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)

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?

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!

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?

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.

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.

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?

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.

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.

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?

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

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

How would you describe "old me" and the "something else" that took over your body?

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?

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.

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.

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!!

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?

You should go to the hospital

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.

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.

My brother died from falling on concrete. He didn't have insurance and thought he couldn't afford to pay for the medical bills so he just went to bed that night after taking some Tylenol saying im fine and never woke up. My nephew went the next morning to see if he would go to work but he was cold. Now we take head injuries very seriously. He was only 30.

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!

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

So sorry for your family's loss.

My friend got hit in the head by a baseball going about 60 miles per hour blacked out for about a second then was ok and head didn't hurt about 2 hours later is that bad?
Thank you
I REALLY HOPE SOMEONE can PLEASE give me advice....I SERIOUSLY need it. This is regarding myself. Back around the beg of Feb, I fell and hit the very back, upper part of my head HARD on concrete. I was dazed, but got up and ended up falling and hitting the same spot. I have no insurance, so I didn't go to the Dr. Now,months later, I'm STILL dealing with dizziness....ESPECIALLY when moving from a laying down position. I've started getting a few headaches......the dizziness seems to becoming more intense when it does happen...and I'm nauseous... My question to y'all, is, could this be something serious? It's now may and that was 3 months ago.....if I had a concussion or a injury....could it be worse now? What could this possibly be? Also, even now, touching that part of my head, it still feels bruised. Any ideas or thoughts on what could have happens or what could be going on now, would GREATLY be appreciated!

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.

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

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?

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.

Thanks. Your words of advice and clear explanation helped me make a decision. Blessings!

I was in caye Caulker Belize when I fell down two steps on concrete floor. I was lifted up by two men and escorted to my vacation cottage. I started to vomit and had some trickles of blood from my nose. I was put to bed because there was not a dr on the island. I laid the next day as well and had to catch a plane back to the USA. I went to the ER the following day and a cat scan was done and drs determine I had a brain bleed. Was not allowed to go home. Was put on some meds and release the next day. It has been over a week and I still am very dizzy when I get up from a sitting or lying potion. I can hear very well from one ear. A scary thought that this can happen to anyone and being in a third world country really is scary time to have a brain bleed. It can take up to 6 mo to 2 years to clear.

This helped me a lot thnx

Thank you for the concise article.  It gave me exactly what I needed to know after I was knocked over and sent flying by one of my horses, landing on my back and crashing my head on the ground.  I was dazed but did not lose consciousness, but had a headache and was dizzy and sleepy the rest of the day.  The next day my headache got much worse and then I started vomiting.  Still I wasn't sure if I really needed to be checked out at a hospital as I wasn't sure what they could actually do for me if it was a concussion,  or what the risks were.  That's when I found this article and learned about the danger of a brain bleed and that a CT scan should be done to check for that.  That decided it for me,  even though no one likes a trip to the ER and all the waiting you typically have to do there.  (Fortunately in my country - Canada - there was no cost to me, which I admit makes the decision a lot easier).  They did a CT scan and gave me pain and anti-nausea medication through an IV.  Thankfully my scan came back normal,  but I am still glad I took the advice of this article and got checked.  I would urge anyone who has a head trauma  to do the same.  All you have to do is read some of these comments to see the dire and sad consequences that can and have occurred if you don't.

This really helps thank you

Eleven years ago, fell at work, passed out a few minutes and then a passed out again, fifteen minutes later and didn't remember the incident. While passed out during in second time, two managers came upon me, thought I was sleeping, could not rouse me, so just waited for me to regain consciousness. Didn't think to call Reedy Creek fire department for me. They suspended me, let me go to drive home in a daze. Next day, my friend tells me l probably have a concussion. So called work. Went to company first aid, they sent me to hospital Celebration in Florida...and then told me hours later.. Nothing was wrong with me. But I knew I wasn't right in the head..math skills screwed up, missing huge chunks of memory to this day. Oh, got fired too. So I learned not to trust big hospitals.

I fell flat on my face and banging my head above my right eye about 4 weeks ago, I have had a bad headache since and I'm feeling drained and can't be bothered to do anything, I'm normally an active lady but all I want to do is sleep and be left alone. I do feel a little sick sometimes. I don't want to go to hospital because I know they won't give me a cat scan because I had a bad fall years ago and they said I had trauma to my brain and it would settle. what should I I do about this injury?

I was taken to the emergency room in an ambulance after falling and hitting my head hard. My forehead above my right eye was bleeding, but I got no attention from the hospital, even to apply antiseptic and bandage the area.  With all the more serious illnesses and injuries continually pouring in, I was never seen for a ct scan or anything else. I had to go to urgent care the next morning and they didn't even have a ct scanner. 

I hit the front of my head on a metal merry-go-round when i was about six years old. I lost consciousness, but my grandmother just took me home. I was out cold for two days. My grandmother said i came back different. Maybe so, but no violent or antisocial behaviors. Still hit my head occasionally, but go to doctor every time.

Cat scans are very expensive. I had one a few years ago after I closed a trunk bike rack on my head at full speed, and I had insurance back then, but I saw the bill what it would have been without insurance and it was $4500. It's probably even more now.

I don't have health insurance so I might not go to the doctor it sounds expensive to receive a cat scan

I was in a car accident and I'm having confusion blurred vision loss of balance have fallen twice since, have gone to the ER twice, once had a CT of the skull of the brain and it showed no brain bleed. Could I still have a concussion or concussion syndrome?

Anytime you fall or hit your head (NO MATTER WHAT), even if its a light fall, you should take yourself or the victim to hospital. A simple cat scan can save a live. Most people die from falling because of brain injuries that go untreated . Be proactive.

On Monday (today is Thursday) I hit my head not hard on a brick wall. I have been feeling light headed when I get up ever since I did not go to a hospital because I was in no pain what should I do? I am still light headed when I get up.

I bumped my head really hard while getting out of the car. It's going to go be week on Sunday. I keep getting headaches were I hit my head. Is that normal?

I fell on the ice this morning, hit my head and back so hard, what should I do? Any help

You are absolutely correct about those around you needing to take some control about steering you to hospital. I collided with a piece of solid equipment at work with a bleeding scalp and seeing stars. No one suggested I see the ER docs even though this happened in the OR. 48hrs later with a bad headache and 'not feeling right' I attended the ER but had to accept the UK NICE guidance and so no scan was done. I was not able to be as forthright as I would normally be and, as my husband is not medical, he could not do it on my behalf. Few weeks later a skull fracture was diagnosed with a leak of CSF. I am a doctor. 

To the person who said there is nothing anyone can do -- yes, there is. My mom, at 83 years of age, had brain surgery not once, but twice to relieve pressure from bleeding. Five years later, she's still doing great. 

Good for Mama! I pray she lives to be 100.

I am 75 and hit my head on a steel car and had bad pain for 15 seconds. 5:00PM. I forgot about it and went and cooked dinner. Went to bed at 9:00PM. Awoke at 11:00PM from a dream and my vision was a mess. Things were all upside down. Hubby called 911 and they said I must of had a stoke and life lighted me to a big hospital. I was vomiting and they kept giving me shots. I was helpless as I kept sleeping from the shots. They gave me Heparin drips and placed me on Warafin. 8 weeks now and I still cannot walk straight. I wobble and feel like I may fall. I use a walker. All else is good except I am still having headaches at the top of my head and in my lower right back area. I do not think I had a stroke. I am diagnosing myself as having a concussion from the 5:00PM hit on my head. Now they want me on Eliquis for the rest of my life. I truly feel I was diagnosed incorrectly.

Pages