Post-Car Accident Head Injuries and Symptoms - Neurosurgery

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Head injury from a car accident?


Hello, Doctor.
A few days ago, I was in a car accident where I hit a tree.
The left side of my face is bruised and swollen, and there are slight fractures in my orbital bone and skull.
I have bruises on my neck and limbs.
The doctor said it would heal on its own.
I went to Chi Mei Hospital's emergency department, and I was told that I was conscious, but I only remember being in the hospital.
I have no recollection of the minutes leading up to the accident or what happened in the ambulance.
During the emergency visit, they performed a CT scan and said there were no major issues, and there was no mention of internal bleeding or concussion.

Three days later, I followed up with a neurosurgeon.
I explained my symptoms, which include headaches and sharp pains.
Whenever I get into a car and it starts moving, I feel very uncomfortable and nauseous.
The back of my head is very sensitive, and even touching my head causes pain.
Lying in bed is uncomfortable whether I lie on my left side, right side, or on my back.
After sleeping, I wake up with neck pain, similar to having a stiff neck.
My head feels heavy and foggy, and I occasionally feel nauseous.
However, the doctor did not provide much feedback.
They prescribed medication similar to what I received in the emergency department, with an additional medication for nerve pain.
Additionally, I was recently diagnosed with a cold, and my symptoms are not fully resolved; I have a clear cough.
A few days ago, I noticed blood in my phlegm, which varies in frequency.
I later went to the thoracic surgery department for an X-ray, and the doctor mentioned that I have bleeding.
Since I hit my face and my eyes were swollen, now that the swelling has subsided, I can barely open my eyes.
However, I noticed that my vision is blurry when looking at distant objects, and it feels chaotic.
I have some astigmatism, but the situation is noticeably different from before the accident, and it is uncomfortable to look.
When walking outside, I even feel dizzy.

I went to see an ophthalmologist, who tested for double vision in front of me and said there were no issues.
The dizziness is related to the concussion, but I don’t have significant problems with near vision.
However, I feel that distant objects appear chaotic and I have a sense of double vision.
The ophthalmologist said this is due to my nearsightedness and astigmatism, but I rarely wear glasses and it doesn’t affect my daily life.
Before the accident, I didn’t have this issue, and I would feel uncomfortable looking at distant scenery, not at my phone.

Could this also be a neurosurgical issue? Should I wait for my follow-up with the neurosurgeon to ask about these problems? I haven’t been able to find a clear reason for my symptoms, and I have already visited the hospital multiple times in the past few days.

Yeh, 20~29 year old female. Ask Date: 2023/06/15

Dr. Zhao Shaoqing reply Neurosurgery


Hello: You can schedule an appointment for a consultation in the neurosurgery department for a detailed evaluation and examination.
Issues related to trauma can sometimes manifest later.
If new problems arise, further examinations can be arranged for confirmation.
Changhua Hospital cares about your health.

Reply Date: 2023/06/15

More Info


After a car accident, especially one that involves head trauma, it’s crucial to monitor symptoms closely and seek appropriate medical care. Based on your description, it sounds like you have experienced a range of symptoms following your accident, including bruising, swelling, headaches, nausea, and visual disturbances. Here’s a comprehensive overview of what you might be experiencing and the steps you should consider taking.


Understanding Your Symptoms
1. Post-Traumatic Amnesia: The inability to recall events leading up to or immediately following the accident is known as post-traumatic amnesia. This can occur after a head injury and may be temporary. It’s a sign that your brain has experienced trauma, even if a CT scan did not reveal any significant issues.

2. Headaches and Sensitivity: The headaches you’re experiencing, particularly if they are throbbing or accompanied by nausea, could be indicative of post-concussion syndrome. This condition can occur after a concussion and may include symptoms like headaches, dizziness, and sensitivity to light or noise. It’s not uncommon for these symptoms to persist for weeks or even months after the initial injury.

3. Visual Disturbances: The blurred vision and discomfort you’re experiencing, especially when looking at distant objects, could be related to several factors. While your eye exam may not have shown any acute issues, the trauma could have affected your ocular muscles or the way your brain processes visual information. This is sometimes seen in cases of concussion or other forms of head trauma.

4. Neck Pain: The neck pain you describe, similar to a "stiff neck" or "wry neck," could be due to muscle strain or whiplash, which is common in car accidents. This can contribute to headaches and discomfort.


Recommended Actions
1. Follow-Up with Specialists: Since you have already seen a neurologist and an ophthalmologist, it’s important to continue following up with them. If your symptoms persist or worsen, don’t hesitate to seek a second opinion or ask for further testing. It may be beneficial to consult a neuro-ophthalmologist, who specializes in visual problems related to neurological conditions.

2. Symptom Management: For headaches, over-the-counter pain relief (if not contraindicated) can be helpful. However, if your headaches are severe or persistent, your doctor may prescribe medication specifically for migraine or tension-type headaches. It’s also important to stay hydrated and rest as needed.

3. Physical Therapy: If neck pain and headaches continue, physical therapy may be beneficial. A physical therapist can help with exercises to improve neck strength and flexibility, which may alleviate some of your discomfort.

4. Monitoring Symptoms: Keep a detailed log of your symptoms, including when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare providers in determining the best course of action.

5. Rest and Recovery: Allow yourself time to recover. Avoid activities that require intense concentration or physical exertion until you feel better. Gradually reintroduce activities as tolerated.

6. Emergency Symptoms: Be vigilant for any worsening symptoms such as severe headaches, repeated vomiting, seizures, or changes in consciousness. If you experience any of these, seek emergency medical attention immediately.


Conclusion
In summary, your symptoms following the car accident are concerning and warrant careful monitoring and follow-up with your healthcare providers. It’s essential to communicate openly with your doctors about your ongoing symptoms and any new developments. Recovery from head trauma can be a gradual process, and it’s important to be patient with yourself as you heal. If you feel that your concerns are not being adequately addressed, don’t hesitate to advocate for yourself and seek further evaluation. Your health and well-being should always come first.

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