What to Do Immediately After Hitting Your Head

You hit your head. Maybe it was a fall, a car accident, a collision on the field, or walking into something in the dark. You might feel fine. You might feel off but not sure why. What you do in the next few hours matters more than most people realize, and the guidance has changed significantly from what many people were taught growing up.

First: Recognize When This Is an Emergency

Before anything else, certain symptoms following a head impact require emergency evaluation and should not be managed at home. Call 911 or go to an emergency room immediately if any of the following are present after hitting your head:

• A headache that is severe, worsening, or does not respond to over-the-counter pain medication
• Repeated vomiting (more than once)
• Seizures or convulsions
• One pupil that is larger than the other
• Extreme drowsiness or inability to be awakened
• Slurred speech
• Increasing confusion or unusual behavior
• Weakness or numbness in the arms or legs
• Loss of consciousness, even briefly

These symptoms may indicate a serious intracranial injury, including bleeding or swelling inside the skull, that requires immediate medical intervention. Do not wait to see if they improve.

If Symptoms Are Present But Not Emergent

Symptoms that are present but do not include the emergency indicators above still warrant medical evaluation, ideally within 24 to 48 hours. These include headache, dizziness, nausea, feeling foggy or slowed down, memory difficulty, sensitivity to light or noise, balance problems, and visual disturbances.

According to the Centers for Disease Control and Prevention (CDC), you do not need to lose consciousness to have a concussion. Fewer than ten percent of concussions involve loss of consciousness. The absence of that marker does not mean the injury is minor or does not require attention.

A primary care physician, urgent care provider, neurologist, or sports medicine physician can evaluate a suspected concussion, rule out more serious injury, and establish a management plan that reduces the risk of prolonged recovery.

Immediate Steps in the First 24 to 48 Hours

Stop the activity

If the head impact occurred during physical activity, sports, work, or any other demanding task, stop immediately. Do not return to that activity on the same day. This applies to adults and children. The brain is in a state of vulnerability following a concussion, and continued physical or cognitive exertion worsens the injury and increases recovery time.

Rest, but not complete inactivity

Current clinical guidelines recommend relative rest in the first 24 to 48 hours following a suspected concussion. This means reducing physical and cognitive demands significantly, but not necessarily lying in a dark room in total isolation. Screen time, reading, loud environments, and demanding mental tasks should be minimized. Light activity such as short walks is generally acceptable if it does not worsen symptoms.

Complete rest beyond the first 48 hours is no longer recommended by most clinical guidelines and may actually slow recovery by increasing anxiety and disrupting sleep.

Do not take aspirin or ibuprofen immediately

In the first 24 hours after a head injury, aspirin and ibuprofen should be avoided unless directed by a physician, as these medications can increase bleeding risk. Acetaminophen is generally considered appropriate for headache management in the acute period. Confirm medication choices with the treating provider.

Do not drink alcohol

Alcohol impairs the brain's ability to recover from injury and can mask worsening symptoms. It should be avoided entirely during the acute recovery period following a head injury.

The sleep question

The old guidance about keeping someone awake after a head injury has been revised. Current medical guidelines do not recommend keeping a person awake after a concussion. Sleep is important for neurological recovery. However, someone should check on the injured person periodically during the first night to ensure they can be awakened and are not showing worsening symptoms. If the person cannot be awakened or shows the emergency symptoms listed above, seek emergency care.

Monitoring Symptoms in the First Days

Concussion symptoms do not always appear immediately. Some develop over hours or days following the injury. Keeping a simple symptom log in the first week after a head impact is clinically useful, particularly if a medical evaluation is needed.

Note the time and nature of the original impact, when symptoms first appeared, what the symptoms are, how severe they are on a scale of one to ten, and whether they are improving, staying the same, or worsening. This information helps the treating provider make an accurate assessment and guides decisions about return to activity.

Watch specifically for symptoms that are worsening rather than improving after the first day or two. Worsening symptoms warrant prompt medical evaluation even if the initial presentation seemed mild.

What to Expect in the Days Following

For most adults, concussion symptoms begin to improve within the first week. Full recovery typically occurs within seven to fourteen days. Children and adolescents generally take longer, often two to four weeks.

During this period, pacing is the most important management tool available. This means staying within the threshold of activity that does not worsen symptoms, gradually increasing demands as symptoms improve, and building in recovery time after exertion. Pushing through significant symptoms to maintain normal activity levels typically delays recovery.

Headache, fatigue, cognitive fog, and light sensitivity are common during recovery and generally improve with time and appropriate pacing. If symptoms are not improving after two weeks or are significantly interfering with work, school, or daily life, follow up with a medical provider.

Return to Activity

Return to full physical activity, including sports and exercise, should follow a stepwise process guided by symptoms. The general principle is gradual reintroduction of demands, with each step taken only when the previous level is tolerated without symptom worsening.

No one should return to contact sports or high-risk physical activity on the same day as a suspected concussion. For organized sports, most clinical guidelines and many state laws require clearance from a healthcare provider before return to play following a concussion.

For children and adolescents, return to full academic participation should precede return to full physical activity. Cognitive demands can worsen symptoms and prolong recovery when introduced too quickly after concussion.

For a detailed guide to the recovery process, see our article: Concussion Recovery: What to Expect and What Actually Helps.

When to Be More Concerned

Most concussions resolve fully with appropriate management. Seek follow-up medical evaluation if symptoms are not improving after two weeks, if they are worsening despite appropriate rest and pacing, or if they are significantly affecting daily functioning.

When symptoms persist beyond three months, the condition may be classified as post-concussion syndrome. For a complete overview of PCS, see our article: Post-Concussion Syndrome: What It Is, Why Symptoms Persist, and What Families Need to Know.

For more on what happens when a concussion is not appropriately managed, see: What Happens If a Concussion Goes Untreated.

For Caregivers and Family Members

If someone in your care has hit their head, your observations in the hours and days following are clinically significant. You know their baseline behavior, sleep patterns, and cognitive function. Changes from that baseline, even subtle ones, are worth noting and reporting to a medical provider.

Your role includes monitoring for worsening symptoms, helping reduce physical and cognitive demands during recovery, and advocating for appropriate evaluation and management if the injury is being minimized by others.

If the person is reluctant to seek care or insists they are fine, particularly in an athletic or military context where there is pressure to continue, trust your observations. A brain injury that is dismissed in the acute phase carries greater risk of prolonged recovery and long-term consequences.

Related Brain Injury 101 Articles

• Concussion Recovery: What to Expect and What Actually Helps
• What Happens If a Concussion Goes Untreated
• Post-Concussion Syndrome: What It Is, Why Symptoms Persist, and What Families Need to Know
• Concussion in Children: Signs, Symptoms, and What Parents Need to Know
• Concussion vs Brain Injury: What Is the Difference?

Frequently Asked Questions

What should you do immediately after hitting your head?

Stop any physical activity, seek emergency care if you have warning signs such as worsening headache, vomiting, seizures, or confusion, and see a medical provider within 24 to 48 hours for any symptoms. Rest and reduce physical and cognitive demands for the first 24 to 48 hours.

Should you sleep after hitting your head?

Yes. Current medical guidelines support sleep after a concussion. Sleep is important for neurological recovery. Someone should check on the injured person periodically during the first night to ensure they can be awakened and are not showing worsening symptoms.

What should you not do after hitting your head?

Do not return to physical activity on the same day. Do not take aspirin or ibuprofen in the first 24 hours without medical guidance. Do not drink alcohol. Do not push through worsening symptoms. Do not assume you are fine because you did not lose consciousness.

How do you know if a head injury is serious?

Seek emergency care for worsening headache, repeated vomiting, seizures, unequal pupils, extreme drowsiness, slurred speech, increasing confusion, or weakness in the extremities. Any of these symptoms following a head impact requires immediate medical evaluation.

How long should you rest after hitting your head?

Relative rest is recommended for the first 24 to 48 hours. Complete rest beyond that period is no longer recommended by most clinical guidelines. Gradual return to activity guided by symptoms is the current standard approach.