Dizziness and headache?
Hello, Dr.
Zhang.
I would like to ask you about an incident that happened 10 months ago when I hit my head and had a small amount of bleeding from my scalp.
At that time, I only felt pain, so I didn't see a doctor.
A few months later, the impact site started to occasionally hurt, but it wasn't very painful.
It is also accompanied by dizziness, especially when I bend down or turn my head.
Sometimes, I experience brief moments of instability while standing.
I consulted a doctor and underwent an MRI and carotid artery examination, which showed no issues.
However, in the past few days, I suddenly noticed a depression near the impact site on the back of my head.
I asked the doctor, and he said it was nothing to worry about, but the area of the depression is painful.
Could you please explain why this depression appeared suddenly and what kind of examination I should undergo to determine the cause of the depression?
Feng Zhi, 50~59 year old female. Ask Date: 2021/03/16
Dr. Zhang Junwei reply Neurosurgery
Without a physical examination, it is difficult to understand what you mean by "indentation." I recommend consulting a neurosurgery outpatient clinic for evaluation.
Reply Date: 2021/03/16
More Info
After experiencing a head injury, particularly one that involves a significant impact, it is not uncommon for individuals to develop symptoms such as headaches and dizziness. In your case, the timeline of events and symptoms you described suggests a few potential underlying issues that merit further exploration.
Firstly, the initial impact you sustained, which resulted in a small amount of bleeding from the scalp, could have led to a mild traumatic brain injury (TBI), commonly referred to as a concussion. Even if you felt fine immediately after the injury, it is possible for symptoms to manifest later, which can include headaches, dizziness, and even cognitive disturbances. The fact that you are experiencing pain at the site of the injury months later, along with dizziness when moving your head, could indicate that there is still some residual effect from the initial trauma.
The presence of a "dimple" or depression in the area where you were injured is particularly concerning. This could be a sign of a few different conditions. One possibility is that the impact caused a localized area of bone remodeling or a small fracture that has not healed properly. In some cases, the body may absorb some of the bone tissue in response to trauma, leading to a depression in the skull. Another possibility is that there could be an underlying issue related to the soft tissues or muscles surrounding the injury site, which might be contributing to your pain and the sensation of dizziness.
Dizziness, especially when moving your head, can be attributed to several factors. It could be related to vestibular dysfunction, which is often seen after head injuries. The vestibular system, which helps control balance, can be affected by trauma, leading to symptoms such as vertigo or a sensation of unsteadiness. Additionally, tension headaches or cervicogenic headaches, which originate from issues in the neck, can also cause dizziness and are often exacerbated by head movements.
Given your symptoms and the recent discovery of the depression in your skull, it is advisable to seek further evaluation from a neurologist or a specialist in head injuries. They may recommend additional imaging studies, such as a CT scan, to assess the integrity of the skull and the underlying structures. This can help determine if there is any significant damage that requires intervention.
In the meantime, it is essential to monitor your symptoms closely. If you experience worsening headaches, increased dizziness, or any new neurological symptoms such as vision changes, weakness, or difficulty speaking, you should seek immediate medical attention.
In terms of management, ensuring adequate rest and avoiding activities that could exacerbate your symptoms is crucial. Engaging in gentle neck exercises and maintaining good posture may also help alleviate some of the discomfort associated with dizziness. If your symptoms persist or worsen, medication may be prescribed to help manage headaches or dizziness, depending on the underlying cause identified by your healthcare provider.
In conclusion, while it is reassuring that initial imaging studies did not reveal any significant issues, the persistence of your symptoms and the new development of a depression in the skull warrant further investigation. It is essential to work closely with your healthcare team to ensure a comprehensive evaluation and appropriate management of your condition.
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