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What to do if…
you hit your head and later develop worsening headache, nausea, or unusual sleepiness

Short answer

With worsening symptoms after a head injury, go to the Emergency Room now. Call 911 immediately if you’re very drowsy/hard to wake, vomiting repeatedly, having a seizure, or acting confused.

Do not do these things

  • Do not “sleep it off” alone if you’re unusually sleepy, your symptoms are worsening, or you’re hard to wake.
  • Do not drive yourself if you feel sleepy, dizzy, confused, or your symptoms are worsening.
  • Do not drink alcohol or use recreational drugs after a head injury.
  • Do not take sedating medications (sleep aids, strong sedating antihistamines, sedative pain medicines) unless a clinician tells you to.
  • Do not start taking aspirin for pain after a head injury unless a clinician tells you to. If you’re prescribed aspirin or blood thinners, do not stop them without medical advice.
  • Do not ignore repeated vomiting, a headache that’s getting worse, or increasing drowsiness because the injury seemed minor.

What to do now

  1. Call 911 right away if any danger sign applies. This includes: a headache that gets worse and does not go away; repeated nausea or vomiting; looks very drowsy, cannot be woken up, or cannot stay awake; seizure/convulsions; slurred speech; weakness, numbness, or decreased coordination; one pupil larger than the other or double vision; increasing confusion, restlessness, agitation, or unusual behavior; cannot recognize people or places; loss of consciousness and now worsening.
    • If the injured person is a child: call 911 or go to the ER right away if they have any of the adult danger signs above, or if they won’t stop crying and can’t be consoled, or won’t nurse/eat.
  2. If symptoms are worsening but you’re stable, go to an ER now. Worsening headache, nausea, or unusual sleepiness after a head injury is a reason to choose the ER/ED rather than “waiting to see.”
  3. Do not stay alone. Have someone stay with you (or keep the injured person with you) through the next sleep/overnight period and seek urgent care if symptoms worsen.
  4. Treat it as higher risk and choose the ER promptly if any apply: you take blood thinners (or have a bleeding disorder); you’re an older adult; the impact was high force (car crash, significant fall); you had any loss of consciousness or a memory gap.
  5. Reduce strain while you’re getting help. Rest quietly; avoid screens/bright light if they worsen symptoms; sip water; try bland food if tolerated. For pain, acetaminophen is usually the safest first choice unless a clinician has told you otherwise.
  6. Bring key info to the ER (or have it ready). When and how the injury happened, how symptoms have changed, any vomiting episodes, any blackout/memory gap, your medication list (especially blood thinners), allergies, and major medical conditions.

What can wait

  • You do not need to decide whether this is “just a concussion.” The key decision now is urgent evaluation because symptoms are worsening.
  • You do not need a detailed symptom log; just keep the timing of the injury and what worsened clear.
  • You do not need to decide today about work, school, sports, or driving until you’ve been evaluated.

Important reassurance

It’s understandable to feel alarmed when symptoms worsen later — that’s exactly why “get checked” guidance exists. Going in now is a protective step to rule out serious problems and get the right monitoring or treatment.

Scope note

These are first steps only. Recovery guidance (rest, return to activity, follow-up) depends on the ER evaluation and clinician instructions.

Important note

This is general information, not medical advice or a diagnosis. If you’re unsure whether someone is “more sleepy than usual,” or the injured person is a child, pregnant, or medically complex, choose urgent evaluation rather than waiting.

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