Delayed Symptoms After a Concussion: What to Know

Q: Delayed Symptoms After a Concussion: What to Know

Hello： Based on your description, it may be necessary to consider cervical spine disorders, as the likelihood of intracranial hemorrhage is relatively low. <br>External factors such as traffic accidents, falls, impacts to the head against hard objects, or excessive force during c

Head trauma

Hello doctor, I would like to ask about a concussion I had from a car accident.
I was wearing a helmet when I hit my head on the ground, and I was conscious at the time.
During the week following the incident, I only experienced dizziness, which resolved after a week.
Now, more than a month later, I suddenly have some pain in the back of my head (which does not affect my normal activities, and the symptoms have persisted for a week).
Initially, the pain was mostly on the left side, but now it has shifted to the right side, and occasionally I feel pain all over my head.
My arms also occasionally feel tingly (but I can exert normal strength).
What could be the issue? Is there a possibility of delayed intracranial hemorrhage?

Niming, 20~29 year old female. Ask Date: 2020/03/03

Dr. Jiang Junyi reply Neurology

Hello: Based on your description, it may be necessary to consider cervical spine disorders, as the likelihood of intracranial hemorrhage is relatively low.
External factors such as traffic accidents, falls, impacts to the head against hard objects, or excessive force during cervical rotation can lead to cervical instability, dislocation, and cervical disc herniation.
Typical discomfort symptoms associated with cervical radiculopathy include pain in the shoulder or arm, as well as numbness, tingling, and weakness in the palm and fingers.
Regarding cervical joint disorders, they can cause neck pain and stiffness, as well as pain that may extend to the shoulder, arm, and hand due to compression of nearby nerve roots.
Treatment can be divided into pharmacological therapy: When nerves are compressed, an inflammatory response occurs, leading to symptoms such as pain, numbness, and weakness.
Non-steroidal anti-inflammatory drugs (NSAIDs) are used for treatment, as they have both anti-inflammatory and analgesic effects, which can reduce the inflammatory response and alleviate pain.
Physical therapy includes:
1.
Heat therapy: Primarily increases local blood circulation and improves muscle ischemia.
2.
Shortwave and ultrasound therapy: Mainly promotes blood circulation in deeper tissues.
3.
Transcutaneous electrical nerve stimulation (TENS) and medium-frequency vector interference waves: Can provide local pain relief and alleviate tension in the neck and shoulders.
4.
Cervical traction: Commonly used for degenerative cervical arthritis, disc herniation (cervical osteophytes), with associated nerve root compression, and cervical injuries without fractures or joint instability, but with nerve compression.
Cervical traction can be utilized for rehabilitation, but X-ray examination is necessary beforehand to confirm joint stability.
Cervical collars: Used to prevent cervical instability and avoid further nerve tissue damage, suitable for injuries such as sports injuries, car accidents, or falls that lead to excessive flexion or extension of the cervical spine.
I recommend consulting with a neurologist or a rehabilitation physician to discuss examination and treatment options.
However, due to the recent COVID-19 pandemic, it is advisable to wait until the situation stabilizes before going to the hospital for examination.
Please also implement self-protection measures, including cleaning and disinfection, before and after seeking medical care.
Wishing you good health, safety, and happiness.
Dr.
Jiang, Department of Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2020/03/03

More Info

Understanding the symptoms following a concussion is crucial, especially when they manifest weeks after the initial injury. In your case, it seems you experienced a concussion from a car accident, and while you were initially symptom-free after a week, you are now experiencing new symptoms such as localized headaches and occasional arm numbness.

First, it's important to note that concussions can lead to a variety of symptoms that may not appear immediately. These symptoms can include headaches, dizziness, cognitive difficulties, and emotional changes. The fact that you experienced headaches a month after the injury raises some concerns, particularly regarding the possibility of delayed complications such as post-concussion syndrome or even more serious issues like delayed intracranial hemorrhage.

Delayed Intracranial Hemorrhage: This condition can occur when there is bleeding within the skull that does not present immediately after the injury. It can take days or even weeks for symptoms to develop, which may include worsening headaches, confusion, nausea, or neurological deficits. The fact that you are experiencing headaches that have shifted from one side of your head to the other, along with occasional arm numbness, could potentially indicate that there is something more serious at play.
Post-Concussion Syndrome: This is another possibility. It can occur when symptoms persist for weeks or months after the initial injury. Symptoms may include headaches, dizziness, fatigue, irritability, and difficulty concentrating. The headaches you are experiencing could be a part of this syndrome, especially if they are accompanied by other cognitive or emotional symptoms.

Neurological Evaluation: Given your symptoms, it is advisable to seek a thorough evaluation from a healthcare professional, preferably a neurologist. They may recommend imaging studies such as a CT scan or MRI to rule out any serious complications like bleeding or swelling in the brain.
Management and Treatment: If it is determined that your symptoms are due to post-concussion syndrome, treatment may include rest, cognitive therapy, and possibly medications to manage headaches or other symptoms. It's also essential to avoid activities that could risk another concussion while you are still recovering.

In summary, while your initial recovery seemed to progress well, the emergence of new symptoms after a concussion warrants careful evaluation. Delayed intracranial hemorrhage is a serious concern that should not be overlooked, and post-concussion syndrome could also be a contributing factor to your ongoing symptoms. Please consult a healthcare provider as soon as possible to ensure proper assessment and management of your condition. Your health and safety are paramount, and timely intervention can make a significant difference in your recovery.

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