When Should You Go to the ER After a Head Injury?

Not every head injury is an emergency — but some are

Most concussions don't require emergency medical care. The majority of people who sustain a concussion will recover with proper management and don't need hospital-level intervention.

However, some head injuries involve complications that are urgent and potentially dangerous. Knowing the difference matters.

Go to the ER immediately if you notice any of these

These symptoms may indicate a more serious brain injury — such as a bleed, swelling, or skull fracture — that requires urgent medical evaluation:

• Worsening headache that keeps getting worse over hours
• Repeated vomiting (more than once)
• Seizure or convulsion
• Loss of consciousness lasting more than 30 seconds
• One pupil larger than the other
• Increasing confusion or inability to recognize people or places
• Slurred speech or inability to speak clearly
• Weakness, numbness, or tingling on one side of the body
• Inability to walk or severe coordination problems
• Clear fluid from the nose or ears
• Significant drowsiness — unable to stay awake or very difficult to rouse

In children, also watch for:

• Inconsolable crying
• Refusal to eat or nurse
• Any of the above symptoms

When in doubt, go to the ER. It's always better to be checked and reassured than to miss something serious.

When the ER may not be necessary

If the head injury was mild and you're experiencing typical concussion symptoms without the red flags above, the ER may not be the most useful next step. Emergency departments are designed to rule out life-threatening conditions — not to manage concussion recovery.

A typical ER visit for a minor head injury will involve a neurological screening and possibly a CT scan. If those are clear, you'll likely be discharged with instructions to rest and follow up with your doctor.

This is appropriate. But it's also where many patients get stuck — the ER rules out emergencies but doesn't provide a path forward for persistent symptoms.

What to do after the first 48 hours

Once serious injury has been ruled out (either by the ER or by a physician), the focus shifts to recovery management. This is where concussion physiotherapy fits in.

If you're experiencing headaches, dizziness, brain fog, neck pain, or sensitivity to light and noise in the days following a head injury, a concussion assessment can identify what's driving your symptoms and start targeted treatment.

You don't need to wait weeks to seek help. Current evidence supports early assessment and active management — not prolonged rest and waiting.

A note on scope

We're physiotherapists, not emergency physicians. We don't diagnose brain bleeds or fractures, and we don't replace emergency care. What we do is provide expert assessment and treatment for the symptoms that follow a concussion — once urgent conditions have been ruled out.

If you're unsure whether you need the ER or a physiotherapy assessment, call us. We'll help you figure out the right next step.