Post-Injury Symptoms: Brain Edema, Numbness, and Bone Pain

Cerebral edema, scalp numbness, bone pain?

Hello, I would like to briefly describe my condition.
Four weeks ago, I was involved in a motorcycle accident and was hospitalized for three weeks, being discharged last week.
During this time, I underwent debridement surgery twice and a skin graft.
Upon arrival at the emergency department, I was diagnosed with cerebral edema, a mild concussion, a torn ligament in my right big toe, a fractured index finger, and multiple contusions that required suturing.
I have two questions I hope to clarify:
1.
Within a week of my discharge, I experienced shortness of breath, palpitations, generalized weakness, wheezing, night sweats, and hand tremors on two occasions (both occurring at night).
After these episodes, I did not return to a major hospital but went to a small clinic where the doctor suspected hyperthyroidism, although previous tests indicated I did not have it.
I am currently awaiting the results of my blood tests.
However, I am more concerned about whether the symptoms I experienced are related to the swelling on the outside of my head and the numbness of the skin.
Is there a possibility that there are other issues occurring in my brain, or could it simply be hyperthyroidism?
2.
After the debridement on my right elbow, it seems that the joint pain is worsening, and I am unable to bend my arm.
I have already consulted the attending physician, who mentioned that the pain is due to the accident.
However, I did not have this issue initially.
Could it be that the wound has infected the bone, or is it possible that the depth of the debridement has caused surrounding inflammation?

DAN, 30~39 year old female. Ask Date: 2021/05/26

Dr. Xu Kaixi reply Surgery

1.
The symptoms associated with the diagnosis you provided, "cerebral edema and mild concussion," primarily include dizziness and headaches, which are not directly related to the symptoms you mentioned, such as "shortness of breath, palpitations, generalized weakness, wheezing, night sweats, and tremors." The main treatment for "cerebral edema and mild concussion" is conservative management, including rest and medication, while monitoring for any other symptoms related to head trauma.
Theoretically, the symptoms of dizziness and headaches should improve over time.
2.
After debridement and healing of the elbow wound, scar tissue will form, which may lead to neuropathic pain.
Since the injury is located at a joint, the pain may be more pronounced, and the recovery time may be longer.
Additionally, the range of motion in the elbow joint may be restricted due to scar tissue, affecting mobility.
It is recommended to consult with a rehabilitation specialist to assess the need for rehabilitative therapy.

Reply Date: 2021/05/26

More Info

I'm sorry to hear about your recent accident and the challenges you're facing during your recovery. It sounds like you've been through a lot, and it's understandable to have concerns about your symptoms. Let's address your questions regarding your post-injury symptoms, particularly focusing on brain edema, numbness, and bone pain.

1. Symptoms Related to Brain Edema and Numbness
After a traumatic brain injury (TBI), such as the one you experienced from your motorcycle accident, it's common to have a range of symptoms due to brain edema (swelling) and other potential complications. The symptoms you described—shortness of breath, palpitations, generalized weakness, sweating, and tremors—could be multifactorial. While they may seem alarming, they can arise from various causes, including:
- Anxiety or Stress Response: The trauma of the accident and subsequent hospitalization can lead to anxiety, which may manifest as palpitations, sweating, and tremors, especially during the night.

- Thyroid Issues: As your doctor suggested, hyperthyroidism (overactive thyroid) could cause symptoms like palpitations and sweating. It's good that you're awaiting blood tests to clarify this.

- Neurological Concerns: Although your initial CT scan indicated brain edema, it’s crucial to monitor for any new or worsening neurological symptoms. Numbness and changes in sensation can occur due to nerve compression or damage, which might not have been fully assessed after your initial hospitalization.

Given that you have numbness and skin insensitivity, it’s essential to follow up with a neurologist. They may recommend additional imaging, such as an MRI, to evaluate the brain and surrounding structures more thoroughly. This will help rule out any complications like post-traumatic seizures, further edema, or other neurological issues.

2. Pain in the Right Elbow and Potential Infection
Regarding the pain in your right elbow following the debridement and skin graft, it’s not uncommon to experience increased pain after such procedures. However, there are several possibilities to consider:
- Post-Surgical Pain: After surgeries, especially those involving deep tissue, it’s normal to experience pain as the body heals. This pain can sometimes be exacerbated by inflammation in the surrounding tissues.

- Infection: If there is a concern about infection, especially if the pain is worsening or if you notice increased redness, warmth, or discharge from the surgical site, it’s crucial to seek medical attention. An infection can lead to osteomyelitis (infection of the bone), which would require prompt treatment.

- Joint Stiffness: After an injury, especially with immobilization, joints can become stiff. Physical therapy may be necessary to regain range of motion and strength in your elbow.

Recommendations
1. Follow-Up with Specialists: Given your symptoms, it would be wise to consult both a neurologist for your brain-related concerns and an orthopedic specialist for your elbow pain. They can provide targeted assessments and treatment plans.

2. Monitor Symptoms: Keep a detailed log of your symptoms, including when they occur, their severity, and any associated factors (like stress or activity levels). This information can be invaluable for your healthcare providers.

3. Physical Therapy: If you haven’t already, consider starting physical therapy for your elbow. A therapist can help you with exercises to improve mobility and strength, which may alleviate some of the pain.

4. Stay Informed: Continue to advocate for your health. If you feel that your concerns are not being addressed adequately, don’t hesitate to seek a second opinion or ask for further evaluations.

In conclusion, your symptoms warrant careful monitoring and follow-up with appropriate specialists. Recovery from a traumatic injury can be complex, and it’s essential to address both physical and psychological aspects of healing. I wish you a smooth recovery and hope you find the answers you need to feel better soon.

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