Post-Impact Symptoms: Long-Term Neurological Effects

Symptoms after a gravitational impact?

Hello, doctor.
I would like to inquire about an incident that happened several years ago when I was hit on the top of my head by a corner of a life jacket made of foam after falling from a height.
I underwent some examinations at that time, but the doctor said there was no concussion.
However, over the years, I have experienced intermittent pain on the top of my head before getting up from sleep.
I feel dizzy to the point that I cannot get out of bed, which causes me headaches.
Recently, this has started again, and I also experience motion sickness when riding in a vehicle.
While at work, I find myself yawning and feeling sleepy, and I feel like I am not getting enough rest.

Miss Huang, 30~39 year old female. Ask Date: 2017/12/07

Dr. Jiang Junyi reply Neurology

Hello, based on your description, generally speaking, head trauma without loss of consciousness, the use of anticoagulants, or the presence of significant local hematomas typically indicates mild symptoms.
Additionally, since your symptoms have persisted for over two years, the correlation is even lower.
As for the frequent dizziness, it should be monitored continuously.
Common causes of dizziness include: 1.
Neurogenic reflexes causing decreased peripheral vascular tone, leading to blood pooling in peripheral tissues and insufficient blood flow to the brain.
2.
Orthostatic hypotension due to changes in posture, such as when standing up suddenly or getting out of bed.
Conditions like autonomic dysfunction and cardiovascular medications may contribute to this.
3.
Narrowing, obstruction, or insufficient blood flow in local cerebral vessels.
4.
Issues related to blood itself, such as low blood pressure, hypoglycemia, or anemia.
Regarding the feeling of drowsiness, I'm not sure if you are using any anti-dizziness medications (which may cause drowsiness) or if you have sleep disorders.
I recommend consulting a neurologist for further evaluation and treatment.
Wishing you good health and peace.

Reply Date: 2017/12/07

More Info

Post-impact symptoms, especially following a head injury, can manifest in various ways and may lead to long-term neurological effects. Your experience of head pain, dizziness, and sleep disturbances years after the incident raises important considerations regarding potential underlying issues that may not have been fully addressed at the time of your injury.

Firstly, it’s essential to understand that even if a concussion or traumatic brain injury (TBI) was not diagnosed immediately following the incident, subtle changes in brain function can still occur. Symptoms like headaches, dizziness, and cognitive difficulties can be indicative of post-concussion syndrome (PCS), which can develop after a mild TBI. PCS can lead to persistent symptoms such as headaches, dizziness, fatigue, and sleep disturbances, which may align with your experiences.

The headaches you describe, particularly those that occur upon waking, could be tension-type headaches or migraines, which can be exacerbated by stress, lack of sleep, or changes in routine. The fact that you also experience dizziness and difficulty with motion (like feeling nauseous while riding in a vehicle) suggests that there may be vestibular involvement, which is not uncommon after head injuries.

Moreover, the sensation of not feeling well-rested despite adequate sleep could be linked to several factors, including sleep disorders such as sleep apnea, which can be more prevalent in individuals with a history of head trauma. Sleep disturbances can significantly impact cognitive function and overall well-being, leading to increased fatigue and difficulty concentrating.

Given the complexity of your symptoms, it is crucial to seek a comprehensive evaluation from a healthcare professional, preferably a neurologist or a specialist in brain injuries. They may recommend imaging studies, such as an MRI or CT scan, to rule out any structural issues that could be contributing to your symptoms. Additionally, neuropsychological testing can help assess cognitive function and identify any deficits that may have developed over time.

Treatment options may vary based on the underlying causes of your symptoms. For headaches, a combination of lifestyle modifications, physical therapy, and possibly medication may be recommended. If sleep disturbances are identified, addressing them through sleep hygiene practices, cognitive behavioral therapy, or other interventions may be beneficial.

In summary, while your initial assessment post-injury did not indicate a concussion, the symptoms you are experiencing now warrant further investigation. Long-term neurological effects from head injuries can be subtle and may evolve over time. A thorough evaluation will help determine the best course of action to manage your symptoms effectively and improve your quality of life. Remember, you are not alone in this, and seeking help is a vital step toward recovery.

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