Evaluating Long-Term Effects of Traumatic Brain Injury on Neurological Health

Four years ago, I sustained a concussion to the right posterior part of my brain?

Doctor: Hello, four years ago during my postpartum period, I fell from a table and hit the back right side of my head, resulting in a large swelling.
I was taken to the emergency room, and after a CT scan, it was determined that I had a subdural hematoma causing the swelling, but there was no concussion.
Over the past four years, I have experienced distressing symptoms such as dizziness, headaches, palpitations, chest tightness, and stiffness in my neck and shoulders.
I have visited numerous hospitals and consulted various specialties without finding a cause, and I was eventually told it might be autonomic nervous system dysfunction.
Recently, I have developed severe left-sided hand tremors and my left side shakes while I sleep, leading me to suspect whether this could be related to the head injury I sustained four years ago.
Could you please help me evaluate this? Thank you.

Yuan Xiaojie, 30~39 year old female. Ask Date: 2021/07/19

Dr. Cai Zongzhang reply Neurology

Hello, Ms.
Yuan! If you have a head injury that did not involve the brain, it should not leave any lasting effects.
If you are still experiencing symptoms after four years, there may be another underlying cause.
It is recommended that you visit a neurology outpatient clinic.

Reply Date: 2021/07/19

More Info

Hello, thank you for sharing your experience. It sounds like you've been through a lot since your traumatic brain injury (TBI) four years ago. Evaluating the long-term effects of TBI on neurological health can be complex, as symptoms can vary widely among individuals and may not always be directly linked to the initial injury.

First, let's address your concerns regarding the symptoms you have been experiencing, such as dizziness, headaches, palpitations, chest tightness, and neck stiffness. These symptoms can indeed be associated with TBI, particularly if there has been any disruption to the brain's normal functioning. After a TBI, it is not uncommon for individuals to experience a range of neurological symptoms due to changes in brain chemistry, inflammation, or even structural changes in the brain itself.

1. Post-Concussion Syndrome (PCS): Even if you did not experience a concussion at the time of your injury, the symptoms you describe could be indicative of post-concussion syndrome, which can occur after a TBI. PCS can manifest as headaches, dizziness, cognitive difficulties, and emotional disturbances, and it can persist for months or even years after the initial injury.

2. Autonomic Nervous System Dysfunction: The symptoms of palpitations and chest tightness may suggest some involvement of the autonomic nervous system, which regulates involuntary bodily functions. TBI can lead to dysregulation of this system, resulting in symptoms such as heart palpitations, changes in blood pressure, and gastrointestinal issues.

3. Neurological Evaluation: The recent onset of left-sided tremors and involuntary movements during sleep raises additional concerns. These symptoms could be related to several neurological conditions, including but not limited to essential tremor, Parkinsonian syndromes, or even post-traumatic movement disorders. It is crucial to have a thorough neurological evaluation, including imaging studies if necessary, to rule out any structural or functional abnormalities in the brain.

4. Neuropsychological Assessment: Given the complexity of your symptoms, a neuropsychological assessment may also be beneficial. This can help evaluate cognitive functions such as memory, attention, and executive function, which may have been affected by your TBI.

5. Management and Treatment: Treatment for long-term effects of TBI often involves a multidisciplinary approach. This may include physical therapy for neck stiffness, cognitive rehabilitation for memory and attention issues, and possibly medication for mood stabilization or to address specific symptoms like tremors. Additionally, lifestyle modifications, such as regular exercise, a balanced diet, and stress management techniques, can also play a significant role in recovery.

6. Follow-Up Care: It is essential to maintain regular follow-ups with your healthcare providers, including neurologists and possibly other specialists, to monitor your symptoms and adjust treatment plans as necessary. Keeping a symptom diary can also help you and your doctors identify patterns and triggers related to your symptoms.

In conclusion, while it is possible that your current symptoms are related to your previous TBI, a comprehensive evaluation is necessary to understand the underlying causes fully. I encourage you to seek a consultation with a neurologist who specializes in TBI and movement disorders to get a clearer picture of your condition and to develop an appropriate management plan. Your health and well-being are paramount, and addressing these concerns with a specialist will be a crucial step in your recovery journey. Thank you for reaching out, and I wish you the best in your path to better health.

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