Head Injuries: Symptoms, Risks, and Necessary Evaluations

Q: Head Injuries: Symptoms, Risks, and Necessary Evaluations

Hello： A scalp swelling caused by a head impact does not necessarily indicate intracranial brain injury. <br>If headaches occur more than 10 days a month, it is advisable to visit a neurology clinic.

Head injury

Hello, Doctor.
About four years ago, I was physically abused by a family member who struck me on the head and forcefully pulled my hair.
At that time, the injured area swelled, and I experienced headaches and dizziness.
However, due to threats from other family members, I was too afraid to seek medical attention.
Afterward, I only bought over-the-counter medication for external injuries, and since I have had a history of migraines since high school, I occasionally visited a nearby clinic for medication.
I never got the injury checked because I didn't want to relive the experience.
For about two to three months after the injury, the affected area was very painful, to the point where I couldn't lie on that side while sleeping.
I often felt dizzy, nauseous, and had a lack of appetite, along with severe insomnia (though the insomnia might also be due to academic pressure).
Although the swelling eventually subsided, I still occasionally feel pain that is different from my migraines; it feels like the pain from having my hair pulled or being struck, and it is located exactly where I was hit.
Sometimes, when I am under stress, the pain intensifies.
I also occasionally feel like my concentration is not as sharp, leading to small mistakes, such as frequently typing errors or speaking in a less coherent manner, and I sometimes forget to bring things.
Occasionally, I experience sudden dizziness (usually when the weather is hot).
I would like to know what kind of examinations I should undergo.
Thank you for taking the time to respond!

Juzi, 20~29 year old female. Ask Date: 2023/08/18

Dr. Cai Zongzhang reply Neurology

Hello: A scalp swelling caused by a head impact does not necessarily indicate intracranial brain injury.
If headaches occur more than 10 days a month, it is advisable to visit a neurology clinic.

Reply Date: 2023/08/18

More Info

Head injuries can have a range of symptoms and potential risks, especially when they are associated with trauma, such as the one you described. It is essential to understand that head injuries can lead to both immediate and long-term effects, and your experience of ongoing pain, dizziness, and cognitive difficulties warrants careful evaluation.

Symptoms of Head Injuries
1. Pain and Discomfort: The pain you describe, particularly in the area where you were struck, can be a sign of post-traumatic headaches. These can manifest as tension-type headaches or migraines, especially if you have a history of migraines. The sensation of your hair being pulled or a pressure-like feeling could indicate muscle tension or nerve irritation in the area.

2. Dizziness and Nausea: Feeling dizzy and experiencing nausea can be symptoms of a concussion or other forms of brain injury. These symptoms can persist long after the initial injury, especially if there was significant trauma.

3. Cognitive Changes: The difficulties with concentration, memory lapses, and the sensation of mental fog you describe could be related to post-concussion syndrome, which can occur after a head injury. This syndrome can include a variety of cognitive, physical, and emotional symptoms that can last for weeks or months.

4. Sleep Disturbances: Insomnia or disrupted sleep patterns can be a common consequence of head injuries, often exacerbated by stress or anxiety related to the trauma.

Risks Associated with Head Injuries
1. Post-Concussion Syndrome: As mentioned, this condition can develop after a concussion and may include persistent headaches, dizziness, cognitive difficulties, and emotional changes.

2. Chronic Pain: Ongoing pain in the area of the injury can develop into chronic pain syndromes, which may require specialized treatment.

3. Potential for Serious Conditions: Although you may have initially felt that your injury was minor, it is crucial to rule out more severe conditions such as intracranial hemorrhage, skull fractures, or other structural brain injuries, especially given your symptoms.

Recommended Evaluations
Given your history and ongoing symptoms, it is advisable to seek a comprehensive evaluation from a healthcare professional, preferably a neurologist or a specialist in brain injuries. Here are some steps you might consider:
1. Neurological Examination: A thorough neurological assessment can help determine if there are any deficits in your cognitive function, coordination, or other neurological signs.

2. Imaging Studies: Depending on the findings from your neurological exam, your doctor may recommend imaging studies such as a CT scan or MRI of the brain to check for any structural abnormalities or injuries that may not have been detected initially.

3. Cognitive Assessment: If cognitive difficulties persist, a neuropsychological evaluation may be beneficial to assess memory, attention, and executive function.

4. Pain Management: If headaches or pain are significant, discussing pain management options with your healthcare provider is essential. This may include medications, physical therapy, or other interventions.

5. Mental Health Support: Given the trauma associated with your injury, it may also be helpful to seek support from a mental health professional to address any emotional or psychological impacts of the experience.

Conclusion
Your symptoms following the head injury you experienced four years ago are concerning and should not be ignored. It is crucial to seek medical attention to ensure that any underlying issues are addressed and to develop a comprehensive treatment plan tailored to your needs. Early intervention can significantly improve outcomes and help you manage your symptoms more effectively. Please prioritize your health and seek the necessary evaluations as soon as possible.

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