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 (468)

Hi Alyssa, Can you make an appointment with your primary doctor or your GP?

If I banged my head by fainting twice yesterday and still dizzy and sick today sure I go hospital.

About 1 and half weeks ago I hit my head and knocked myself out (type1 diabetic had a low blood sugar ). I was seen my a dr in my local ed and sent home. Headache won’t go and I still don’t feel like my normal self. Worried.

My 11 yr old got hit in the right temple (forehead) with a metal water bottle at school. I wasn't there, but was told is was harder then a tap, and she had some swelling. Took her to urgent care to be looked at a day later and they said she doesn't have a concussion. However, today I received a call from the school nurse that her head hurts still, and last night she woke up complaining of the same thing. I gave her Motrin and it helped. The school gave her Tylenol, and that helped. Should I take her to the ER or should I see if it gets better.

Have you tried calling her primary care doctor? They would probably be able to provide guidance.

Hi -looking for some advice on post-concussion symptoms (6 mos. plus?). Back in July 2018 (6 mos. ago) took a fall, missing a 10" step onto a tiled floor. Never hit the ground but came within a few inches. Jerked myself up --all on the right side. Within 10 days neck pain, dizziness, headaches, exhaustion & insomina ensued. Told I had severe whip lash. Been to lots of docs since: GP, neurologist, orthopedist, and then mostly recently naturopathy and an osteopathy (who finally said you actually had a concussion and mild TBI) . HAd the typical MRI (got a thumbs up your brain looks good) back in August; x-ray of spine & neck also all good. Just showing some arthritis in neck from a similar neck injury. My nagging symptoms: muscle tightness and milder pain still in neck but more disturbing is headache daily over right eye, hot/warm feeling when turning head to right side and occasional facial numbness and tingling --mostly if I work too much, dont get enough sleep. Just concerned after 6 mos. why not going away !! I am 52 year old Mom who works part-time now, volunteers at school/scouts but still can't get back to full-time regular life activities. Any advice from someone with similar stuff ?

I would try a chiropractor! I had a whiplash injury years ago and chiropractic adjustments were the only thing that helped me.

Look into concussion therapy which is a type of physical therapy. My husband did the same thing - slipped down our stairs, briefly his head hit the stair and he didn’t even realize it. He was diagnosed with a concussion as well and had all the typical symptoms but they would not get better even months later and they affected his ability to focus, concentrate, his eyes wouldn’t work together, he was extremely moody (and he’s normally really mellow). He mentioned it to his PT who was working on the tension in his neck and back from the fall and the PT sent my husband to their concussion specialist who put him in a program to retrain his brain after the injury. It was extremely hard, but it worked and finally more than six months after the initial fall he was feeling more like himself. Find a concussion specialist. There is so much involved with a concussion. It is not just a brain bruise that needs time to get better. Good luck!

I got hit in the head with a beer bottle multiple times. Not hard enough to lump or anything but it hurt for a couple of days.  Since then I started having head pain. I can’t tell where coming from but think it’s the top of my head. I went to the hospital and had a cat scan. It’s been two weeks now with nonstop dull pain in my head that doesn’t go away. The pain just started 2 weeks ago but the hit was like 2 to 3 weeks before that. The cat scan came back ok. They said they didn’t see anything and since I can’t point out where exactly it’s hurting in my head they can’t do anything. I stress a lot over many things. Am I going to be ok? Could it just be stress? Am I going be ok since they said cat scan came back ok or should I still worry? I’m really worried.  Not sure how to check responses on here. please make sure I can see. I am worried

I'm so sorry that this happened to you Nolan.

Please do not worry honey, it will work out. I can't offer you an immediate solution but I can tell you what I would do. What I HAVE done. What I'm CURRENTLY in the midst of, lol!

Nolan, you're not crazy and I may SOUND like I am, lol, but rest assured, I am not (my family debates that).

Okay, since the scans have come back okay, you can start ruling things OUT... troubleshooting. This is good but there are a few things you might want to get in order first.

One, if you have a primary physician that listens to you that you trust, speak with them about how you're feeling. Explain that you will be needing to do some tests to rule out whatever is needed to in order to figure out whatever this mystery condition is that you have is so that you can start treating it RIGHT AWAY.  Nolan, if they are not on board, you find a physician who will be and work EXTREMELY closely with them. They may ask you to see specific specialists. Do it. 

Now, this is not to say that you have to start taking a bunch of meds. They may try to do that... throw meds at ya to get you out of their hair. All that will do is treat symptoms. You want to treat the condition or disease, not just the symptoms. Run labs/tests/samples and make sure that if it's not uploaded into a shared system, YOU GET COPIES. This way, your primary and special teams have access.

Next, support. You need to make sure you have someone to unload on. This stuff can get really overwhelming... therapy rocks. Lean on friends and family... sign up for yoga dude.

Lastly but MOST importantly. Believe whatever you will my dear but trust in God. THE HIGHER POWER. If you can just Trust for that Guidance even the slightest amount, you will see that this burden is MUCH lighter to carry at these super heavy times.

Slow it down a bit, be in the moment, understand that the journey you're about to embark on is an amazing one. It's one of strength, perseverance and humility.

Also... get yourself the audible book "The Mindful Way Through Depression". Not saying you're depressed, love. However, research shows that when people begin to suffer pain that interferes with life, stress, anxiety and depression have an easier foothold. This book breaks it down SO WELL and it has meditational exercises that were helpful as well.

Congratulations Nolan! You're about to tap into a new, better, stronger, you! God Bless You!

I slipped on ice yesterday and landed straight on the back of my head. Surprisingly there’s no lump on my head and its not too sore to the touch. But I am experiencing whiplash and can’t move my neck well and I get very tired when I move my face or try talking. I also feel as if my eyes are criss crossed and seem very sensitive to light. It’s also strange bc it has seemed to affect the left side of my brain and body more. My left side of my brain and my face will feel heavy and numb and fuzzy. I don’t know what’s happening.

a few weeks back i hit the left side of my forehead accidentally on the wall frame n i put ice on it. i took panado and it eased the pain. it was a bit sore but no bleeding or bump appeared. the uneasiness comes now and then. however today i woke up with pain on that side. i put ice on it again and it was quite painful. the pain was going down to my left eye and left temple. i took two panados. the pain is easing away. is it something for me to be concerned about? do I have to see a doctor?

My wife slipped on the ice and fell straight back on her head. She seems to be fine , just very sore and a nice lump on the back middle part of her head just above her neck. Neck is tight and sore. Not sure if I should make her go into ER or just keep an eye on her?

Same thing just happened to me. Went to Urgent Care, and passed all the neurological tests. I feel fine, except I have a sore neck. The NP at Urgent Care said a CT scan was not medically necessary, so I never got one -- even though I wanted one.

How did your wife fare? Did you get a CT scan?

I was walking down from my hilly and icy driveway thinking that I can master it again, but went totally different. I went down with the weight of the stuff that I carried. My lower body went first then I hit the back right side of my head. I stood up immediately. I started to feel some pressure around my brows. After few hours, I didnt feel anything wrong with myself. Even the area that was hit, doesn’t feel anything different. I’ve searched online about the symptons, called a nurse, and I don’t seem to have any pain going on. But the nurse still encouraged me to get checked. It has been 8 hours since I hit my head, I can feel some hollow feeling in the right top side of my head. Other than that, I am still debating if I need to go to ER to check. I’ve already scheduled an doc appointment to check myself in the next few days.

I slipped on ice today. I fell flat on my back and my head hit the sidewalk. I have a small headache and a little soreness in my neck. I had my hood on to my coat and a small clip in my hair. Hoping I hit the clip against concrete.

That exact same thing happened to me last Saturday. I finally went to the hospital on Thursday to make sure it wasn't serious, and there was nothing wrong. The doctor told me she didnt see any fractures, swelling, bleeding or anything abnormal. I was having some random headaches since then and some pressure feelings in my head that felt kind of unusual. But my doctor said that a hit that hard will take at least 2 weeks to return back to normal.

I fell last Monday striking the back of my right side of the head. I saw my optometrist and had a full retinal scab that showed no brain bleed. I did go to the chiropractor felt great the first couple of days however I cannot stand without nausea, a headache and right sided pain. I cannot stand bright lights. My husband thinks I’m faking. I don’t feel like my self. I am a nurse and know that concussions take time to heal. What do you if you can’t even stand? Without vertigo?

"My husband thinks I’m faking."

How awful. Why on earth would anyone fake this. Swap him out....

Earlier today, I was in a fight and got punched hard on my head. It didn't hurt at first but after about 20 minutes I begin to have a huge headache and when I touched where I got hit at there is this knot. I've had this headache for over six hours now and I don't want to go to the hospital for something mild and not serious, what should I do.
P. S. I'm only 14, would it be serious?

I was punched in my face and supposedly knocked out. I got told i was unconscious for a short while, and they poured water on my face to try and wake me. Eventually i responded and reportedly drove home. I do not remember driving home, i do not remember getting punched or anything. When i woke up the next morning there was blood on my pillow which drained from my ear. I cannot look at bright lights or hear loud sounds or its excruciating. The next morning i was vomiting and couldnt hold any food down and my head has been in constant pain. I dont know if this is common for a concussion and i should kust keep resting and taking aleve, or go to the hospital. I already have a lot of medical bills and cant really afford anymore but if its the difference between life and death or serious injury i guess ill go. I just dont know what to do.

David, Of course you should go to the ER! ALL of those symptoms are caused by severe head injury! I know medical bills can pile up, I’m sorry, but yes, this is a life and death situation. Also, there’s a chance for possible brain damage from not getting any treatment at all. Take care!

Earlier, about 3 hours ago, i was at the park with my friends and i was on the swing. One of them pushed it really hard and it flipped over, taking me with it. I hit the back of my head pretty hard and I was really dizzy for a few moments after. When I went home, i started developing a headache and felt sleepy. I told my parents during dinner and they were concerned, and told me to get some sleep. As i was getting ready, my back suddenly started hurting. I was told to just lie down with like 3 pillows elevating my head. I'm worried on what to do next. Is this serious?

ive sustained a head injury yesterday evening. i stood up while sitting on the lower bunkbed and hit my head realy hard. i didnt vomit and there dont appear to be any bleeding. immidiatel after i had trouble keeping my eyes open, felt like i going to throw up (which i didnt) and had problem with balance. i quickly got to the 24\7 clinic where there theykept me for an hour and half to watch me and see if everyhting is ok. after thaty i was released since i appeared to feel better. a shower later and a terrible headache at night i woke up in the morning sensitive to lights and strong sounds. my head is still sore and the place which connects to my neck is as well. im worried, how do i know ill be fine and my brain isnt slowly bleeding out? the doctors there assured me im fine and gave me advil for the pain but i cannot be sure.
sincerly a concerned young adult.

Hi I got hit with a bottle of water half full someone was trying to throw it at my friend but unfortunately it hit my back right side of my head so it didn’t hurt at first I thought wow that hit hard so about a week or so later I notice it hurt in that spot I touched it nothing was noticeable by touch so a few days later it quit then I think I pulled my neck muscle cause my neck was a little stiff for a few days it’s healed pretty much now but it’s been a week like I said after the water battle thing now I feel a little dizzy later in the day and tired in the middle of the day and off balanced a little I haven’t lost conciseness or anything severe

Is there any recommendations for me to do to heal it I believe I have a concussion or a small one at least I hope

So I have been having seizures right but the doctors tell me they are pseudo seizures. I don’t know though. I have the worst symptoms ever. My head goes numb, I have verdigo, nausea, weakness on one side, slurred speak at times. Nobody will listen to help me and all my parents think I am fine and just tell me to get over it. Plus the doctors won’t do anything and won’t let me have a ct scan Because my one a few months ago came back normal what should I do I feel like I’m getting worse

You should continue to go to your doctor and seek a remedy for your medical problems. If he/she does nothing, you may need to change physicians.

On October 27, 2018, I fell hitting my left brow bone on a cement floor. It was bad enough I should have called 911. I am on SSI, very TIGHT budget. Lucky to get groceries. I hurt so bad, touching it was not an option. I had the whole left side of my face, both eyes and my ear, almost back with purple, orange etc. Started having blurred vision and bad headaches. Now I am having them 24/7. What should I do?

Glad to know I’m Not alone here! I’ve been sleeping a lot ( it’s all I do!!) after being hit on the back of the head & back by my apt buildings front door! Swung off the hinges & hit me HARD knocking me down. Having all symptoms of a concussion, guess I need to go to ER!

I slip while I'm in the shower and I hit my right side of my head. I was dizzy for few seconds. I need to know what I should look for after this incident?

I know the feeling I have fallen 6 times in the bathtub hitting the back of my head and neck every time. My husband and I work opposite schedules so when I'm in the shower he is fast asleep. This last time gave me such a headache trying to sleep is painful because no matter how I sleep it hurts. My doctors act like its no big deal because I didn't pass out.

I fell backwards and hit my head on the concrete 4 days ago. I felt weird, shaky and tingly after the first day. The last 3 days I still feel kind of weird and all I want to do is sleep and that is not like me to do. I am thinking of going to the ER but not sure if I am overreacting or not.

I fell 3 days ago. I fell face first hitting my forehead then my nose. It hurt so bad I was screaming a d crying. Blood was everywhere as my nose was bleeding like crazy. I am also taking warfarin (blood thinner). I had a really bad headache too. I felt at the time I should have gone to the ER to be safe. My husband thought I would be okay so I didnt go. I no longer have a headache. I just want to be assure since this happened several days ago that I am okay. I have 2 black eyes and a huge knot on my forhead besides that I feel okay. Nancy Q

Nancy it’s always better to be safe than sorry. Especially since you are on Warfarin, you would be more likely to have a brain bleed than the average person. Your doctors office should also have an on call service don’t be afraid to use it, that’s what they pay them for! :)

I had a reaction to eating seafood 6 nights ago, I fainted twice and fell face first in the bathroom tile. Goose egg over right egg brow, swollen nose bridge, and cut up gums above top teeth, luckily no blood. I went to emergency, they did ecg and blood test but they never checked my head or brought up concussion stuff, yesterday I was totally fine, today my forehead has mild headache, I’m hoping this is from healing and not some internal bleeding or concussion...? Ugh, anxiety gets the best of me!

I fell this morning. I landed on by back on our front porch, I was dizzy and could not get up for a few minutes. this happened about 4:45 this am, I was getting ready to leave for work. now at 10:00 am I feel dizzy and have a headache. I just don't feel right. need advice on what I should do.

Shit. I fell yesterday. At lunch. Walking back to the work truck. Fell hard. Landing on the back of my head. Like straight on the back of my head. I weigh 250. 6'0 tall. I hit HARD! Hardest fall ever. And today, I can not get up on my own. The muscles in my neck feel like I'm being held down by my throat when I try to get up. Everything hurts from my back to my calves. It's super crazy.

I hope your okay... I would say get checked out to make sure nothing major is wrong.

Yeah, go to the ER...

My husband has stitches on his forehead and scrapes on the back of his head. He went to the hospital and they said they would call us if he had a concussion. They did a CAT scan. Should I keep checking on him tonight or can I go to sleep and not have to worry?

I was struck on the left side of the head with a foam dodge ball really hard and I started to cry and freak out. At first, I thought it just shook up my nervous system and didn't think about it, but after at least 5 hours, I still feel pain whenever I move around. I feel it on the top right side of my head if that helps. Is this a concussion or did I just get a headache? I feel like I should go to the hospital but I don't know if it is very serious or not. Should I go?

my husband fell on ice in the driveway. fell flat on his back and smacked his head. He got up, was fine, about 1 hour later nausea and headache. He never got checked out. Now he has pressure behing his eyes, bridge of nose, etc. sensitivity to light and reading? Should he go to ER?

I hope you did! These are tel tell signs of a concusion

Yes! And lots of rest! No TV, phones, reading, stress etc! I wish someone has told me this early on! It took me 5+ years to feel normal again

I was trying to hang an air freshener. I'm 5'3 so I use a step stool. I slipped off of the stool and the air freshener slipped out of my hand and hit my temple. I've been dizzy/light headed since. Any thoughts?

Years ago I was an assistant manager at a convenience store. I was working 2nd shift with one other employee who hit his head really hard on a low doorway to a cooler. He was dazed and kind of slurring his speech and couldn't stand up without leaning on something or focus his attention on anything. I couldn't take him to the hospital because I would have had to close the store if I did and there was nobody else I could call in at that hour (about 11 at night). I also didn't want to call an ambulance because the kid had no insurance and no money. So I called the Manager and said that the employee was injured and needed to go to the hospital. The Manager reluctantly came and got the kid and took him to the ER (and had to wait there with him for hours). He came back and told me it was "just" a mild concussion and fired me. I always wondered if I was really in the wrong for insisting that he had to go to the hospital. I appreciate this article because now I finally feel vindicated.

You did the right thing. My mother is an HR director for a factory. She would insist her employee seek medical attention if there was a possibility of a concussion. Your boss was a d*ck and you could have fought that. That's bullsh*t. Good on ya though! You were justified!

That’s a violation of Labor Laws. You are protected by OSHA Whistleblower Law for reporting workplace injuries. Get a good labor lawyer!

God will open up another door of better employment for you, keep doing the right thing as for the manager pray for him clearly his heart was in the wrong place.

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