I Hit My Head and I’m on Blood Thinners – What Should I Do?

We fight aggressively to maximize your compensation and ensure you receive what you deserve.

Call: 405-605-2426

Immediate Steps to Take

URGENT: If you hit your head while on blood thinners, seek immediate medical attention—even if you feel fine or have no symptoms. Internal bleeding can occur without warning and may become life-threatening. Do not wait and see; get a prompt medical evaluation to protect your health.

If you’ve hit your head while taking blood thinners, seek immediate medical attention. Do not wait to see if symptoms appear. A slow bleed can worsen without obvious warning signs.

Call 911 or Go to the Emergency Room If You Experience:

The following list outlines critical symptoms you should watch for after a head injury while on blood thinners:

• Loss of consciousness, even briefly
• Severe headache after your injury
• Vomiting after hitting your head
• Confusion or feeling disoriented
• Vision problems or double vision
• Difficulty speaking or slurred speech
• Weakness or numbness anywhere
• Seizures or convulsions
• Blood or fluid from your ears or nose

Even Without Symptoms, Seek Medical Evaluation If:

Seek medical evaluation if you meet any of these criteria, even if you have no symptoms.

• You hit your head hard enough to feel pain
• You fell from any height
• You were in a car accident
• You’re over 60 years old

You take warfarin, apixaban (Eliquis), rivaroxaban (Xarelto), dabigatran (Pradaxa), or another anticoagulant.

What to Tell Medical Personnel:

When speaking with medical personnel, be prepared to provide this information:

• Exactly which blood thinner you take and the dosage
• When you last took your medication
• How the head injury occurred
• Any symptoms you’re experiencing, even if minor

Consider wearing a medical alert bracelet that indicates you take blood thinners – this can be lifesaving if you become unconscious.

Understanding Your Risk

Taking blood thinners significantly increases your risk of serious complications from head injuries. Here’s why your situation requires special attention:

The Statistics

Traumatic brain injury affects more than 2.8 million Americans annually, according to 2023-2024 data. Updated June 2024. Seek immediate care if you suspect a head injury while on blood thinners.(CDC Data, 2022-2023)

As of 2023, more than 10 million Americans are prescribed blood thinners—a 45% increase since 2016. Updated June 2024. This rise highlights the importance of understanding head injury risks.(CDC/NCHS 2022-2023)

Patients on blood thinners who experience head trauma have a significantly increased risk of brain bleeding, with studies showing a 5–7% risk of intracranial hemorrhage after even mild head injuries (CDC, 2022; JAMA, 2023).

Why Standard Protocols Don’t Apply to You

According to the AHA 2023 head injury protocol, patients on blood thinners who experience head trauma should receive immediate evaluation.

For patients not on blood thinners, doctors often feel comfortable discharging them from the emergency department after a normal head CT scan if they have no symptoms. However, this standard approach may not be appropriate for patients taking blood thinners, where immediate discharge after a normal head CT may pose additional risks.

The anti-clotting effects of your medication mean that serious bleeding can start more easily, continue longer, and be harder to stop. Take extra precautions to prevent head injuries.

• Bleeding can start more easily
• Bleeding may last longer
• Bleeding is harder to stop
• Bleeding may occur hours or days later

Warning Signs That Require Emergency Care

After a head injury while on blood thinners, you need to monitor yourself carefully for signs of internal bleeding, such as worsening headache or nausea.

Immediate Red Flags:

If you experience any of these immediate red flag symptoms, seek emergency care right away:

• Severe or worsening headache
• Repeated vomiting
• Increasing confusion or disorientation
• Trouble seeing or double vision
• Difficulty staying awake or loss of consciousness
• Seizures
• Weakness or numbness in arms or legs
• Difficulty speaking or slurred speech
• Loss of coordination or balance

Subtle Signs That Still Require Attention:

These subtle symptoms still require medical attention:

• Persistent mild headache that doesn’t improve
• Nausea without vomiting
• Feeling unusually tired or drowsy
• Mild confusion or trouble concentrating
• Personality or behavior changes
• Sensitivity to light or noise

Remember: You cannot tell when an accident causes internal bleeding in your head. The bleeding may not cause symptoms immediately, which is why medical evaluation is crucial even if you feel fine initially.

Why Blood Thinners Make Head Injuries More Dangerous

Understanding how your medication affects bleeding can help you appreciate why head injuries require immediate attention when you’re on blood thinners.

How Blood Thinners Work

Blood thinners affect your body in the following ways:

Blood thinners don’t actually “thin” your blood. Instead, they work through two main mechanisms:

There are two primary types of blood thinners:

Anticoagulants (such as warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto), and dabigatran (Pradaxa)) help prevent blood clots. After the first mention, we refer to each medication by its generic name only. Antiplatelet medications (such as aspirin and clopidogrel (Plavix)) prevent platelets from clumping together, reducing clot risk. After introducing each by generic (brand), we use only the generic name in subsequent references.

The Problem with Head Injuries

These are the primary ways that blood thinners make head injuries more dangerous:

When you hit your head, small blood vessels in your brain can tear. Normally, your body would quickly form clots to stop this bleeding. However, blood thinners interfere with this natural process, meaning:

Blood thinners increase the risks associated with head injuries in these ways:

• Bleeding starts more easily from minor trauma
• Bleeding continues longer since clots form slowly
• More blood accumulates where it shouldn’t
• Pressure builds up inside your skull

Types of Dangerous Brain Bleeding

The main types of brain bleeding include the following:

The term “brain bleed” refers to bleeding anywhere inside your skull. There are several types:

Outside the Brain Tissue:

Types of bleeding that occur outside the brain tissue include:

• Epidural hematoma: bleeding between skull and brain covering
• Subdural hematoma: bleeding between coverings
• Subarachnoid hemorrhage: bleeding in the space around the brain

Inside the Brain Tissue:

Types of bleeding that occur inside the brain tissue include:

• Intracerebral hemorrhage: bleeding within brain tissue
• Intraventricular hemorrhage: bleeding in brain’s fluid-filled spaces

All of these can be life-threatening, especially when blood thinners prevent normal clotting.

If you or a loved one has been injured in an accident caused by someone else’s negligence, act now.

Call: 405-605-2426

What to Expect at the Emergency Department

If you’re on blood thinners and hit your head, the emergency team treats your case as high-risk. Expect urgent evaluation the moment you arrive. The staff will act quickly and take your situation very seriously.

Initial Assessment

During your initial assessment, expect the following steps:

• Immediate evaluation of neurological status
• Detailed history about your medication and dosage
• Physical exam of neurological function
• Blood tests to check your clotting function (INR and PT/PTT)

Imaging Studies

Common imaging studies include:

• Head CT scan is usually first
• MRI may be ordered for more detail
• Repeat imaging may be needed

Treatment Considerations

Treatment considerations may involve these options:

The medical team may consider:

Typical treatment considerations may involve:

• Reversing your blood thinner if bleeding is found
• Administering clotting factors or medications
• Extended observation even with normal scans
• Neurosurgical consultation if bleeding found

Important Communication

Make sure to communicate the following information to your healthcare team:

Make sure to tell the emergency department staff:

Be ready to share the following details with the emergency department staff:

• Exact name and dose of your blood thinner
• When you last took your medication
• Why you take a blood thinner
  • atrial fibrillation
  • previous stroke
  • etc.
• Any other medications
• Your medical history, especially prior bleeding

The Risk of Delayed Brain Bleeding

One of the most concerning aspects of head injuries in patients on blood thinners is the risk of delayed intracranial hemorrhage – bleeding that doesn’t show up immediately but develops hours, days, or even weeks later.

Research Findings on Delayed Bleeding

Recent research findings about delayed bleeding include:

Recent medical research has revealed important information about delayed bleeding risks:

Research shows these findings about delayed bleeding:

• Hemorrhage rates up to 6% within 24 hours in some patients and some developed symptomatic bleeding 2–28 days after injury
  [PubMed]
• Bleeding complications occurred up to 54 days post-injury in one study [PubMed] and normal initial CT does not rule out delayed bleeding.

Why This Happens

Several factors contribute to delayed bleeding:

• Ongoing anticoagulation effects prevent normal clotting
• Small vessel tears may worsen over time
• Initial bleeding may be too small to detect
• Secondary injury from swelling can cause new bleeding

Extended Risk Periods

Extended risk periods documented in research include:

Unlike patients not on blood thinners, your risk period extends well beyond the typical 24-48 hour observation window. Research has documented cases of delayed bleeding occurring:

Extended risk periods for delayed bleeding include:

• 2–8 days after injury (most common)
• Up to 28 days in some cases
• Up to 54 days in extreme cases

Managing Other Bleeding While on Blood Thinners

While dealing with your head injury, you should also know how to manage other types of bleeding that may arise, now detailed in our dedicated Legal Resources sidebar.

Minor Cuts and Scrapes

Follow these steps for minor cuts and scrapes:

For small wounds, follow these steps from Harvard Health’s bleeding management guide:

For minor cuts and scrapes, follow these steps:

1. Clean the wound under running water
2. Apply firm pressure with gauze or cloth
3. Elevate the area above your heart
4. Maintain pressure for at least 10 minutes
5. Don’t worry if it takes longer to stop

Nosebleeds and Bleeding Gums

For nosebleeds and bleeding gums, try the following:

• Pinch your nose for 10 minutes
• Press on bleeding gums with gauze
• Don’t use hydrogen peroxide
• Seek medical attention if bleeding lasts over 30 minutes

Serious Bleeding Emergencies

Call 911 immediately if you encounter any of the following serious bleeding emergencies:

Call 911 immediately for:

Call 911 right away if you notice:

• Gushing blood that won’t stop
• Large wounds needing stitches
• Bleeding from major trauma
• Internal bleeding signs (abdominal pain, chest pain, trouble breathing)

While waiting for help:

While waiting for help, take these steps:

• Apply maximum pressure
• Use a tourniquet if trained
• Elevate injury above the heart
• Don’t remove embedded objects

Types of Brain Bleeds You Should Know About

Understanding the different types of brain bleeds can help you recognize why your situation requires careful monitoring and why symptoms might develop differently. Below, we’ve combined information about brain bleeds both outside and inside the brain tissue to streamline your understanding.

• Epidural Hematoma: Bleeding between the skull and the outer covering of the brain; often associated with skull fractures; can cause rapid deterioration and may include a ‘lucid interval’ before decline.
• Subdural Hematoma: Bleeding between the brain coverings; more common in elderly patients and those on blood thinners; can be acute or chronic; often results from minor trauma in anticoagulated patients.
• Subarachnoid Hemorrhage: Bleeding in the space around the brain; often causes severe, sudden headache (“worst headache of my life”); may be accompanied by nausea, vomiting, and neck stiffness.
• Intracerebral Hemorrhage: Bleeding directly into brain tissue; can occur in any part of the brain; symptoms depend on location and size; often causes focal neurological deficits.
• Intraventricular Hemorrhage: Bleeding into the brain’s fluid-filled cavities; can block normal fluid drainage and cause increased pressure inside the skull.

The location of bleeding determines symptoms. For example:

• Frontal lobe bleeding may cause personality changes or difficulty with decision-making.
• Temporal lobe bleeding may affect speech or memory.
• Cerebellum bleeding may cause balance and coordination problems.
• Brainstem bleeding can affect vital functions like breathing and heart rate.

Understanding the different types of brain bleeds can help you recognize why your situation requires careful monitoring and why symptoms might develop differently.

Epidural Hematoma involves bleeding between the skull and the outer covering of the brain.

• Bleeding between skull and brain covering
• Often occurs with skull fractures
• Can cause rapid deterioration
• Lucid interval then rapid decline

Subdural Hematoma is bleeding between the dura and arachnoid layers of the brain’s covering.

• Bleeding between coverings
• More common in elderly and those on blood thinners
• Acute (24–48 hours) or chronic (weeks)
• Often from minor trauma in anticoagulated patients

Subarachnoid Hemorrhage is bleeding in the space between the brain and the tissues covering it.

• Bleeding in the space around the brain
• Severe, sudden headache
• May cause nausea, vomiting, neck stiffness

Intracerebral Hemorrhage is bleeding within the brain tissue itself.

• Bleeding into brain tissue
• Can occur anywhere in the brain
• Symptoms depend on bleed size and location
• Often causes neurological deficits

Intraventricular Hemorrhage occurs when blood pools in the brain’s ventricular system.

• Bleeding into fluid-filled cavities
• Can block brain fluid drainage
• May increase pressure inside the skull

The location of bleeding determines symptoms:

Symptoms may differ based on where the bleeding occurs. For example:

• Frontal lobe bleed: personality or decision-making changes
• Temporal lobe bleed: affects speech or memory
• Cerebellum bleed: balance and coordination problems
• Brainstem bleed: affects breathing and heart rate

We are committed to providing compassionate, personalized representation every step of the way.

Call: 405-605-2426

Long-term Monitoring and Follow-up Care

After your initial emergency department evaluation, ongoing monitoring is crucial, even if your initial tests were normal.

What Your Doctor May Recommend

Your doctor may recommend one or more of the following:

Extended Observation:

Your doctor may recommend the following for extended observation:

• Hospital admission for 24–48 hours of monitoring
• Repeat CT scans for delayed bleeding
• Neurological checks every few hours
• Blood tests for clotting function

Outpatient Monitoring:

Outpatient monitoring may include:

• Instructions on warning signs
• Follow-up appointments with your doctor
• Possible neurology consultation
• Instructions on when to return to ER

Medication Management Decisions

Medication management decisions will consider:

Your healthcare team will need to balance:

Medication management decisions are based on several considerations:

• Bleeding risk from continued anticoagulation
• Clotting risk if anticoagulation is stopped
• Reason for blood thinners (stroke prevention, heart, etc.)
• How long to hold medication if bleeding happens

This decision requires careful consideration of your individual medical situation and should never be made without consulting your healthcare providers.

Long-term Symptoms to Monitor

Monitor for these long-term symptoms after your head injury:

For weeks after your head injury, watch for:

Monitor yourself for these symptoms over the following weeks:

• New or worsening headaches
• Vision or hearing changes
• Balance or coordination difficulty
• Memory problems or confusion
• Personality changes
• Weakness or numbness
• Speech difficulties

When Medical Negligence May Be Involved

While most healthcare providers appropriately manage patients on blood thinners who suffer head injuries, details on legal options are available in our Legal Resources sidebar.

Potential Areas of Medical Malpractice

Inappropriate Blood Thinner Prescribing:

Potential prescribing errors include:

• Prescribing blood thinners unnecessarily
• Wrong type or dose of blood thinner
• Not considering patient risk factors
• Inadequate blood level monitoring

Failure to Properly Manage Head Injuries:

Medical management errors may include:

• Discharging a patient too soon after trauma
• Not ordering proper imaging
• Not providing enough observation
• Missing signs of brain bleeding

Medication Errors:

Medication errors can include:

• Pharmacy gave wrong medication
• Continuing blood thinners when they should be stopped
• Not reversing anticoagulation when bleeding occurs
• Lack of coordination between providers

Key Elements of Medical Malpractice Claims

A medical malpractice claim typically requires the following elements:

For a successful medical malpractice claim, several elements must be present:

A medical malpractice claim generally requires these elements:

1. Duty of care – provider must give appropriate care
2. Breach of duty – failed standard of care
3. Causation – breach directly caused injury
4. Damages – you suffered harm

When to Consider Legal Consultation

You may want to consult an attorney if any of these situations apply:

You may want to consult with a medical malpractice attorney if:

You may want to speak with an attorney if:

• Brain bleed from improper blood thinner management
• Head injury not properly evaluated
• Discharged too soon, developed complications
• Medication errors contributed to complications

Understanding your legal rights can be important, especially given the serious and potentially permanent effects of some head injuries. Further legal resources can be found in the sidebar.

Prevention and Safety Tips

While you need blood thinners for important medical reasons, you can take steps to reduce your risk of bleeding complications:

Home Safety Measures

Home safety measures can help reduce your risk of falls or injuries. Consider the following:

• Remove tripping hazards like rugs and cords
• Install grab bars in bathrooms and stairs
• Improve lighting in your home
• Wear non-slip shoes with support
• Keep walkways clear

Activity Modifications

Adjusting your activities can help prevent injuries. Here are some recommendations:

• Avoid high-risk activities like contact sports
• Use protective equipment (helmet for biking)
• Take your time when standing up
• Be careful on stairs and uneven surfaces

Medical Management

Proper medical management is crucial. Follow these tips:

• Wear a medical alert bracelet
• Keep an updated medication list
• Follow up regularly with your provider
• Don’t skip doses or stop medication without supervision
• Report unusual bleeding to your doctor

Emergency Preparedness

Be prepared for emergencies by taking these steps:

• Know the signs of serious bleeding
• Have emergency contacts ready
• Know the nearest emergency department
• Keep insurance information accessible

Frequently Asked Questions

If you’ve been injured in an accident, don’t take chances – schedule your free consultation.

Free Case Consultation

Additional Resources

American Academy of Neurology: Head injury while on anticoagulation

Cleveland Clinic: Comprehensive medical information about brain bleeds and hemorrhages

Evaluation of Emergency CT Scans and the Importance of Prompt Imaging

Neurology Clinical Practice: Understanding Head Trauma in Patients on Anticoagulants

Harvard Health’s detailed guide on managing bleeding while taking blood thinners