Post-Concussion Symptoms: Pain and Numbness Explained

Post-concussion syndrome may involve symptoms such as pain and numbness?

Hello, Doctor.
On the night of October 1st last year, I slightly bumped the upper right side of my head against a car door after slipping.
It hurt a lot at the moment, and I instinctively rubbed it.
Later, I started feeling dizzy and quickly applied ice, which helped reduce the pain.
I occasionally iced it when I got home.
By the afternoon of the third day, I began to feel dizzy again, so I visited a nearby clinic where I was prescribed medication for dizziness and pain relief.
However, I continued to experience dizziness and a tight sensation in my head and neck.
On the night of October 12th, I suddenly felt very dizzy and went to the emergency room, where a CT scan of my head was performed.
The doctor said there was no major issue with my brain and prescribed anti-dizziness medication, which helped significantly.

However, starting in early January this year, I began to experience strange symptoms; the area where I had bumped my head would occasionally feel sharp pain and numbness, but it wasn't daily.
On January 7th, I made an appointment with a neurosurgeon.
Since the previous CT scan showed no issues, the doctor suggested a scan of my neck.
I reviewed the report on January 21st, which also indicated no problems.
I was again prescribed medication for dizziness and pain, with instructions to take them if I felt uncomfortable.

In recent days, these symptoms have been occurring daily, with no specific pattern for when they happen—sometimes in the afternoon, sometimes at night, and occasionally waking up with a numb head.
The symptoms include slight pain in the area I bumped, occasional numbness, and tightness or numbness from the back of my neck to the base of my skull, sometimes extending to the left side as well.

I would like to ask if these symptoms are also residual effects of a concussion, as mentioned in some articles I read earlier.
Could they persist for a long time as described? Since the examinations have all indicated no issues, I'm unsure which specialty to consult next.
I'm feeling a bit anxious and don't know how to proceed.
I hope you can help clarify this for me.
Thank you.

Xiao Zhen, 40~49 year old female. Ask Date: 2021/01/28

Dr. Zhang Junwei reply Neurosurgery

It doesn't sound like post-concussion syndrome; it's just a general bruise and cervical strain.
It's recommended to take anti-inflammatory medication and get plenty of rest.

Reply Date: 2021/01/28

More Info

Post-concussion symptoms can be quite complex and distressing, especially when they persist for an extended period after the initial injury. Based on your description, it seems that you experienced a significant head injury from a fall, which led to a series of symptoms including dizziness, pain, and numbness in the affected area. These symptoms can indeed be associated with post-concussion syndrome (PCS), which is a condition that can occur after a concussion or mild traumatic brain injury (TBI).

Understanding Post-Concussion Syndrome
Post-concussion syndrome is characterized by a variety of symptoms that can last for weeks, months, or even longer after the initial injury. Common symptoms include:
1. Headaches: These can vary in intensity and may resemble tension-type headaches or migraines.

2. Dizziness and Balance Issues: Many individuals report ongoing dizziness, which can be exacerbated by movement or changes in position.

3. Cognitive Difficulties: Problems with concentration, memory, and mental clarity are frequently reported.

4. Emotional Changes: Anxiety, depression, and irritability can also occur.

5. Sleep Disturbances: Insomnia or changes in sleep patterns are common.

Pain and Numbness
The pain and numbness you are experiencing in the area of the injury, as well as in the neck and back of the head, can be attributed to several factors:
- Nerve Irritation: The impact from your fall may have caused irritation or inflammation of the nerves in the cervical spine, leading to symptoms such as numbness or tingling.

- Muscle Tension: The muscles in the neck and upper back may become tense or strained due to the injury, contributing to pain and discomfort.

- Cervical Strain: If there was any whiplash or strain to the cervical spine during the fall, this could also lead to ongoing symptoms.

Duration of Symptoms
It is not uncommon for post-concussion symptoms to persist for an extended period. Some individuals may recover fully within a few weeks, while others may experience symptoms for several months or longer. Factors that can influence recovery include the severity of the initial injury, the presence of pre-existing conditions, and the individual's overall health.

Recommendations for Management
1. Follow-Up Care: Since you have already seen a neurologist and had imaging studies that did not show any significant issues, it may be beneficial to continue follow-up care with a specialist who understands post-concussion syndrome. A neurologist or a rehabilitation specialist with experience in concussion management would be ideal.

2. Physical Therapy: Engaging in physical therapy can help address muscle tension and improve neck strength and flexibility, which may alleviate some of your symptoms.

3. Pain Management: If you are experiencing significant pain, discussing pain management options with your healthcare provider is essential. This may include medications, physical therapy, or other modalities.

4. Cognitive and Behavioral Therapy: If cognitive symptoms or emotional distress are significant, cognitive-behavioral therapy (CBT) may be beneficial.

5. Lifestyle Modifications: Ensure you are getting adequate rest, staying hydrated, and avoiding activities that may exacerbate your symptoms. Gradually reintroducing activities can also help.

6. Monitoring Symptoms: Keep a diary of your symptoms, noting when they occur and any potential triggers. This information can be valuable for your healthcare provider in tailoring your treatment plan.

Conclusion
In summary, the symptoms you are experiencing could indeed be related to post-concussion syndrome, and it is essential to continue seeking appropriate medical care. While it can be frustrating to deal with ongoing symptoms, many individuals do find relief with the right combination of treatments and support. Don't hesitate to reach out to your healthcare provider for further evaluation and to discuss your concerns. Your health and well-being are paramount, and there are resources available to help you navigate this challenging time.

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