Persistent Head Pain Two Months After Car Accident: What to Do?

Head injury from a car accident, still swollen and painful after two months?

Hello, I was in a car accident in early March in mainland China, where I experienced a 90-degree impact with the ground.
I sustained a laceration on the upper right side of my head and do not remember how I was transported to the hospital; that part is unclear to me.
However, I was conscious for the most part, but I lost a significant amount of blood.
Upon arrival at the hospital, my hair was cut, and I received several stitches immediately.
Initially, there was swelling and deformation in my brain.
For the first two weeks, I experienced persistent dizziness, but gradually the swelling subsided and the wound healed.
After my condition improved, I returned to Taiwan to recuperate.
A month later, the pain diminished, and I thought everything was fine.
However, recently, the right side of my head where I was impacted has started to swell and hurt.
I feel pain even when lying on a pillow, which has disrupted my sleep for the past two months.
Could you please advise me on which specialist I should consult or what kind of examinations I should undergo? Thank you.

Fumei, 20~29 year old female. Ask Date: 2016/04/27

Dr. Zhang Junwei reply Neurosurgery

Please schedule an appointment for a neurosurgery outpatient examination!

Reply Date: 2016/04/27

More Info

After experiencing a car accident, especially one that involved a significant head injury, it is not uncommon to have lingering symptoms such as persistent headaches, especially if they arise weeks or even months after the incident. In your case, the fact that you are experiencing pain on the right side of your head two months post-accident warrants further evaluation.

Firstly, it is essential to understand that head injuries can lead to a variety of complications, including but not limited to post-concussion syndrome, which can manifest as headaches, dizziness, and cognitive difficulties. Given your history of a significant head injury, it is crucial to monitor your symptoms closely. The pain you are experiencing could be due to several factors, including:
1. Post-Traumatic Headaches: These can occur after a head injury and may be tension-type headaches or migraines. They can be triggered by stress, anxiety, or even changes in sleep patterns.

2. Cervical Issues: Sometimes, injuries to the head can also affect the neck, leading to referred pain in the head. If you have any neck stiffness or pain, this could be contributing to your headaches.

3. Intracranial Issues: Although you have had imaging studies done, it is still important to consider the possibility of complications such as post-traumatic intracranial hemorrhage, cerebral edema, or other structural changes that may not have been evident in initial scans.

4. Emotional and Psychological Factors: The trauma from the accident can lead to anxiety, depression, or PTSD, which can also manifest as physical symptoms, including headaches.

Given your ongoing symptoms, I recommend the following steps:
1. Consult a Neurologist: A neurologist specializes in disorders of the nervous system, including headaches and post-concussion syndrome. They can perform a thorough evaluation, including a detailed history and neurological examination, and may recommend further imaging studies such as an MRI to rule out any complications that may not have been visible on the initial CT scan.

2. Consider a Pain Management Specialist: If your headaches are severe and persistent, a pain management specialist can help you explore various treatment options, including medications, physical therapy, or even alternative therapies such as acupuncture.

3. Physical Therapy: If there are any cervical spine issues contributing to your headaches, physical therapy may help alleviate pain and improve function.

4. Psychological Support: If you find that your emotional state is affecting your recovery, consider speaking with a mental health professional. They can provide strategies to cope with the psychological aftermath of the accident.

5. Lifestyle Modifications: Ensure you are maintaining a healthy lifestyle, including proper hydration, nutrition, and sleep hygiene. Stress management techniques such as mindfulness, yoga, or meditation can also be beneficial.

In summary, while it is not uncommon to experience headaches following a head injury, persistent symptoms that interfere with your daily life should be evaluated by a healthcare professional. A multidisciplinary approach involving neurology, pain management, physical therapy, and psychological support may provide the best outcome for your recovery. Remember, early intervention can often lead to better management of symptoms and a quicker return to normalcy.

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