Post-Concussion Symptoms: Seeking Help for Persistent Neurological Issues

Post-concussion syndrome

A 68-year-old elderly individual fell on the street a few months ago for unknown reasons, resulting in a head injury with a laceration on the left forehead that required 5-6 stitches.
After the laceration healed, the individual developed insomnia and a persistent tingling sensation in the head that has not subsided.
The elderly person is reluctant to visit the hospital for further evaluation.
We would like to inquire about the possible symptoms and which specialty department they should consult for an examination.

Ye Zi, 40~49 year old female. Ask Date: 2022/08/08

Dr. Jiang Junyi reply Neurology

Dear Ms.
Yeh,
You mentioned that "after the head laceration healed, it caused insomnia and a tingling sensation in the head." This may be attributed to two possible reasons: localized nerve damage due to the injury or compression of the cervical nerve roots caused by external force.
Cervical nerve root compression is often associated with tightness in the cervical muscles and degeneration of the cervical spine.
Symptoms may include pain at the affected site, discomfort, muscle stiffness, or neurological sensations.
It is advisable to increase the intake of B vitamins and remind the elderly to stand up and perform stretching exercises every half hour to avoid exacerbating symptoms due to nerve compression and muscle tightness.
Physical therapy can be beneficial, including:
- Heat therapy: Primarily aimed at increasing local blood circulation and improving muscle ischemia.
- Transcutaneous electrical nerve stimulation (TENS) and medium-frequency vector interference waves: These can provide local pain relief and alleviate tension in the neck and shoulders.
- Cervical traction: Commonly used for degenerative cervical arthritis, herniated discs (cervical osteophytes), with associated nerve root compression, and cervical injuries without fractures or joint instability that compress the nerves.
Cervical traction can be utilized for rehabilitation, but an X-ray should be performed beforehand to confirm joint stability.
I recommend discussing examination and treatment options with a neurologist or a rehabilitation physician.
Thank you for your inquiry, and feel free to reach out for further discussion on related issues!
Wishing you good health and peace,
Dr.
Jiang Junyi
Department of Neurology, Taoyuan Hospital

Reply Date: 2022/08/08

More Info

Post-concussion syndrome (PCS) can be a challenging condition to navigate, especially for older adults who may have additional health concerns. In the case of the 68-year-old individual you mentioned, it is important to understand the potential symptoms and the appropriate steps to take for evaluation and treatment.

After a concussion, which is a type of traumatic brain injury (TBI), individuals may experience a variety of symptoms that can persist for weeks, months, or even longer. Common symptoms of PCS include headaches, dizziness, fatigue, difficulty concentrating, irritability, anxiety, and sleep disturbances. The sensation of numbness or tingling, as described in your inquiry, can also occur and may be indicative of nerve involvement or other neurological issues.

Given the history of a head injury and the ongoing symptoms of insomnia and persistent numbness, it is crucial for the individual to seek medical attention. While the patient may be hesitant to return to the hospital, it is essential to emphasize the importance of a thorough evaluation to rule out any serious underlying conditions.
The appropriate specialty for this situation would be a neurologist. Neurologists specialize in diagnosing and treating disorders of the nervous system, including the brain, spinal cord, and nerves. They can conduct a comprehensive assessment, which may include a neurological examination, imaging studies (such as MRI or CT scans), and other diagnostic tests to determine the cause of the persistent symptoms.
In addition to consulting a neurologist, it may also be beneficial for the individual to consider seeing a psychiatrist or psychologist, especially if they are experiencing anxiety, depression, or other emotional difficulties related to their condition. Mental health professionals can provide support and therapeutic interventions that may help alleviate some of the psychological burdens associated with PCS.

If the individual is resistant to seeking medical help, it may be helpful to encourage them by discussing the potential benefits of treatment, such as improved quality of life, better sleep, and a reduction in discomfort. Sometimes, addressing the fears or misconceptions about medical visits can help motivate individuals to seek the care they need.

In summary, for the 68-year-old individual experiencing post-concussion symptoms, the best course of action would be to consult a neurologist for a thorough evaluation of their neurological symptoms. Additionally, involving mental health professionals can provide comprehensive support for both the physical and emotional aspects of recovery. It is important to approach the situation with empathy and understanding, as the individual may be dealing with fear or anxiety about their health. Encouraging open communication about their symptoms and the potential benefits of seeking help can facilitate their journey toward recovery.

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