour, I hit my head against metal saddle and it hurts alot, Put I didn't bleed, And wasn't sick and I've eaten and drinked normally, Should I visit doctor I have a red bump

I hit my head a cuple of minuutes ago and I feel reely dizzy

I whacked my head on the ground quite hard and 24 hours later I can still feel it. I have a splitting headache and it really hurts. Should I go to A&E?

Couple of weeks ago my 3 year old head butted me in the temple felt dizzy at the time been getting headaches on and off been told by the doc yesterday I suffer with anxiety not sure what to do because I’m thinking all sorts

Few nights ago I fell and hit the back of my head on driveway. Had a huge headache, took ibuprofen and had a huge massive bump on head. Slept that night just fine and by morning the bump disappeared as if it was never there and now the spot is sore. I have headaches since but no other symptoms or unusual behavior. Should this be concerning especially with the bump on the back top on the head disappearing so quickly?

I had the hiccups and decided to hold my breath. I got dizzy so I grabbed onto the cat tree and told myself to lower to my knees. Next thing I know I’m waking up on the tile with my head aching but also numb. I’m at work and continued my shift after. My head hurts to touch and is swollen. Should I go in?

I am 32 years old and I was hanging something up in my sons room and I fell off the chair I hit The back of my head and my back The next day now I am sore my neck hurts my back and I feels a little weird little headaches here and there should I be worried

About 4 hours ago I was lying on my floor and my phone was on charge on my nightstand. I hit the charger cord and my phone fell down and hit my left ear. Ever since then I’ve had a massive headache and my ear and jaw hurt on that side. I’m not sure what I should do or if it’s even serious.

Hello Dr. Bazarian,

I fell on April 3. 2020. I was riding my bike, I lost oxygen, passed out, and fell to the ground. I hit concrete, asphalt, a curbing. My joints are still hurting and burning. Because of the COVID-19, I did not see the ER until April 10,2020.

I have most of the symptoms except for seizures. I tried to get up off the ground for 15 minutes, but my legs kept shaking, weak, and giving out. My memory is bad. I had bruises going up my spine, head, and down the entire right side. I cried..Help me.

It is now May 17, 2020, I still hurt really bad. I have been crying in my sleep. I don't know what to do. :C

My doctors do not want to see me until the COVID-19 is over. I am in intense pain. I have reduced sleep due to the pain. My head hurts a lot. I have moderate brain damage due to my parents.

Please help me.

I’m not a doctor but would like to say that you should get this checked ASAP

How are you now? I'm concerned for you. I hope you went to an ER or something so you could get checked. This sound serious. :(

Please get that looked at even a video appt.

Hi I’m sorry for the trauma your are experiencing after the incident. Have you been able to get help ?

My hitted my head hard with a big plastic mayonnaise jar last night...on the side of my head...
Now I fill slightly headache and this coldness inside my head... should I go or not

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