Post-Concussion Symptoms: When to Seek Medical Attention

Post-concussion syndrome?

Hello, doctor.
On January 2, 2019, I was involved in a motorcycle accident where I collided with another vehicle, causing me to be thrown off and hit my head.
I don't remember whether my knee, buttocks, or head was the first point of impact.
I did not lose consciousness at the time; I fell on my left side and was lying on the road.
I was unable to get up due to dizziness for about five minutes until a passerby helped me to stand.
After the incident, I noticed two significant scratches on my helmet, which I suspect were from hitting the back of my head first and then rolling over to hit my left side.
I was taken to the emergency room, where the doctor diagnosed me with a mild concussion and prescribed some pain medication, advising me to monitor my condition for 72 hours.
I followed the doctor's advice and stayed home to observe myself for a week without experiencing dizziness, projectile vomiting, or altered consciousness.
Now, more than a month later, I have suddenly started experiencing dizziness and headaches (though not severe enough to cause instability or prevent me from sleeping).
I also feel that my concentration is not as sharp as it used to be, and I get tired easily.
After researching online, I found many articles stating that post-concussion syndrome can indeed cause dizziness and headaches.
However, I also came across some news about intracranial hemorrhages occurring a month after a concussion, which has made me a bit worried.
I understand that very mild symptoms may not warrant a CT scan, but I would like to ask if I need to return for a follow-up appointment immediately, or if this is just a typical post-concussion symptom that I can continue to observe.
What symptoms should I be vigilant about that would require immediate medical attention? Thank you for your response, and I appreciate your hard work.

Miss Yan, 20~29 year old female. Ask Date: 2019/02/16

Dr. Zhang Junwei reply Neurosurgery

It is important to monitor whether the current symptoms worsen or persist without improvement.
Generally, such symptoms tend to improve with adequate rest.
If there is no improvement, a consultation with a neurosurgery outpatient clinic should be scheduled for further evaluation and treatment.

Reply Date: 2019/02/16

More Info

After experiencing a concussion, it is essential to monitor your symptoms closely, as post-concussion syndrome can manifest in various ways. Your initial assessment by the emergency physician, which indicated a mild concussion, is a good starting point. However, the emergence of new symptoms, such as dizziness, headaches, and difficulty concentrating, warrants further attention.

Understanding Post-Concussion Symptoms
Post-concussion syndrome (PCS) can occur after a concussion and may include a range of symptoms such as headaches, dizziness, fatigue, irritability, difficulty concentrating, and sleep disturbances. These symptoms can persist for weeks or even months after the initial injury. It is crucial to understand that while some symptoms may be mild, they can still significantly impact your daily life and functioning.

When to Seek Medical Attention
Given that you are experiencing new symptoms over a month after the initial injury, it is advisable to consult with a healthcare professional. While it is common for individuals to experience lingering effects after a concussion, the appearance of new or worsening symptoms can indicate that further evaluation is necessary. Here are some specific symptoms that should prompt immediate medical attention:
1. Severe Headaches: If your headaches become more intense or change in character, this could be a sign of complications.

2. Persistent Dizziness or Balance Issues: If you experience significant dizziness or feel unsteady, it is essential to seek medical advice.

3. Nausea or Vomiting: If you start experiencing nausea or vomiting, especially if it is persistent, this could indicate increased intracranial pressure.

4. Confusion or Changes in Consciousness: Any changes in your level of consciousness, confusion, or difficulty waking up should be taken seriously.

5. Visual Disturbances: Blurred vision or other visual changes can also be a sign of complications.

6. Weakness or Numbness: If you notice any weakness or numbness in your limbs, this could indicate a more serious issue.

Next Steps
Since you are currently experiencing mild symptoms, it may be appropriate to monitor your condition for a short period. However, given your concerns about potential complications, it would be wise to schedule a follow-up appointment with your healthcare provider. They may recommend further evaluation, such as imaging studies (like a CT scan or MRI) if they deem it necessary based on your symptoms and clinical examination.

In the meantime, consider the following self-care strategies:
- Rest: Ensure you are getting adequate rest and sleep, as fatigue can exacerbate symptoms.

- Limit Screen Time: Reducing time spent on screens can help alleviate headaches and eye strain.

- Stay Hydrated: Dehydration can worsen headaches and dizziness, so drink plenty of fluids.

- Gradual Return to Activities: If you are returning to physical activities or work, do so gradually and pay attention to how your body responds.

Conclusion
In summary, while some symptoms may be typical after a concussion, the emergence of new symptoms should not be ignored. It is always better to err on the side of caution and consult with a healthcare professional for a thorough evaluation. They can provide guidance on managing your symptoms and determining if further investigation is necessary. Your health and well-being are paramount, and seeking timely medical advice can help ensure a safe recovery.

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