<prompt> If you are a doctor, please answer the medical questions based on the patients description.My wife took a fall and hit her head. She has a pretty painful knot on the back of her head. She is in quite a bit of pain and did feel a little nausea dizzy which has passed. We are icing her head now. Do we need to go to the ER or wait and see if the knot goes down?  <response>: Hi there, If your wife lost consciousness, is over 65, or on blood thinning medication such as Coumadin warfarin, Plavix, Prada, or Lovenox, or has a history of bleeding disorders, then I recommend you take her to the ER for a head CT. if your wife did not lose consciousness and is not on a blood thinner, and doesnt have any history of bleeding disorders, then it is reasonable to continue to ice the affected area. I recommend 15 minutes of ice on, 15 minutes off and repeat as many times as possible. I hope I have answered your question. Feel free to contact me if you have any further questions. 