Persistent Head Pain After Trauma: A Patient's Journey

Head issues?

Hello, Doctor: In 2004, I had a conflict with a classmate, and while I was napping on my desk during lunch, this classmate struck the back right side of my head forcefully with something, possibly a chair, as he is quite large.
This was not a single strike! At that time, I was unconscious for a long while.
When I painfully woke up, I felt extreme pain in the back right side of my head, and I could barely see the surroundings.
I forgot to apply ice initially and instead used a traditional Chinese medicine ointment with safflower, trying to alleviate the intense pain, but it was ineffective! After that incident, a large lump formed near the back right side of my head, close to my right ear.
It wasn't until a few years later that I recalled why that area of my head was so painful! Every time I got a haircut, the barber would mention the lump.
I also consulted with rehabilitation and traditional Chinese medicine doctors, but the improvement was very slow! The rehabilitation doctor even said the affected area was quite serious! Fortunately, I survived that incident.
Since then, the pain in the back of my head has persisted, and I occasionally feel dizzy.
I am unsure what happened to my head back then (in 2004), as I did not see a doctor at the time.
I wonder if I had a concussion or what kind of examinations I should undergo? The pain has continued until now, and the lump remains large! Due to the slow progress of rehabilitation and traditional Chinese medicine treatment, I asked the rehabilitation doctor to prescribe me topical ointments like Aisa and Sishu.
Whenever I get a haircut, I shave my head to make it easier to apply the medication.
Since I wash my hair frequently, it grows back quickly, making it difficult to apply the ointment after a while because it gets on my hair, and the scalp area is hard to treat.
As of now (2020), the large lump is still there, and the pain occasionally flares up.
Sometimes, I massage it directly with my hands, but it is still ineffective.
The lump remains hard.
I suspect there is internal injury to my head! What treatment should I pursue? What examinations should I undergo? I am a person with mental disabilities, and I apologize if my writing is unclear! I can only input what comes to mind, and this is my limit.
Thank you for your response.

Qiu Zhiyao, 30~39 year old female. Ask Date: 2020/03/25

Dr. Li Zhonghuai reply Surgery

Hello! It is recommended to visit a hospital for an ultrasound to determine if there is any residual hematoma.
Although the injury occurred years ago, theoretically, the blood clot should have been absorbed.
However, in clinical practice, there are cases where the clot does not get absorbed and forms a capsule, which can compress surrounding tissues and cause symptoms.
Take care! Changhua Hospital is concerned about you!

Reply Date: 2020/03/25

More Info

I'm sorry to hear about your ongoing pain and discomfort following your head injury. It sounds like you've been through a lot since that traumatic event. Let's break down your situation and discuss what you might consider doing next.

First and foremost, it’s important to recognize that head injuries can have long-lasting effects, especially if they were severe or went untreated initially. In your case, the repeated trauma to the right side of your head, particularly if it caused you to lose consciousness, raises concerns about potential complications such as a concussion or even more serious conditions like a hematoma (a collection of blood outside of blood vessels) or skull fracture.
The persistent pain and the lump you describe could indicate a few things. It might be a result of soft tissue damage, such as contusions (bruises) or even a chronic condition like post-traumatic headache, which can occur after head injuries. The fact that you have a hard lump suggests that there may be some residual swelling or even a buildup of scar tissue in that area.
Given that you have been experiencing these symptoms for many years, it is crucial to seek a thorough evaluation from a healthcare professional, preferably a neurologist or a neurosurgeon. They can conduct a detailed examination and may recommend imaging studies, such as a CT scan or MRI, to assess the condition of your brain and skull. These tests can help identify any structural issues that may be contributing to your ongoing symptoms.

In terms of treatment, it sounds like you have already tried various topical medications and therapies. While these can provide some relief, they may not address the underlying issue. A neurologist might suggest other treatment options, including physical therapy, medication for pain management, or even more advanced interventions if necessary.

Additionally, since you mentioned that you are a person with mental disabilities, it’s essential to have a support system in place. If possible, bring a family member or friend with you to appointments to help communicate your concerns and ensure that you receive the care you need.

As for your question about whether you might have had a concussion, it’s possible, especially given the loss of consciousness and the severity of the impact. Concussions can lead to a range of symptoms, including headaches, dizziness, and cognitive difficulties, and they can sometimes have long-lasting effects if not properly managed.

In summary, I strongly encourage you to seek a comprehensive evaluation from a specialist who can assess your condition and recommend appropriate treatment. It’s important to address these ongoing symptoms, as they can significantly impact your quality of life. Remember, you deserve to feel better and to have your concerns taken seriously. Don’t hesitate to advocate for yourself in seeking the care you need.

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