Persistent Dizziness After Head Injury: When to See a Neurosurgeon?

Persistent dizziness after a head injury?

Hello Dr.
Lai, I sustained a head injury while playing basketball at the beginning of April when I went for a rebound.
Initially, I did not experience any discomfort, but the next day when I woke up, I started to feel dizzy and nauseous, although I did not actually vomit.
I spent that day resting in bed.
The following day, the dizziness persisted, and any movement of my body made it worse, leading to mild headaches.
I then visited a neurologist, who performed some tests and assessed that my condition was stable, prescribing me medication.
However, the dizziness has not improved, although it hasn't worsened either.
I find that lying down or sitting still helps reduce the dizziness, but any movement involving my head exacerbates the symptoms.
If I don't rest and go out for a few hours, I sometimes feel extremely dizzy.
It wasn't until early June that I had an EEG, and the doctor reviewed the results, which showed no abnormalities.
I have continued taking the medication, but I still haven't recovered.
I would like to ask Dr.
Lai if it is necessary to see a neurosurgeon.
After all, injuries like this are typically evaluated by a surgeon, or should I consider getting an MRI or other detailed examinations?

Dan, 20~29 year old female. Ask Date: 2016/07/08

Dr. Lai Zhaokang reply Neurosurgery

Hello, head injuries should prioritize seeing a neurosurgeon for more comprehensive treatment.
Your symptoms resemble post-concussion syndrome and may also be associated with inner ear balance issues.
It is recommended to consult both a neurosurgeon and an otolaryngologist at Changhua Hospital for further evaluation.
// Neurosurgeon Dr.
Lai Chao-Kang.

Reply Date: 2016/07/08

More Info

After experiencing a head injury, persistent dizziness and other symptoms can be concerning, and it's essential to evaluate the situation carefully. Based on your description, it seems that you sustained a head injury while playing basketball, which initially did not present any immediate symptoms. However, the subsequent onset of dizziness, nausea, and mild headaches indicates that your body is reacting to the trauma.

In general, head injuries can lead to various complications, including concussions, which may not always present immediate symptoms. The fact that you experienced dizziness and nausea the day after the injury suggests that you might be dealing with a mild concussion or post-concussion syndrome. These conditions can lead to prolonged symptoms, including dizziness, headaches, and cognitive difficulties.

You mentioned that you have already consulted a neurologist who performed some tests and prescribed medication. While the initial assessment may have indicated that your condition was manageable, the persistence of your symptoms warrants further evaluation. It is not uncommon for symptoms to evolve or persist after a head injury, and if you are still experiencing significant dizziness, it is advisable to seek further medical attention.

Regarding your question about whether to see a neurosurgeon, it is essential to consider a few factors. If your symptoms have not improved and are affecting your daily life, it may be beneficial to consult a neurosurgeon or a specialist in neurotrauma. They can provide a more comprehensive evaluation, which may include imaging studies such as an MRI or CT scan to rule out any structural issues or complications, such as intracranial bleeding or other injuries that may not have been apparent during your initial assessment.

Additionally, if you experience any of the following symptoms, you should seek immediate medical attention:
1. Worsening Headaches: If your headaches become more severe or change in character, this could indicate a more serious issue.

2. Neurological Symptoms: Any new neurological symptoms, such as weakness, numbness, difficulty speaking, or changes in vision, should be evaluated promptly.

3. Persistent Vomiting: If you begin to vomit or feel increasingly nauseated, this could be a sign of increased intracranial pressure or other complications.

4. Loss of Consciousness: If you experience any episodes of fainting or loss of consciousness, it is crucial to seek emergency care.

In summary, while your initial evaluation by a neurologist was reassuring, the persistence of your dizziness and discomfort suggests that further investigation may be necessary. Consulting a neurosurgeon can provide you with a more in-depth assessment and help determine if additional imaging or treatment is required. Remember, it is always better to err on the side of caution when it comes to head injuries, as timely intervention can prevent potential complications.

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