Long-Term Effects of Head Trauma: A Neurological Perspective

Injured due to assault?

Hello, doctor.
Around the years 2003-2004, during my school years, I had a conflict with some classmates, which led to one of them hitting me on the back right side of my head with a metal chair.
At that time, I lost consciousness, and I am unsure if there were any further assaults afterward.
However, I felt pain when I touched the left back side of my head afterward.
I am not sure if this was due to pressing on an acupoint.
When I regained consciousness, there was a significant swelling on the back right side of my head.
My vision was unclear, I experienced severe headaches, and I felt extremely dizzy when I turned my head.
At that moment, I forgot to apply ice and instead used a traditional Chinese medicine ointment for massage.
I was diagnosed with a mental illness at the age of 20 and have been on medication ever since.
After several decades, during which I experienced the passing of my mother, I did not pay much attention to my head injury.
In the years following 2004, I experienced severe headaches, and despite massaging the affected area with my palm, it did not help.
I felt mentally unclear and exhibited symptoms similar to a concussion.
I am unsure if these symptoms are related to my mental illness or something else.
Additionally, I have experienced excessive daytime sleepiness, which has not changed to this day.
Sometimes, I can sleep for a very long time without any reason.
When I have work, I often spend my days off sleeping at home.
I later visited a rehabilitation department, but the results were not significant.
The rehabilitation doctor noted the large swelling on the back right side of my head and remarked that it was quite serious.
Recently, I thought about leaving the swelling untreated, fearing it might lead to long-term issues as I age.
Sometimes, it causes pain, and even my barber has noticed the large swelling when cutting my hair.
I am currently seeing a traditional Chinese medicine practitioner, taking herbal medicine, and receiving acupuncture.
A few days ago, a certain acupuncturist treated me, and I had a strong reaction, experiencing headaches, dizziness, and nausea the next day, although I did not vomit.
This acupuncturist also pointed out that I might have had a concussion at that time.
However, since the assault that caused my concussion, I have not received any treatment until now.
I find it incredible that I am still alive and fear the possibility of long-term sequelae.
I understand that the body gradually absorbs the hematoma, as I have been informed by doctors.
However, it seems to be healing very slowly.
I would like to seek help from a neurologist or neurosurgeon for an examination, but I am unsure what tests to undergo or if they are necessary.
Additionally, I am concerned about potential out-of-pocket expenses, as my family relies on living assistance.
I kindly ask for your guidance and advice, which I will remember.
I apologize for the lengthy message and appreciate your valuable time.
Thank you, doctor, for your hard work.

Hsieh Cheng-Chieh, 40~49 year old female. Ask Date: 2023/11/06

Dr. Peng Shiwei reply Neurology

Hello, due to current regulations, I am unable to provide treatment to patients without an in-person consultation.
If you have concerns regarding your brain injury, I recommend scheduling an appointment for a physician to evaluate and treat you personally.
If any tests or further treatment are necessary, I believe the doctor will explain that to you.
Thank you for your inquiry.

Reply Date: 2023/11/06

More Info

Understanding the long-term effects of head trauma is crucial, especially in cases like yours where significant injury occurred. Based on your description, it seems you experienced a severe head injury that resulted in a hematoma (a collection of blood outside of blood vessels) and symptoms consistent with a concussion. The fact that you lost consciousness and experienced significant pain and swelling indicates that this was a serious event.

Long-Term Effects of Head Trauma
1. Cognitive Impairments: Head injuries can lead to various cognitive issues, including memory problems, difficulty concentrating, and a general feeling of mental fog. These symptoms can persist long after the initial injury, especially if the injury was severe. In your case, the ongoing issues with clarity of thought and memory could be related to the trauma you experienced.

2. Emotional and Psychological Effects: Given your history of mental health issues, it is important to consider that head trauma can exacerbate existing conditions or lead to new psychological symptoms. Depression, anxiety, and mood swings are common after significant head injuries. The trauma of your injury, combined with the stress of losing a loved one, may have compounded these effects.

3. Physical Symptoms: Chronic headaches, dizziness, and fatigue are common complaints following head trauma. The fact that you have experienced persistent headaches and a feeling of heaviness in the affected area suggests that there may still be underlying issues that need to be addressed. The swelling you mentioned could indicate that there is still some residual hematoma or other complications.

4. Sleep Disturbances: Your description of excessive sleepiness and difficulty waking up can also be linked to head trauma. Sleep disturbances are common after concussions and can be exacerbated by stress and anxiety.

Recommendations for Evaluation and Treatment
1. Neurological Evaluation: It would be beneficial to consult with a neurologist who can perform a comprehensive evaluation. This may include imaging studies such as an MRI or CT scan to assess any lingering effects of the trauma, such as structural changes in the brain or persistent hematomas.

2. Rehabilitation: Given your ongoing symptoms, a referral to a rehabilitation specialist may be warranted. They can provide targeted therapies to help with cognitive rehabilitation, physical therapy for any neck or head pain, and strategies to manage headaches.

3. Psychological Support: Since you have a history of mental health issues, it may be helpful to engage with a mental health professional who can help you process the trauma of your injury and provide coping strategies for your ongoing symptoms.

4. Monitoring Symptoms: Keep a detailed record of your symptoms, including when they occur, their severity, and any triggers you notice. This information can be invaluable for your healthcare providers in tailoring a treatment plan that addresses your specific needs.

5. Lifestyle Modifications: Consider incorporating lifestyle changes that promote brain health, such as a balanced diet rich in omega-3 fatty acids, regular physical activity (as tolerated), and cognitive exercises. Additionally, ensuring you have a consistent sleep schedule can help improve your overall well-being.

Conclusion
Your concerns about the long-term effects of your head injury are valid, and it is crucial to seek appropriate medical evaluation and support. While it may feel overwhelming, taking proactive steps towards understanding and managing your symptoms can lead to significant improvements in your quality of life. Don’t hesitate to reach out to healthcare professionals who can guide you through this process. Your health and well-being are paramount, and addressing these issues now can help mitigate potential long-term consequences.

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