Sudden Loss of Consciousness and Fever After Head Injury: What to Do?

Sudden loss of consciousness leading to a fall, with the head striking the floor, followed by persistent fever?

Hello Doctor, last night I stood up from a chair and suddenly felt dizzy, then lost consciousness and fell to the ground, hitting my head on the floor.
When I regained consciousness, I had no memory of how I fell; it seemed like I leaned back.
My head is very painful and has a noticeable bump.
A few hours later, I experienced mild throat pain, and the next morning I started to have a fever, which persisted until the evening, reaching a high of 38.3 degrees Celsius.
I have been experiencing chills and sweats, my face feels hot, and I have stiffness and pain on both sides and at the back of my neck.
My heart rate has reached 125 beats per minute.
The throat pain has not improved, but I can still eat without discomfort.
I took a Tylenol at 1 PM and another at 9 PM, which alleviated the chills and fever temporarily, but the fever returned after the medication wore off.
Could you please tell me what the issue might be? Is it related to my head injury? What should I do? Thank you.

Xiao Xin, 10~19 year old female. Ask Date: 2023/09/23

Dr. Wu Mukhan reply Neurology

Hello, sudden dizziness accompanied by altered consciousness can be dangerous, as it may be caused by conditions such as cerebrovascular disease, epilepsy, encephalitis, or central nervous system infections, all of which require thorough examination.
If symptoms persist, it is advisable to go to the emergency department as soon as possible for evaluation by a physician to avoid any delay in treatment.

Reply Date: 2023/09/23

More Info

Experiencing a sudden loss of consciousness, especially following a head injury, is a serious medical concern that warrants immediate attention. The symptoms you describe—loss of consciousness, severe headache, fever, neck stiffness, and elevated heart rate—could indicate several potential issues, including but not limited to a concussion, intracranial hemorrhage, or even an infection such as meningitis.

First and foremost, the loss of consciousness after a head injury is particularly alarming. It suggests that there may have been a significant impact to the brain, which could lead to a concussion or more severe traumatic brain injury (TBI). The headache and swelling at the site of impact are common symptoms following a head injury, but the presence of fever and neck stiffness raises additional concerns.

Fever following a head injury can sometimes indicate an infection, particularly if there is neck stiffness and pain. Meningitis, an infection of the protective membranes covering the brain and spinal cord, can present with symptoms such as fever, headache, and neck stiffness. The fact that you are experiencing a high fever (38.3 degrees Celsius) and chills, along with a rapid heart rate (tachycardia), is concerning and should not be taken lightly.

Given these symptoms, it is crucial that you seek medical attention as soon as possible. Here are the steps you should take:
1. Immediate Medical Evaluation: Go to the nearest emergency room or urgent care facility. It is essential to have a healthcare professional evaluate your condition, especially since you have experienced a loss of consciousness and are now exhibiting signs of fever and neck stiffness.

2. Diagnostic Imaging: The medical team may perform a CT scan or MRI of your head to check for any bleeding, swelling, or other injuries to the brain. This is particularly important given your loss of consciousness and the headache you are experiencing.

3. Neurological Assessment: A thorough neurological examination will be conducted to assess your cognitive function, reflexes, and overall neurological status. This will help determine if there are any immediate concerns that need to be addressed.

4. Blood Tests: Blood tests may be performed to check for signs of infection or inflammation, which could help in diagnosing conditions such as meningitis or other infections.

5. Monitoring: You may need to be monitored for changes in your condition, especially if there are concerns about a TBI or infection. This could involve observation in a hospital setting.

6. Treatment: Depending on the findings, treatment may vary. If it is determined that you have a concussion, you may be advised to rest and avoid activities that could exacerbate your symptoms. If an infection is diagnosed, appropriate antibiotics or antiviral medications may be initiated.

In summary, your symptoms are concerning and could indicate a serious condition related to your head injury. It is imperative that you seek medical attention without delay to ensure proper evaluation and treatment. Do not wait for symptoms to worsen; prompt action is essential for your health and safety.

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