Post-Accident Neurological Issues: Symptoms and Recovery

Regarding dizziness after a car accident, issues related to the frontal lobe of the brain, neck problems, and intracranial hemorrhage?

Hello, Doctor: Regarding the topic in question, I suffered a head injury after a car accident while wearing a helmet, and I lost consciousness upon impact with the ground.
At the emergency room, the doctor only addressed my more obvious external injuries, neglecting the less visible ones.
Due to my unconscious state and intracranial hemorrhage, I was hospitalized in the intensive care unit for three days.
The diagnosis given by the doctor included subarachnoid hemorrhage, coccygeal fracture, and ocular muscle paralysis.
On the third day, after regaining consciousness, I was transferred to a general ward because my brain had successfully absorbed the blood.
However, after becoming aware, I experienced severe pain in my head and neck, tingling and numbness on the left side of my face and hand, double vision, and loss of smell and taste.
There was also no response when tapping my knees, and I felt extremely dizzy, making it impossible to walk independently.
The neurosurgeon kept telling me that it was not a concern.
Later, my family suggested transferring to another hospital for further evaluation, which displeased the doctor, who then reiterated the previous diagnosis.
The next day, after transferring to a second hospital, the neurosurgeon reviewed the CT scan and informed us that the tingling in my hands and face, along with neck pain, were due to the fifth and sixth cervical vertebrae compressing the nerves from the traumatic injury.
He stated that pain relief was possible, but a cure could only be achieved through surgery, so I was admitted for surgery scheduling (I couldn't rely on pain medication for life).
After the doctor replaced the artificial cervical disc, the tingling sensation and neck pain ceased.
During the consultation, I asked the doctor about my dizziness, double vision, and loss of smell and taste.
The doctor explained that this was due to significant impact causing damage to the frontal lobe nerves, which could not be surgically repaired and would require gradual recovery through medication.
When I asked the first hospital about the same issue during a follow-up visit, the doctor provided the same explanation regarding frontal lobe nerve damage.
I inquired why the diagnosis included ocular muscle paralysis instead of frontal lobe damage, to which he silently replied that they were essentially the same.
He mentioned that to examine the frontal lobe nerves, I would need to go to Taichung Veterans General Hospital, as the current hospital did not have the necessary equipment (I am from the southern region).
After sharing all this, I would like to ask some professional questions: 1.
What is the relationship between intracranial hemorrhage and subarachnoid hemorrhage (what potential sequelae should be avoided)? 2.
Is the frontal lobe nerve damage responsible for my dizziness and loss of smell and taste? How long is the expected recovery period? Can medication truly facilitate recovery? Is special equipment required to assess the condition of the frontal lobe? 3.
As of now, my vision has improved somewhat, but the dizziness and loss of smell and taste remain unchanged.
4.
Is there a recovery period after replacing the cervical artificial disc? What should I be aware of? How long is the integration period for the disc?

Gua Gua Cheng, 30~39 year old female. Ask Date: 2020/04/04

Dr. Lai Zhaokang reply Neurosurgery

1.
Subarachnoid hemorrhage is a type of intracranial hemorrhage.
2.
Observation and treatment may be possible for 3-6 months, with potential improvement.
There is no specific medication, but acupuncture treatment in conjunction with traditional Chinese medicine can be considered.
For frontal lobe instrumentation, inquiries should be directed to a major medical center (as its clinical significance is minimal; very few patients require further investigation since treatment approaches are generally similar and will not significantly change after examination).
3.
Continue treatment.
4.
Generally, 3 months; you should consult your surgeon, as they have the responsibility to answer your questions.
Best wishes.
/// Neurosurgery Dr.
Lai Chao-Kang.

Reply Date: 2020/04/04

More Info

Post-accident neurological issues can be complex and multifaceted, especially following a traumatic brain injury (TBI) like the one you experienced in your car accident. Let's break down your questions and concerns systematically.

1. Relationship Between Intracranial Hemorrhage and Subarachnoid Hemorrhage:
Intracranial hemorrhage refers to bleeding within the skull, which can occur in various locations, including the subarachnoid space. Subarachnoid hemorrhage (SAH) specifically involves bleeding into the space between the brain and the tissues covering it. This condition can lead to increased intracranial pressure, which may cause severe headaches, neurological deficits, and can potentially lead to complications such as vasospasm (narrowing of blood vessels) that can further impair blood flow to the brain. Long-term consequences can include cognitive deficits, motor impairments, and in severe cases, death. It is crucial to monitor for symptoms such as severe headaches, changes in consciousness, or neurological deficits, as these may indicate complications.

2. Frontal Lobe Nerve Damage and Associated Symptoms:
Damage to the frontal lobe can indeed result in a variety of symptoms, including cognitive impairments, changes in personality, and loss of certain sensory functions such as smell (anosmia) and taste (ageusia). The symptoms you describe—dizziness, loss of smell and taste, and visual disturbances—can be linked to frontal lobe injury. Recovery from such injuries can vary significantly depending on the extent of the damage. While some functions may improve over time with rehabilitation and medication, others may take longer or may not fully recover. The recovery period can range from weeks to months, and in some cases, ongoing therapy may be necessary.

3. Recovery and Rehabilitation:
The recovery process for brain injuries is often gradual and can be influenced by various factors, including the severity of the injury, the individual's overall health, and the effectiveness of rehabilitation efforts. Medications may help manage symptoms and facilitate recovery, but they are not a guaranteed solution for restoring lost functions. Specialized assessments, such as neuropsychological evaluations or advanced imaging techniques (like MRI or functional MRI), may be needed to evaluate the extent of frontal lobe damage and guide treatment.

4. Post-Surgery Recovery from Cervical Artificial Disc Replacement:
Following cervical artificial disc replacement, there is typically a recovery period during which the body heals and adjusts to the new disc. This period can vary but often lasts several weeks to months. During this time, it is important to follow your surgeon's guidelines regarding activity restrictions, physical therapy, and pain management. You may experience some discomfort as your body adapts, but significant pain should be addressed with your healthcare provider. The integration of the artificial disc into the surrounding tissue is crucial for long-term success, and this process can take time.

In conclusion, your symptoms and recovery trajectory are influenced by the nature of your injuries and the treatments you have received. It is essential to maintain open communication with your healthcare providers, seek second opinions if necessary, and engage in rehabilitation programs tailored to your specific needs. Regular follow-ups and assessments will help monitor your progress and adjust treatment plans as needed. Remember, recovery from brain injuries can be a long and challenging process, but with appropriate care and support, many individuals can achieve significant improvements.

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