Head Injuries: Symptoms, Medications, and Recovery

Regarding the issue of head trauma?

Hello, doctor.
I am 21 years old, and I would like to describe my situation: On January 27, 2022, around 2 to 3 PM, I was moving heavy objects into my car when the trunk door did not fully open and hit me.
The impact was quite strong, and I immediately crouched down.
During the impact, I was conscious and did not lose consciousness or experience any bleeding, but the area became red and swollen.
After the impact, I rubbed the area (although I later found out this was not advisable) and applied ice about 4 to 5 times (icing for 10 to 20 minutes, then resting for 20 minutes).
A few hours later, I began to feel headaches and dizziness, along with a sensation of my thoughts lagging behind what I was seeing, and I felt sleepy (which may also be due to taking cold medication).
Since I still felt dizzy upon waking up, the next day (January 28, 2022), I went to the neurosurgery outpatient clinic at Kaohsiung Medical University for an examination.
Since there was no bleeding and I did not lose consciousness, the doctor took an X-ray (only an X-ray examination) and said everything looked fine but advised monitoring.
The doctor mentioned that my sleepiness might be related to the cold medication I was taking.
The doctor prescribed me two medications: Diphenidol and Alinamin-F 50.
After taking them, my dizziness became more pronounced, and I started feeling sleepy.
I researched the side effects of Diphenidol and found that drowsiness is listed, but the medication packaging only mentioned "occasional dry mouth" as a side effect.
I would like to ask: 1.
Do the medications prescribed by the doctor have side effects of dizziness and drowsiness? Is this side effect normal, or should I stop taking the medication? 2.
Is it normal to feel dizzy and sleepy after the impact (before taking the medication)? 3.
The doctor said the X-ray showed no issues, which I assume means there are no fractures.
Should I still be concerned about the possibility of internal bleeding? 4.
Is this a concussion? How long does it typically take for improvement to be considered normal? 5.
I know that head injuries require monitoring for about 72 hours; if I still experience dizziness and headaches after 72 hours, should I go to the hospital? 6.
The impacted area is on the right side of my head, approximately in the middle to the back.
Should I avoid lying on my right side while sleeping, and which position is more appropriate: lying flat or on my left side? I look forward to your response, and thank you for your patience in reading this.

Chen Tongxue, 20~29 year old female. Ask Date: 2022/01/28

Dr. Zhao Shaoqing reply Neurosurgery

1.
Do the medications prescribed by the doctor have side effects such as dizziness and drowsiness? Are these side effects normal, or should the medication be discontinued? Answer: All medications can have a certain degree of side effects.
If you experience discomfort after taking them, it is advisable to return for a follow-up and discuss it with your doctor.
2.
Is it normal to feel dizzy and sleepy after a collision (before taking any medication)? Answer: Dizziness and nausea can be symptoms of a head injury, but the severity and presentation can vary among patients.
It is recommended to continue monitoring your symptoms and discuss them with your doctor.
3.
The impacted area is the right side of the head, approximately in the middle to the back.
Should I avoid lying on my right side while sleeping, and which position is more appropriate: lying flat or on my left side? Answer: If there is an injury, it is important to avoid positions that may exacerbate the injury.
It is recommended to find a comfortable sleeping position that does not put pressure on the injured area.
Your health is a priority at Changhua Hospital.

Reply Date: 2022/01/28

More Info

Understanding head injuries is crucial, especially after experiencing trauma like the one you've described. Your situation involves a significant impact to the head, which can lead to various symptoms and complications. Let's address your questions systematically.

1. Medication Side Effects: Both Diphenidol and Alinamin-F can indeed cause drowsiness and dizziness as side effects. Diphenidol is an antihistamine that can lead to sedation, which might explain your increased desire to sleep. If these side effects are bothersome or impair your daily activities, it would be wise to consult your doctor about possibly adjusting your medication or dosage.

2. Post-Injury Symptoms: Experiencing dizziness and a feeling of sleepiness after a head injury can be normal, especially if you have sustained a concussion or mild traumatic brain injury (TBI). These symptoms can occur due to the brain's response to trauma, and they may persist for a few days to weeks depending on the severity of the injury.

3. Concerns About Internal Bleeding: While the X-ray results indicated no fractures, it is important to note that X-rays do not visualize soft tissue or internal bleeding. The risk of intracranial bleeding, such as a subdural or epidural hematoma, can still exist, especially if you experience worsening symptoms like severe headaches, confusion, or changes in consciousness. If you have any concerns, it is advisable to seek further evaluation, possibly with a CT scan, which is more effective in assessing brain injuries.

4. Concussion Diagnosis: Given your symptoms and the mechanism of injury, it is plausible that you have experienced a concussion. Recovery from a concussion varies widely among individuals, but many people start to feel better within a week or two. However, some may experience prolonged symptoms, known as post-concussion syndrome, which can last for weeks or even months.

5. Monitoring Symptoms: The 72-hour observation period is critical after a head injury. If you continue to experience dizziness or headaches beyond this timeframe, or if your symptoms worsen, it is essential to return to the hospital for further assessment. Persistent symptoms may indicate complications that require medical attention.

6. Sleeping Position: After a head injury, it is generally recommended to avoid lying on the injured side (in your case, the right side) to minimize discomfort and potential pressure on the injury site. Sleeping on your back or the left side is advisable. Ensure that your sleeping environment is comfortable and supportive to promote better rest during your recovery.

In addition to these points, it is essential to follow up with your healthcare provider regularly. They can monitor your recovery and adjust your treatment plan as necessary. Avoiding strenuous activities, getting plenty of rest, and staying hydrated are also important during your recovery phase. If you have any new symptoms or concerns, do not hesitate to seek medical advice. Your health and safety should always come first.

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