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 (485)

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.

4 days ago I was in my office and got up to get some folders from the floor beside my desk. My depth perception must've been off, because as I bent down (rather quickly) I smacked the front of my forehead (by my hairline) really hard. My teeth seemed to shake & my eyes went funny for a second, both I'd expect from a hard hit...the area is still tender to the touch, no bruising, but headaches all 4 days since. My oldest daughter has had 5 soccer related concussions. I feel I know my way around them, & don't believe I had one. Generally how long will this headache & tenderness last? No vomiting, no loc, just some nausea & the headache. I feel crummy...not big on going to the ER for Anything. Never taken seriously.

Feeling dazed, headache and nausea are ALL symptoms of concussion. If you're not feeling up for the ER, then at least call your primary care physician and run how you're feeling by them.

Last night a heavy glass figure fell off fridge and busted my head open, I have headache and the injury feels it is going down backnif neck. Is this normal? I did not pass out.

A headache after a head injury is one of the symptoms listed above that the doctor suggests getting medical attention for.

I was boarded against the glass in hockey, went down and saw stars, did not pass out. Head hurt for a day or two. This was 2 weeks ago. This past weekend was in a tournament, jumped up to grab puck came down and my skates came out from under me and head hit ice. Just stars again, I did not black out. I have persistent headaches (through out my whole head) and nauseated. Sometimes I have forgotten what I was doing. I have been sleeping but figured from tylenol..thoughts???

Feeling dazed and confused, headaches, and nausea after a head injury are all symptoms of concussion. You should definitely get medical attention. Especially considering that you've had two injuries in just the last couple of weeks. There should also be concussion protocol in place for you team?!

I passed out a few days ago. I fell in my driveway which is mostly dirt and rocks. I fell on my back hitting the back of my head on the ground. I woke up and got to my front door before passing out again. I didn’t feel pain until the day after and still today. I’ve had a headache since and neck pain and stiffness. My back hurt for a day or two but not as much. Should I be concerned about my head or neck?

Hello, I fell in the bathroom knocked my back head on the wall.. No pain until 2 days after, now having on n off headache from the back of my head, my BP rose (170 n something) though v hypertension before now. I v bn taking Naproxen sodium 275mg since yesterday but getting temporary relief. Do I need to go to hospital or not?
Thanks

Absolutely need to go by the sounds of it. Even to get checked out. Better to be safe than sorry or worse.

I was in a hurry I hit my head on the acrylic sinks I refused to go to the ER my family told me I was Dazed and Confused trying to go to sleep the bathroom is between kitchen and in my room nice shoes went to my room my glasses went into the kitchen it left a knot on my hand now it's been 2 Days Later and it still hurts I'm having headaches everyday since then and yes I did throw up couple times after it happened but it's been a couple days now and when I open my left eye and shut my right eye I have blurred vision but when I close my left eye I can see very very good from my right eye and I've been keeping my left eye closed

Both vomiting and "feeling dazed or confused" are listed above as reasons to promptly go to the ER. Considering it's been days and you still feel bad, you should probably seek medical attention. At least call your primary care physician.

My face slammed into a pole at work two days ago, Monday around 1 pm. Split my eyebrow open, black eye and cheek swollen and bruised.
Two days later I'm feeling nauseas, headachy, and swollen worse.

I had a broken gas powered weed eater in the shed. Up about three feet, motor side down. The head of it is broken off. It fell over, the round pole part hitting me in the left temple. It hurt bad but no loc or vomiting. Just a quarter sized slightly raised swelling lump and slight bruising and small scrape. Had a headache earlier before it happened and had taken OTC migraine meds that relieved it. Headache came back immediately and is still there. My son had a chemo treatment yesterday so I don't want to go to ER if it's not necessary.

How are you? Did you get a response. Usually outward swelling is a better sign. Headache can be an issue. Did it knock you out?

I stepped on the end of a rake and the other end hit me in the left front forehead. I have a large bump that has gone down from when it happened yesterday at 3pm. I am also a panic attack person, so I am not sure if my reaction is from the bump or panic anxiety: never passed out, naseauted, etc . Should I be concerned? it’s a concussion or anxiety

I fell and hit the back of my very hard on wood flooring. I just have a headache and big bump on the back of my head. I had a meningioma resection 17yrs ago. Should I go ER and be checked out because of my former surgery!

Yesterday I fell riding a hover board on the road I hit hard first my tailbone then my head slammed back at first I thought I was good but now slight neck movements hurt and I can't lay my head down it has to be in the side. I'm 14 so what should I do?

You probably sprained some of your neck muscles or pulled one. It should get better in about a week if that's all that it is. If you have any naseua or amnesia you should go to the doctor.

Hello,
Back in 2006 I was a patient at Cabrini Hospital in New York City and I was given the medication Clozeril for schizophrenia which made me feel like I was hit in the back of the head by a two-by-four (twice). The caused me to have severe lapse in judgement not to mention the pain that I was in.
I have not fully recovered from this but was wondering if you knew of anyone else who has been through the same thing as I have?
I'm currently on Wellbutrin (but more for quitting smoking than anything else) yet am still very psychotic)
Any thoughts on what I have written?

A glass plaque fell on my daughter’s head st school. She says she’s fine but her head hurts. Should I take her to the hospital. She has sports practice in an hour and I’m not sure I should take her. Thank you.

My 11 year old banged her forehead on a desk it wasn't bleeding but she got a headache and her back started hurting she was also extremely cold what should I do

I was at the park with my friends and we were playing Marco Polo. I was slipping off the red swirly thing that you climb up on and I fell. I hit my head on the metal part of the structure and my arm got hit on every single bump of the red swirly thing and I have bruises all over my arm. I have a bump on the left side of my head. It hurts constantly. I got picked up early from school today. It was bleeding when it happened yesterday.. It hurts after I smile or when I raise my eyebrows. What should I do to feel better?

I would get this checked! Go to the ER or doctors

Hello My 6 year old fell in the bathtub and hit the temple part of his head. He has a slight bump and bruise. He said he has a headache but otherwise acting normal. Should I go to the hospital?

I hope you took him straight to the hospital, it is harder to determine in children if it's serious

i was at a parade ang got into a fight with someone and all of his friends jumped me i was kicked in the head a few times and i noticed a small dent in my skull... what should i do

Go to the hospital now!!

I fell down in my garage 3 days ago going up a step flat on my back hitting my back, and head on the concrete it and I cried, but I got up and got some paper towels to help apply pressure. The bleeding stopped I went into the house and sat for a while, I have a lump on the ( R ) side of my head and the base of my skull, and neck feels swollen my shoulder's hurt and spasm also my lower back hurts. Do you think it's to late to go to the ER, or see my doctor on Monday??

There is no such thing as too late to seek help. If you have any visible sign of injury or any symptom persisting more than a few moments, go to the ER... better safe than sorry.

Today I was at the park with my family I was trying to do a pull up on the monkey bars. I thought there was enough space between my head and the other pole behind me but there wasn't. When I went up my head hit the pole. It hurt bad not to the point where I was gonna cry, but it did hurt. It's been a couple of hours and I have a light headache and when I touche the top of my head it hurts, should I be worried? (I am 12 years old)

A week ago I got hit on the head with a roof window pretty hard, and it started bleeding. Half an hour later I felt really dizzy and weak, and I had to sit down for a while. I went to the doctor, no stitches were needed as the cut was not deep, but used glue to stop the bleeding. I still feel pain,at times just a sharp pain, or a headache during the day. The pain does not last long but almost everyday, and sometimes when I am standing I feel dizzy. Is this normal?

I was involved in a very serious car accident where the car went off a cliff. I was thrown up and down over and over again as the car rolled over and over and over down a two thousand foot cliff. I received several injuries which mostly were minor except for a burst fracture of T12 and my spinal canal was closed 50% with bone fragments. I received two Harrington rods, bone out of my hip to replace the crushed vertebrae in my back. I also sustained an injury where I hit the back of my head really hard and had to receive roughly ten stitches.

My problem and questions are: what head injuries did I receive? I have short term memory loss which is driving me crazy. It is so frustrating (to say the least) to not remember where you put your keys seconds after putting them down. Maybe you can help me? What should or could I do???

I had a craniectomy about 6 1/2 months ago. They basically removed part of my skull and extended part of the muscles holding the brain. About two months ago I tore those muscles and was leaking cerebrospinal fluid. A couple of weeks ago they said it’s still healing.

Yesterday I hit the base of my head pretty hard on a wall where the surgery site and tear was. Today I’ve been having horrible headaches and my neck is so strained. I can’t move and it goes to the middle of my back. I’m also dizzy and can’t concentrate. I’m not sure if I should go in to see if I tore it again or if I should wait it out.

About a week ago my friends had a fight and threw a metal cup that ended up hitting me in the side of the head right by my ear. I iced it but the lump is still there. It still hurts. I have to sleep on my belly with my hands on my forehead. I can't sleep with my head on a pillow because I get light headed and eye pains. I can't brush my hair and I feel like its swelling but it's not. I don't know if I should go to the hospital or not.

My boyfriend was playing basketball, he is very competitive, and he slammed into someone and then hit his head on concrete. He ran the mile today and collapsed to his feet when he was done. I texted him because I was worried and he said his head hurt and that he's been vomiting every 10-15 minutes or so. I am really worried.

I really hope he went to the hospital. Is he doing ok?

He needs medical care

My 7your old daughter was running in school yesterday and fell and hit her head on the side of a table. She was giving an ice pack but school didn't ring me, she was very cranky last night crying alot just not her self she woke this morning and got sick what should I do???

You must take her to the hospital.

I suffered a head injury in a car accident three months ago I’ve since then have the same things I cry all the time staying confused having memory loss be sure she doesn’t have the same symptoms watch for these things I would be sure to have her tested ct scan mri is definitely what you should have her check out as soon as possible

Three weeks ago, one of my twins(3.5yo) was at the bottom of a sledding hill when his brother sled into him, kicking him in the face(according to both). I was at the top of the hill and couldn’t assess the impact. The twin who got hit vomited a little, as if spitting, and then 5minutes later in the car he slept. I thought he had gone unconscious and I shook him which startled him and he started crying. We spoke to a physician over the phone who advised to keep an eye on him re vomiting and lack of consciousness. He slept for an hour with me waking him every 15 minutes to check on his reactions. After an hour nap, he was running around happily. His lip and cheek was a bit swollen but we assumed that if no vomiting and if in good spirits, then it was not a major impact and he was fine. Four days later, he woke from a nap vomiting and we got worried whether it is related to head injury. In Urgent Carentjey said he didn’t have a concussion. He has been his energetic self since. But I still wonder if there is a risk for a blood clot forming andnifnwe should have taken him to the hospital for a CT scan? Thanks for your thoughts!

Had a door hit me three weeks ago, dog loves to run across the porch and hurl his 90lb body into the back door and I happened to turn the handle right as he hit. Within seconds the area swelled enough to fill my hand, like the amount of time it took to reach up and touch it. No loss of consciousness, no amnesia, a little nausea but I also have anxiety which can cause nausea too. I still went to work an hour later and we called the doctor on my lunch but they said they didnt think it warranted a visit. Since that day I've had headaches galore, I get dizzy very easy (which is very uncommon for me, normally I can walk straight in under 10 seconds after spinning rapidly, great party trick), and the area still hurts when I touch it. Should I bring it up to the doctor again or is it just taking a while to heal fully?

If you've been having symptoms after 3 weeks, I'd suspect it's a concussion. I think you should definitely bring it up to your doctor again.

I have post concussion syndrome and I got drunk last night like an idiot and hit my head several times.
I’m in a huge daze and can’t focus on anything
Am I dying? I’m so tired

Hi, I am a 77-year-old lady. I fell and hit my forehead very hard on the coffee table. I did not pass out but had a large bump on my forehead. I went to A&E and the doctor just looked, asked a few questions, and then sent me home. I now have black eyes and have been sweating a lot. Could that be because I am worried something may happen to me? Also, I am flying to America at the end of April. Should it be ok to fly? I'm so worried.

If you are having any continuing symptoms like nausea, blurry vision, headaches, confusion or sensitivity to light, you should see another doctor. The black eyes are bruising from the fall but does not mean concussion. It has been a month since you fell and you should be feeling better by now for your trip.

My husband hit me on the rightside of my brain and I have feeling losing my balance and strong pain on the right side of head and face. Please help me. What to do? Are these symptoms of head injury?

Your husband hit you it’s time to LEAVE. Next step is death

My husband got me on the left side of my face/ear. It’s warm to the touch and starting to hurt. He’s hit several times since we’ve been married. (2001). He locks up the car keys so I can’t go anywhere. He’ll be furious with me if I were to call an ambulance or my dad to come get me.

My husband had been drinking alcohol, he fell and cut the top of his head. He had already vomited prior to the head injury. It has been about an hour and it is still having some bleeding. I know that head injuries always bleed more but how do I know of I need to take him to the hospital.

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