Post-Concussion Symptoms: Dizziness and Fatigue After Injury

Mild concussion

Hello doctor, I was in a car accident at the end of January, which resulted in an injury to the upper left side of my head and a mild concussion.
The wound has healed, but I am still confused because I occasionally experience dizziness, especially when I lie down too quickly, roll over, or tilt my head back.
I visited a doctor in March who said it would gradually improve.
I have been resting at home since the injury, and now it's April.
I have tried to limit my outings, but I'm uncertain how long the dizziness will persist, and I am hesitant to ride a bike.
I still need to find a job, so I hope there are ways to address this issue.
Thank you.
I'm also unsure if the dizziness is due to the injury or lack of exercise, but I still feel very drowsy.
Although I usually get enough sleep, I find it difficult to wake up when the alarm goes off, and after washing my face, I still feel very sleepy and often end up lying back down to sleep.

Xiao Jie, 20~29 year old female. Ask Date: 2018/04/08

Dr. Zhang Junwei reply Neurosurgery

Post-concussion syndrome can only heal through the body's natural recovery process or by taking pain relievers and anti-nausea medications.

Reply Date: 2018/04/08

More Info

After a concussion, it is not uncommon to experience lingering symptoms such as dizziness and fatigue. These symptoms can be attributed to a variety of factors related to the injury and the body's recovery process. In your case, having sustained a concussion from a car accident, it is essential to understand the potential causes of your ongoing symptoms and the best ways to manage them.

Understanding Post-Concussion Symptoms:
1. Dizziness: This can manifest in various forms, including a sensation of spinning (vertigo), lightheadedness, or a feeling of being off-balance. Dizziness after a concussion may be caused by several factors:
- Vestibular Dysfunction: The vestibular system, which helps control balance, can be affected by head injuries. This dysfunction can lead to dizziness, especially when changing positions quickly, such as lying down or turning over in bed.

- Cervical Strain: Whiplash or strain in the neck muscles can also contribute to dizziness. The neck and head are closely connected, and tension or injury in the cervical spine can affect balance and spatial orientation.

- Post-Traumatic Migraine: Some individuals experience migraines after a concussion, which can include dizziness as a symptom.

2. Fatigue: Feeling excessively tired or having difficulty waking up can be a common post-concussion symptom. This fatigue can stem from:
- Sleep Disruption: Even if you are sleeping for long hours, the quality of sleep may be affected by the concussion. Sleep disturbances are common after head injuries, leading to feelings of unrefreshing sleep.

- Cognitive Load: The brain requires more energy to process information after a concussion. This increased cognitive demand can lead to mental fatigue, making you feel tired even after adequate rest.

- Physical Inactivity: A lack of physical activity can also contribute to feelings of fatigue. While it is essential to rest after a concussion, gradually reintroducing light physical activity can help improve energy levels and overall well-being.

Management Strategies:
1. Gradual Return to Activity: While it is crucial to rest after a concussion, prolonged inactivity can lead to deconditioning. Gradually reintroducing light physical activity, such as walking or gentle stretching, can help improve your energy levels and reduce dizziness. Always consult with your healthcare provider before starting any new exercise regimen.

2. Vestibular Rehabilitation: If dizziness persists, consider seeking evaluation from a physical therapist specializing in vestibular rehabilitation. They can provide exercises and strategies to help improve balance and reduce dizziness.

3. Sleep Hygiene: Focus on improving your sleep quality by establishing a regular sleep schedule, creating a calming bedtime routine, and ensuring your sleep environment is conducive to rest. Limiting screen time before bed and avoiding caffeine in the afternoon can also help.

4. Cognitive Rest: Limit activities that require intense concentration, such as reading, using a computer, or playing video games, especially if they exacerbate your symptoms. Gradually increase cognitive demands as tolerated.

5. Follow-Up Care: Regular follow-ups with your healthcare provider are essential to monitor your recovery. If symptoms persist or worsen, further evaluation may be necessary to rule out other underlying issues.

In conclusion, while dizziness and fatigue can be frustrating post-concussion symptoms, they are often part of the recovery process. With appropriate management strategies and follow-up care, many individuals find that their symptoms improve over time. If you have concerns about your symptoms or their duration, do not hesitate to reach out to your healthcare provider for further guidance and support.

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