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 (474)

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.

You could likely sue for wrongful termination! You did the right thing but next time call an ambulance!

My friend bang her head on a ice skating ring. She feels a lil dizzy right after she bang her head. And had a lil head ache. Should she go to the hospital?

It happened to me this evening, I was going along building up speed & within a split second I was on the ice with a paramedic helping me up! The back of my head was bleeding bad, I put my hand on it & my hand was satuated in blood. I think "Novice Ice Skaters" should wear head gear of some sort seriously...

About 27 hours ago I was struck in the mouth by a piece of firewood and my lip and adjoining area split and some front teeth are sore. I was stitched up at Urgent Care where my husband drove me. I woke with a headache this morning and some ringing in my ear (which does happen now and again). The headache is getting worse despite having taken Tylenol. I was unable to eat last night so not sure if that is a factor but I'm not sure if I should be worried about being alone when my husband leaves for 2nd shift work. Do headaches continue to intensify over this time period? I did not lose consciousness and was able to grab a handful of snow to hold against the wound and walk out to find my husband at the wood lot to have him drive me. Not sure what else I should mention. The NP who stitched me up never mentioned concussion to me as a concern although I did feel woozy. The office was very busy so maybe it was an oversight?
Thank you for any feedback.

i hit my head pretty badly 7 years ago ,when i fainted and hit the back of my head on the cemented floor. after the fall, felt bit of concussions and i felt like normal person again. but since then been getting terrible migraines and sleeping difficulties and i noticed that my speech deliverance somehow making me stutter a lot these days(currently) . having difficulties in studying also if focusing way too much causing painful headaches. didnt go to the hospital for checkups tho. is it bad? serious after effects? help me please.

This happened on Thanksgiving, it was around 11 pm and I had taken my medicine, seroquel, when I was leaving the bathroom my vision when blank and I woke up in my room. I remember hitting my head on my desk and waking up on the floor. It was just a complete collapse.

My heart was beating quickly and I was shaking.

The last two days I’ve only felt worse and I’ve felt this constant steady pressure on the right side of my head, I’ve been dizzy and just out of it. I know that two days has gone by but it feels like it hasn’t been that long at all.

I had to leave work early today because there were too many noises and I just felt so dazed.

I’m pretty sure I have a concussion but idk it I should go to the doctors or the hospital. I feel fine, just out of it and just so sleepy all the time.

You should DEFINITELY go to the hospital!!

Your situation is a particularly alarming one and definitely requires the expertise of a well-qualified medical specialist. Go to the best facility you can.

I was really angry I blacked out and smashed my head in a brick wall but it was the top of my head it is very painful to touch and I'm finding it very painful to move my neck should I go to the hospital or is it something seriously wrong?

This happened on Thanksgiving, it was around 11 pm and I had taken my medicine, seroquel, when I was leaving the bathroom my vision when blank and I woke up in my room. I remember hitting my head on my desk and waking up on the floor. It was just a complete collapse.

My heart was beating quickly and I was shaking.

The last two days I’ve only felt worse and I’ve felt this constant steady pressure on the right side of my head, I’ve been dizzy and just out of it. I know that two days has gone by but it feels like it hasn’t been that long at all.

I had to leave work early today because there were too many noises and I just felt so dazed.

I’m pretty sure I have a concussion but idk it I should go to the doctors or the hospital. I feel fine, just out of it and just so sleepy all the time.

I have depression and I hit my head a lot. I have many headaches, and sometimes I forget things really easily. My dad says that I don’t have an injury in my brain. He’s a anesthesiologist so he should know about this stuff. I’m still not sure though, so I just want to know if I have a brain injury or not.

Hi
I triped and tryed to catch myself. In doing this I ran head first into my front door. I hit the left side of my head hard. I didn't black out. I had a large bump on my head. Now it's 3 daya later. Bump went down but head still hurts and it hurts to touch the area. I feel a bit like my head is in a cloud. Should I get checked out or give it time?

I tripped and fell into a brick wall hitting my head off of it and fell down on my knees this past Tuesday (11/20). I went to the ER to get checked out...had multiple x-rays done and was diagnosed with a broken nose, sprained wrist and bruised ribs. I am having horrible headaches since and have started to feel nauseated and a little lightheaded...mind you I did not black out on initial injury. Should I go back and getting rechecked?

26yr son said felt dizzy and fell on kitchen floor hit head on door fridge went to get up fell again and hit side of face on floor..refusing ambulance and taking to dr.. Kept checking on him every hr when sleeping ..how can i help as a mum

I got up to fast from my bed, fainted, hit my head on the back of my head pretty hard on my carpet but then i woke up from the faint immediately, my neck hurts but i feel fine, should i be worried?

Got a small injury above my left eyebrow just near the temple with a steel ring it's a small injury but swelling and bleeding were there..... after 2days severe headache started in temporal region to occipital region 24/7 pain... back of my neck also paining then while sleeping i couldn't turn my head so that i woke up,while opening my eyes I felt very sharp pain in occipital region.... then after 1 or 2 mins I was able to turn my head... why is this happening?

Two days ago I hit a slick spot on my porch and hit my head full force I went a day later to the hospital and the did a ct scan and said everything was normal both sides of my neck hurt and head has a lot of pressure and base of neck is sore and I still feel weird it that normal

I have taken several blows to the head and my head is swollen around my temple arteries, what do I do?!

I fell on my face Monday. I went to the ER and had X-rays and CT scans. No brain bleed and broken bones in head or face. Broken wrist and nerve damage. Diagnosed with a concussion. Vomiting and nausea, pressure and migraine day 2 and 3. Should I go back to the hospital?

Absolutely

My friend sasha has a bad migraine and she noticed bumps on her head and she was bleeding. What do me and sasha do to stop the pain?

I fell down my balcony and hit my head below on concrete. I didnt wake up until the next morning. Was taken to a hospital where I was diagosned with 2 brain bleeds. I still have trouble walking . This happened on May 31, 2018. I had Guillian Barre Syndrome starting in December 2016 which I got from a flu shot. I couldnt walk properly for 7 months when I had GBS and Im wondering if I have a recurrence of GBS now. Is it normal not to be able to walk properly after 2 brain bleeds.

About an hour ago I rolled down 7 stairs hitting the top of my head straight into the wall. I have a big bump, but did not loose consciousness or feel dizzy. I just ake all over my body and where the bump is. I have an ice pack now. Should I worry?

It would still be a good idea to go get that checked out! You never know how serious it could be.

I have the same problem

I have a history of concussions, yesterday my 2 yr old daughter head butted me right on the corner of my eyebrow. It felt as though someone had dribbled my brain like a basketball and I felt really off for a minute, but I had only a little pain afterwards and didnt feel any sort of headache until about 24 hours later. I currently have had a bad pressure headache in that exact spot for about 2 hrs now. Should I worry?

I have had epilepsy all my life due to my mother for drinking while pregnant with me. Years later I have had one too many blows on my head that so much so, that I am now dealing with 4-8 seizures every night. And now I’m wondering if I should go to the er because earlier today, I hit the top of my head with the corner of the bathroom door, I simply thought to myself to just brush it off and just proceeded to go to the grocery store. But what I thought was an aura, because of the sudden blurry vision and the warnings I’ve had before with auras, I had to call my boyfriend up to let him know that I was having an aura, and I was about to have a seizure. The last one I had before this one, I was able to get up and walk away shortly after leaving the hospital. But I had a much harder time being able to do that this time around, and my head felt like it was on fire and my rt side of my neck hurt when I am trying to get up or move it to the right. So now I’m wondering if I should still go to the hospital or not??!! What do you think I should do?

Hello I was running in the rain to get into my suv while trying to keep my glasses from getting wet and tried to jump in really quick and hit the top of my head on the inside of the door frame since I jumped up to get in and didn’t see it since I had my hand over the top of my glasses to keep them from getting wet I heard a crack and only the top of my head hurt really bad that day but now almost a month later my neck and spine still hurt and get stiff from time to time especially when I’m driving or sleeping and I get headaches but not sure if it’s more than usual and I find myself forgetting something while telling someone something a few times in a conversation

Over 5 months ago I hit my head and it swelled to the size of a large grapefruit! I'm still having headaches and my neck hurts bad. I use ice on the back of my neck/skull to lessen the headaches every day and night! 2 weeks ago I hit the other side of my head. Now sharp pains shoot straight to the back and top of my eyeballs. Memory is bad and I forget what I'm saying mid-sentence and I feel woozy.

I'm no doctor when in doubt go to the hospital. Sounds like you might have blood building inside causing pressure when this happens you will get back and spine pain from the pressure. You need to go NOW.

On Tuesday I fell backwards while playing Pickle Ball hitting the back of my head on the concrete. I heard a crack sound when my head hit but do not think I passed out; other players were right there helping me get up.

I had no symptoms anywhere on my body including my head. On Thursday, I played Pickle Ball again. A nurse was present and said keep a eye out for headaches, dizziness etc due to my being 72 years old.

On Friday afternoon I noticed a very slight pressure feel in my head and called my doctor's office. They said not to worry unless symptoms are severe. Is this okay? I cannot tell if I am worrying too much or not!

What did u reply?

Last night I tripped and fell in the dark and my head bounced off the floor, laid there for a few moments dazed and confused. Has I was trying to get up I managed to pull a 6lb jewelry box off the dresser onto my head. After 20 minutes of laying in the floor I was able to get up but was super dizzy nauseous and my vision was blurry on the side I hit. Both times I was hit just so happens to be the right side of my head. All this happened at 8:30-9 at night and my blurred vision has continued over to this morning. Any ideas what I should do

Me and some mates were jumping round across benches, the gap was large but we made it fine. When it was my turn I jumped, landed on one foot and then as if it were a cartoon character falling over a banana, I fell backwards (luckily my body shifted enough for me to land on the bench and not the concrete floor) and whacked my joints, legs, etc. and then the back of my head smacked the bench as if someone fell backwards off a scooter going down a slant. I was fine for a few hours, my body ached a bit but now my body aches even more and now I have a painful headache. Not fun.

My ex beat me pretty bad in late March. I had a knot above my temple. Was dizzy, nauseous n couldn't get myself together for over a week. Now today I'm so dizzy I am walking like a drunk. Could it be as a result of my beating

Go to the hospital and press charges while you’re at it.

I was playing on the floor with my grandsons yesterday. I was laying on my stomach, and the 2 1/2 year old climbed on my back and was standing. Next thing I know, he jumped up then landed on his butt... on the back of my head / neck. I heard a "crack", and my face hit the floor (with glasses on). I screamed. Took me a minute to get up. I was pretty sure the rest of the night. Woke up this morning with the pain in the back of my head being worse... don't know if I need to go see a dr or not?? Or just wait it out.

Hi, I fell and banged my head on wall 5 days ago. I didn't know I did it until I woke up the next day. My head was bruised and small cut. I bathed and it's ok but have a minor headache and bruising. Is this normal after 5 days to still have a headache?

So back in 2011 I remember being in the Marines and getting drunk one night. I woke up with the worse headache ever and I thought it was a hangover because I've never gotten one I thought it had finally happened.

My buddies tell me that I slammed my head against the metal door in our room because I was too drunk and opened it way to hard and fast. Now I don't remember any of it or even when we started drinking.

But I remember the day after I had the worst headache, I was dizzy, and felt nauseous all day. I'm wondering would that have any long lasting effect? Because I never went to see a medic and within 2 days I finally felt better.

A thing I've noticed though is I have random times of slurred speach and can't for the life of me remember people's names. But I can't tell where my PTSD begins and the brain damage ends.

Should I still get a CAT scan from the VA or is the damage done and I missed my opportunity?

What is it called when hit head twice. 1st in front & then back

Whip lash ? Forward and backwards movement of the head . Like when your in a car accident or for small children "shaken baby syndrome"

I was going out to my car last Friday. I fell in the parking lot and landed on pavement on the left side of my head. I was unconscious for 2-3 mins. They said when I came too the were trying to get me in the car to take me home. I got very combative and vomited. I’ve never been combative. They took me home my roommate who has known me for years said I had garbled speech. My boyfriend who took me home and was mad at me. Thought I was drunk and acting this way. My roommate then said I started walking down the the middle of the street. He came up asked me where I was going. Well, he also thought I was just drunk. He took me home I slept until Sunday. Got up head hurt really bad and I had a huge knot on the left side of my head. Finally my head hurt so bad on that side, my vision was blurry, I couldn’t find words when trying to talk. When I went to the ER I’m black behind my ear all the way up the almost the top of my head and it’s huge. The nurse and Dr was lifting my hair up to see how big the black area was. They sent me to a CT stat. They came back to tell me I had 2 blood vessels that slow leaked luckily sealed and I had a lot of blood on that side. Told me that I had moderate Traumatic Brain Injury with hemorrhaging and a concussion. Told me that I was lucky to still be alive. Since then I have done nothing but sleep. My boyfriend of 9 1/2 months broke up with me and was listening to all the people saying I was crazy because I was so combative. I let him know about what the Er said. But, he just said he did know what too say but he was done with this. I didn’t even doing anything. But, my question with a head injury like I have was I combative because of the injury when I came too? I can’t remember anything

I had a small head injury and as well as injury on my forehead and got unconscious. It was due to a motorcycle accident. After the incident I had severe head aches for 3 days now from the time the accident happen and also scenarios of vomiting. What should I do?

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