Head Injury from Bathroom Fall: When to See a Neurologist?

I fell in the bathroom around noon and hit the back of my right head?

Hello Doctor: I slipped and hit my head in the bathroom around noon.
Since the bathroom is small, I didn't fall flat on my back; instead, my head struck the wall behind me at a nearly vertical angle.
I instinctively tried to brace myself with my right hand, which resulted in bruising on the palm of my right hand.
The impact caused swelling and pain on the right posterior side of my head.
After the impact, I immediately stood up but soon felt a tightness in my chest, as if something was pressing down on a specific point, and I also felt a similar pressure at the highest point of my cervical spine.
After about 10 minutes, I started to cough, and the tightness in my chest persisted.
The area where I hit my head became numb, and I felt extremely fatigued and didn't want to talk.
I later rested and slept for about 5 to 6 hours.
Upon waking, the chest tightness and coughing improved, but I still feel some tightness in my chest, and I need to take deep breaths to feel more comfortable.
My right hand has slight swelling.
I would like to know if I should visit a neurology or surgery outpatient clinic tomorrow given these symptoms?

EMMA, 30~39 year old female. Ask Date: 2022/03/14

Dr. Jiang Junyi reply Neurology

Dear Miss Emma,
You mentioned experiencing "chest tightness that feels better with deep breaths, and mild swelling in your right hand.
I would like to ask if you need to visit the neurology or surgery outpatient clinic tomorrow?" Generally speaking, if there is no loss of consciousness, no use of anticoagulants, or obvious localized hematomas, head injuries are mostly minor.
However, if the following conditions occur, you should consider the possibility of delayed bleeding and seek emergency care: (1) worsening vision, seeing double (diplopia), or unequal pupil size.
(2) Clear fluid or blood draining from the ears or nose.
(3) Confusion or unusual behavior.
(4) Numbness or inability to move limbs.
(5) Localized involuntary movements or seizures.
Given your symptoms, it may be worth considering soft tissue injury near the cervical spine.
If the symptoms persist, I recommend seeing a neurosurgery outpatient clinic.
Thank you for your inquiry, and feel free to discuss further.
Wishing you good health, safety, and happiness.
Dr.
Jiang Junyi
Taoyuan Hospital

Reply Date: 2022/03/14

More Info

Based on your description of the incident and the symptoms you are experiencing, it is important to understand the potential implications of a head injury, especially one that occurs from a fall. Head injuries can range from mild to severe, and the symptoms you are experiencing—such as chest tightness, coughing, and numbness in the area of impact—warrant careful evaluation.

Firstly, the mechanism of injury is significant. You mentioned that your head struck the wall at a vertical angle, which can lead to various types of injuries, including concussions or more serious intracranial injuries. The immediate symptoms you experienced, such as chest tightness and a feeling of pressure, could indicate a few different issues. While it is common to feel disoriented or fatigued after a head injury, the combination of symptoms you describe—especially the chest tightness and cough—raises some concerns.

The chest tightness you are feeling could be related to a few factors. It may be a response to anxiety or stress following the fall, but it could also indicate a potential injury to the chest area or even a reaction to the head injury itself. The fact that you experienced numbness at the site of impact is also noteworthy. Numbness can be a sign of nerve involvement or irritation, which can occur with head injuries.

Given the complexity of your symptoms, it is advisable to seek medical attention. A neurologist or neurosurgeon can perform a thorough evaluation to rule out any serious complications, such as a concussion, intracranial hemorrhage, or other neurological issues. They may recommend imaging studies, such as a CT scan or MRI, to assess for any bleeding or structural damage to the brain.

In addition to seeing a neurologist, it may also be prudent to consult with a primary care physician or a cardiologist regarding your chest symptoms. They can evaluate whether there is any underlying cardiac issue or if the symptoms are indeed related to the stress of the fall.

In summary, you should definitely consider seeing a neurologist as soon as possible, especially since you are experiencing ongoing symptoms like chest tightness and numbness. It is better to err on the side of caution with head injuries, as some complications may not present immediately but can develop over time. If you notice any worsening of symptoms, such as increased headache, confusion, difficulty speaking, or changes in vision, you should seek emergency medical care immediately. Your health and safety are paramount, and timely intervention can make a significant difference in your recovery.

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