Head Injury from Car Door: Seeking Guidance on Persistent Dizziness

Hit the upper door beam of the trunk?

Hello Doctor, on June 9th, which was a Thursday during the Dragon Boat Festival, I was trying to retrieve luggage from the third row of my SUV.
I forcefully kicked the door to get in and ended up hitting my head against the upper frame of the rear door.
I experienced intense pain immediately and had to squat down by the car, with the pain lasting for several minutes.
I initially thought it was just a minor bump, but when I got out of bed on the morning of June 11th, I felt dizzy and my vision was spinning, although I did not have any symptoms between June 9th and the morning of June 11th.
Since then, I have been unable to perform any significant movements, such as bending down to shower, turning my head while driving, or getting up and lying down, as well as walking for a while, all of which cause my vision to spin.
I went to the emergency department at Linkou Chang Gung Memorial Hospital, where the initial assessment suggested benign paroxysmal positional vertigo (BPPV).
I was then referred to an otolaryngologist, but after their evaluation, they determined it was not a condition related to their specialty.
I was subsequently referred to a neurologist, who could not confirm whether it was BPPV or a concussion, and advised me to return for a follow-up in three weeks.
In the meantime, I have been taking various medications for dizziness and peripheral circulation disorders (Flunazon), but I have not seen any improvement, and I feel drowsy after taking the medications.
What should I do now? Did I see the wrong specialist? Since I do not have any obvious external injuries, the hospital has been directing me to neurology.
I would like to ask the doctor for any recommendations.

Eric, 50~59 year old female. Ask Date: 2016/06/23

Dr. Zhang Junwei reply Neurosurgery

To be honest, the best thing to do is to rest more and take medication until you feel better!

Reply Date: 2016/06/23

More Info

It sounds like you've been through a challenging experience following your head injury from the car door. Given the details you've provided, it is crucial to address your symptoms of persistent dizziness and the history of your injury comprehensively.

First and foremost, head injuries can lead to a variety of complications, including concussions, vestibular disorders, and even more serious conditions like intracranial hemorrhages, depending on the severity of the impact. In your case, the initial impact from the car door and the subsequent dizziness suggest that there may be underlying issues that need to be further evaluated.

Dizziness following a head injury can arise from several factors. One possibility is a concussion, which is a type of traumatic brain injury that can occur even without a direct blow to the head. Symptoms of a concussion can include headaches, dizziness, confusion, and balance issues. Another potential cause of your dizziness could be vestibular dysfunction, which affects the inner ear and balance system. This could be related to the impact you experienced.

Since you've already seen multiple specialists, including emergency medicine, ENT, and neurology, and they have not reached a definitive diagnosis, it may be beneficial to consider a few additional steps:
1. Follow-Up Imaging: If you haven't already, a follow-up MRI could provide more detailed information about your brain and inner ear structures, especially if there are concerns about potential bleeding or swelling that might not have been visible on initial scans.

2. Vestibular Rehabilitation: If your dizziness is related to balance issues, vestibular rehabilitation therapy (VRT) could be beneficial. This type of therapy is designed to help your brain adapt to changes in balance and can be particularly effective for individuals experiencing dizziness after head injuries.

3. Neurological Evaluation: Since you are experiencing persistent symptoms, it may be worthwhile to seek a second opinion from another neurologist who specializes in post-concussion syndrome or vestibular disorders. They may have different insights or treatment options that could help alleviate your symptoms.

4. Medication Review: You mentioned that the medications you have been prescribed make you feel drowsy. It’s essential to communicate this with your healthcare provider. They may need to adjust your medications or explore alternative treatments that do not have such side effects.

5. Monitoring Symptoms: Keep a detailed log of your symptoms, including when they occur, their intensity, and any triggers you notice. This information can be invaluable for your healthcare providers in determining the best course of action.

6. Lifestyle Modifications: In the meantime, consider lifestyle changes that may help manage your symptoms. Staying hydrated, getting adequate rest, and avoiding sudden movements can help reduce dizziness. Gentle exercises, as tolerated, may also assist in improving your overall balance and coordination.

In conclusion, while it can be frustrating to navigate the healthcare system, it’s important to advocate for yourself and ensure that you receive the appropriate care for your symptoms. Persistent dizziness after a head injury warrants thorough investigation and management, and seeking further evaluations or therapies could lead to improvement in your condition. Don’t hesitate to reach out to your healthcare providers with your concerns and to discuss the next steps in your care.

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