Post-Impact Head Discomfort: Causes and Concerns

Q: Post-Impact Head Discomfort: Causes and Concerns

Hello, sir： You mentioned, "Has the impact to the head caused internal bleeding or delayed bleeding? It has been a year and a half; could it last this long? Additionally, could the earlier tooth extraction have affected the brain? After all, I have been experiencing discomfort in

Head trauma

Hello, doctor.
In the first half of 2020, I had two upper molars extracted, and since then, I have experienced discomfort in my head.
I started seeing doctors, but they all said it was unrelated to the tooth extraction, attributing it to anxiety and sleep issues.
I have taken anti-anxiety medication, but the discomfort in my head persists.
Around October 2020, while at work, I was accidentally struck on the head by a metal pipe weighing about 20 kg that fell from a height of approximately 20 cm.
At that moment, I felt a strong jolt to my head.
After work, I went for an X-ray, which showed no skull fracture, so I didn't think much of it.
However, the discomfort in my head continued, although it wasn't a sharp pain.
In December 2020, I consulted a neurologist who performed a CT scan and said there was nothing wrong inside my head.
He suggested that my neck might be more likely to have sustained an injury, and after an X-ray, he said that was also fine.
Thus, I continued treatment focused on anxiety and sleep issues.
Since it has affected my work and I was worried about having another accident, I stopped working to rest.
Now, after more than a year of rest, I still feel discomfort in my head.

Doctor, could that impact to my head have caused internal bleeding or a delayed hemorrhage? Is it possible for this to last for such a long time, over a year and a half? Additionally, could the earlier tooth extraction have affected my brain? After all, the discomfort in my head began right after the extraction, and I have been feeling dazed and lethargic, as if I am lacking oxygen, which severely impacts my life.
Please help me understand what is happening to me.

Wǒ dào dǐ zěnme le, 30~39 year old female. Ask Date: 2022/03/11

Dr. Jiang Junyi reply Neurology

Hello, sir: You mentioned, "Has the impact to the head caused internal bleeding or delayed bleeding? It has been a year and a half; could it last this long? Additionally, could the earlier tooth extraction have affected the brain? After all, I have been experiencing discomfort in my head since the extraction, feeling dazed and lethargic as if I am lacking oxygen, which is very distressing and severely impacts my life."
Delayed intracranial hemorrhage typically occurs within 48 hours, with an incidence of about 5%.
Generally, if there is no loss of consciousness, no anticoagulant use, or obvious local hematomas, head trauma is mostly mild.
Your symptoms may warrant consideration of cervical spine issues.

In my personal experience, it is common to feel anxious when visiting the dentist, which can lead to neck and back pain the following day.
For nerve repair, I recommend increasing your intake of B vitamins and reminding yourself to get up every half hour to stretch, to avoid nerve compression and muscle tightness in the neck that could exacerbate symptoms.

Regarding sleep, I suggest undergoing sleep monitoring at a sleep center and considering wearing a smartwatch with blood oxygen monitoring, such as the Apple S6, to track your sleep and blood oxygen levels.

Thank you for your inquiry.
If you have further questions, feel free to discuss! Wishing you good health, safety, and happiness.
Dr.
Jiang Junyi, Taoyuan Medical Center, cares about you.

Reply Date: 2022/03/11

More Info

It sounds like you have been experiencing a complex set of symptoms following two significant events: the tooth extraction and the head injury from the falling pipe. Let's break down your concerns and explore the potential connections between these events and your ongoing discomfort.

Firstly, regarding the tooth extraction, it is not uncommon for patients to experience some degree of discomfort or altered sensation in the head following dental procedures, especially if they were extensive or involved the upper jaw. The upper jaw is closely related to the maxillary sinus and the nerves that supply sensation to the face. While it is unlikely that the tooth extraction directly caused any significant brain injury, it could have contributed to a heightened state of anxiety or discomfort, particularly if you were already predisposed to anxiety or stress.

Now, concerning the head injury from the falling pipe, it is crucial to understand that head trauma can lead to various complications, even if initial imaging studies (like X-rays or CT scans) do not show any obvious fractures or acute injuries. The symptoms you describe—persistent discomfort, a sense of fogginess, and feelings of being "off"—could be indicative of several conditions, including post-concussion syndrome, which can occur after a mild traumatic brain injury. This syndrome can manifest as headaches, cognitive difficulties, and emotional disturbances, lasting weeks to months after the initial injury.

You mentioned that the discomfort has persisted for over a year and that you have undergone various evaluations without definitive answers. While it is reassuring that imaging studies have not shown any acute intracranial bleeding or structural damage, it is still possible to experience delayed symptoms related to the injury. Chronic headaches, neck pain, and cognitive issues can arise from the trauma, particularly if there was any whiplash or strain on the cervical spine during the incident.

It is also worth considering the possibility of psychological factors contributing to your symptoms. Anxiety and stress can exacerbate physical discomfort and cognitive difficulties. If you have been preoccupied with the fear of potential brain injury or the impact of your symptoms on your daily life, this could create a cycle of anxiety that perpetuates your discomfort.

In terms of your concerns about delayed bleeding or internal damage, it is generally unlikely for significant intracranial bleeding to occur long after the initial injury without any acute symptoms. However, if you continue to experience new or worsening symptoms, it would be prudent to seek further evaluation. A neurologist may recommend additional imaging or tests to rule out any underlying issues that may not have been apparent in earlier assessments.

Given the complexity of your symptoms and their impact on your quality of life, I would recommend considering a multidisciplinary approach to your care. This could include:
1. Neurology Consultation: To further evaluate your symptoms and consider additional imaging or tests if necessary.

2. Physical Therapy: If there are concerns about neck strain or musculoskeletal issues, a physical therapist can help address these.

3. Psychological Support: Engaging with a mental health professional may help address anxiety and stress, which could be contributing to your symptoms.

4. Pain Management: If headaches are a significant issue, a pain management specialist may offer strategies to help alleviate discomfort.

In conclusion, while it is unlikely that your tooth extraction caused direct brain injury, the head trauma from the falling pipe could be contributing to your ongoing symptoms. A comprehensive evaluation and a multidisciplinary approach may provide you with the relief and clarity you seek. Don't hesitate to advocate for your health and seek further evaluations if your symptoms persist.

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