Head Injuries: When to Seek Medical Attention

Q: Head Injuries: When to Seek Medical Attention

Based on your description： The neurological symptoms you mentioned after taking a hot shower are more likely caused by syncope. <br>Loss of consciousness can occur when cerebral blood flow drops below 30 ml per minute, typically due to a rapid decrease in blood pressure or vasoco

Head issues

Hello Doctor, about three weeks ago, I hit my forehead quite hard.
I didn't lose consciousness at the time, but after two days, I experienced some dizziness and nausea that lasted for about one to two weeks.
I didn't see a doctor.
About five days later, due to the cold weather, I took a long and hot shower.
Afterward, while sitting on a chair, I suddenly felt weakness in my limbs, but there was no numbness.
I was stuttering when I spoke, my vision didn't go black, but I felt a bit dazed, which scared me.
I immediately stood up, took deep breaths, and drank some water.
After about ten minutes, I returned to normal.
This situation only happened once, and I no longer feel dizzy.
I would like to ask the doctor if the condition I experienced after the shower was due to the heat and duration of the shower, or if there could be another reason? Do I need to see a doctor? Thank you.

Chen Tongxue, 10~19 year old female. Ask Date: 2018/02/13

Dr. Jiang Junyi reply Neurology

Based on your description: The neurological symptoms you mentioned after taking a hot shower are more likely caused by syncope.
Loss of consciousness can occur when cerebral blood flow drops below 30 ml per minute, typically due to a rapid decrease in blood pressure or vasoconstriction, leading to reduced cerebral blood flow and subsequent hypoxia.
When you take a hot shower, peripheral blood vessels dilate, which may result in insufficient blood volume within the vessels.
Syncope is more likely to occur when a person is standing, as cerebral blood flow is at its lowest and cardiac output is higher; however, if cerebral blood flow decreases suddenly, it can lead to syncope before the body can adequately respond.
The likelihood of syncope is lower when sitting and almost nonexistent when lying down.
Prior to losing consciousness, there may be prodromal symptoms such as nausea, yawning, dizziness, a feeling of warmth, sweating, and cold extremities.
If you frequently experience these symptoms, do not force yourself to stand; instead, quickly sit or lie down to avoid injury from falling.
Typically, symptoms improve gradually after rehydration and electrolyte replenishment.
It is advisable to discuss examination and treatment with a neurologist or cardiologist.
Wishing you good health, safety, and happiness.

Reply Date: 2018/02/13

More Info

When it comes to head injuries, understanding the symptoms and knowing when to seek medical attention is crucial for your health and safety. Based on your description, it seems you experienced a significant impact to your forehead about three weeks ago, followed by symptoms such as dizziness and nausea. While you did not lose consciousness at the time of the injury, the subsequent symptoms you experienced warrant careful consideration.

Head injuries can lead to various complications, including concussions, intracranial bleeding, and other neurological issues. The fact that you experienced dizziness and nausea two days after the injury could indicate a concussion, which is a type of traumatic brain injury. Symptoms of a concussion can include confusion, headache, dizziness, nausea, and sometimes even changes in mood or behavior. It’s important to note that symptoms may not appear immediately after the injury; they can develop over hours or even days.

The episode you described after taking a hot shower—feeling weak, having slurred speech, and experiencing a moment of confusion—could be related to several factors. One possibility is that the heat from the shower caused a drop in blood pressure, leading to a brief episode of syncope (fainting) or near-syncope. This can happen when blood vessels dilate in response to heat, causing blood to pool in the lower extremities and reducing blood flow to the brain. However, given your history of a head injury, it’s essential to consider that this episode could also be related to the concussion or other neurological issues.

In general, if you experience any of the following symptoms after a head injury, you should seek medical attention immediately:
1. Loss of consciousness: Even if brief, this can indicate a more serious injury.

2. Persistent or worsening headache: If your headache does not improve or gets worse, it could signal complications.

3. Dizziness or balance issues: Ongoing dizziness, especially if it interferes with your ability to walk or function normally, should be evaluated.

4. Nausea or vomiting: This can be a sign of increased intracranial pressure.

5. Confusion or difficulty concentrating: Any changes in your mental status should be taken seriously.

6. Seizures: If you experience a seizure, you need immediate medical attention.

7. Weakness or numbness: Any new weakness or numbness in your limbs should be assessed.

Given that you experienced dizziness and nausea after the injury and then had a concerning episode after a hot shower, it would be prudent to consult a healthcare professional. They may recommend imaging studies, such as a CT scan, to rule out any serious complications like a hematoma or other intracranial issues.

In summary, while your symptoms may have resolved, the history of a significant head injury combined with the subsequent episodes of dizziness and confusion suggests that a medical evaluation is warranted. It’s always better to err on the side of caution when it comes to head injuries, as early detection and treatment can prevent more severe complications. Please consider scheduling an appointment with a healthcare provider to discuss your symptoms and receive appropriate care.

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