Intracranial Hemorrhage: When to Seek Medical Attention

Intracranial hemorrhage

Hello, Dr.
Yeh.
I would like to ask you: As a child, I was a victim of domestic violence and was thrown to the ground, hitting my head, which caused nosebleeds, swelling, and impaired vision.
I also experienced bleeding from both ears; I was struck in the eyes, and at that time, I felt dizzy and had headaches, along with prolonged vomiting.
I often felt nauseous while traveling, and I have lost some memories.
My knees frequently bled.
From ages 10 to 28, I was often beaten, had my neck twisted, my legs pulled, and was subjected to physical assaults, including being bled with needles.
At age 10, I was thrown to the ground and hit my head against a glass door.
My family even hired others to bully me, and I was disturbed while trying to sleep, which led to confusion and a disrupted day-night cycle.
Should I have my head examined? I do not have any visible external injuries.
If necessary, which department should I visit? What kind of examinations should I undergo?

Xue Tu, 30~39 year old female. Ask Date: 2021/12/03

Dr. Ye Qianyu reply Family Medicine

Hello! Based on your description, I recommend that you visit a psychiatry clinic.
As for the examinations, they should be determined by a physician after a consultation.

Reply Date: 2021/12/03

More Info

Given the history of trauma you've described, it is crucial to seek medical attention for a thorough evaluation of your head and overall neurological health. Intracranial hemorrhage (ICH) can occur after head trauma, and symptoms may not always be immediately apparent. Here’s a detailed explanation of why you should consider medical evaluation and what steps to take.

When to Seek Medical Attention
1. Symptoms of Intracranial Hemorrhage: You mentioned experiencing nosebleeds, headaches, dizziness, and visual disturbances, which can be indicative of ICH. Other symptoms to watch for include confusion, difficulty speaking, weakness in limbs, seizures, or loss of consciousness. Given your history of trauma, these symptoms warrant immediate medical evaluation.

2. Delayed Symptoms: Sometimes, symptoms of ICH can develop days or even weeks after the initial injury. This is particularly concerning in cases of repeated trauma, as cumulative effects can lead to more severe complications.

3. Psychological Impact: The history of abuse and trauma you've described can also lead to psychological effects, including anxiety, depression, and post-traumatic stress disorder (PTSD). These conditions can exacerbate physical symptoms and should be addressed as part of your overall health assessment.

Recommended Medical Evaluation
1. Consulting the Right Specialist: Given your symptoms and history, you should consider seeing a neurologist or a neurosurgeon. These specialists are trained to evaluate and manage conditions related to the brain and nervous system.

2. Diagnostic Imaging: The most common initial test for assessing potential intracranial hemorrhage is a CT scan of the head. This imaging can quickly reveal any bleeding, swelling, or structural abnormalities in the brain. In some cases, an MRI may be recommended for a more detailed view, especially if there are concerns about chronic issues or subtle changes.

3. Neurological Examination: A thorough neurological examination will assess your cognitive function, reflexes, coordination, and sensory responses. This can help determine if there are any immediate concerns that need to be addressed.

Follow-Up Care
1. Monitoring Symptoms: After your initial evaluation, it’s essential to monitor any changes in your symptoms. If you experience worsening headaches, new neurological symptoms, or changes in your mental status, seek immediate medical attention.

2. Psychological Support: Given the history of trauma, it may be beneficial to also seek psychological support. Therapy can help address the emotional and psychological impacts of your experiences, which can be just as important as physical health.

3. Preventive Measures: If any injuries or conditions are identified, your healthcare provider will discuss potential treatment options, which may include medication, physical therapy, or other interventions to manage symptoms and improve your quality of life.

Conclusion
In summary, based on your history of trauma and the symptoms you are experiencing, it is highly advisable to seek medical attention. A neurologist can provide a comprehensive evaluation and determine if further imaging or treatment is necessary. Don't hesitate to reach out for help; your health and well-being are paramount.

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