A friends daughter got a brain injury from a car-pedestrian accident. He learned a lot, and told me his take away: If you hit your head and have any concern about it, take Ibuprofen to prevent swelling/inflamation and drive to Ann Arbor (we're in Michigan but that's over an hour away). The first part made sense, the second he said that town and UofM are known for treating that kind of thing. He has them in such high regard that it's worth the drive not even knowing who you're going to see ahead of time!?!?!?

Hm -- the website of Mayo Clinic says that you should avoid Ibuprofen if you might have a concussion, as they may increase the risk of bleeding.

"Avoid other pain relievers such as ibuprofen (Advil, Motrin IB, others) and aspirin, as these medications may increase the risk of bleeding."

See: https://www.mayoclinic.org/diseases-conditions/concussion/di...

One of the challenges in first aid treatment for stroke is “is it ischemic or hemorrhagic?”. The symptoms are similar, but the treatments almost the reverse of each other. Do you want to increase clotting to stop the bleeding, or decrease clotting to keep an existing brain clot small?

Sometimes (for example if it would take hours to bring the patient to a MRI/CT machine) an educated guess as to the answer is the optimal strategy.

Wow, that's really good info. So I guess the answer is get to a hospital asap where they can do some imaging.

"Avoid other pain relievers such as ibuprofen (Advil, Motrin IB, others) and aspirin, as these medications may increase the risk of bleeding."

Wow. Did I misremember and he said Tylenol (acetaminophen)? This is bothering me now, I don't like to carry bad bits of wisdom around!

Prescription Ibuprofen actually carries a Black Box Warning about increased stroke and heart attack risk in general. The OTC version never got the updated warning.