Delayed Symptoms After Head Injury: When to Seek Medical Attention

Head injury

Hello Doctor: On the evening of November 29th, I accidentally bumped the left side of my head against a doorknob while in the bathroom.
At the moment of impact, I did not feel pain, dizziness, swelling, or bleeding, and I remained fully alert and continued to take a shower.
However, after lying in bed for about 5 hours, I experienced intermittent pain at the site of the impact that radiated to my neck, with a noticeable pain sensation traveling from the top down.
There were no other symptoms.
When I woke up on November 30th, I only had a mild headache in other areas and no additional symptoms.
I do not have any significant medical conditions.
Should I be concerned about delayed intracranial hemorrhage or other symptoms? Is it necessary to seek medical attention immediately?

Mr. Huang, 10~19 year old female. Ask Date: 2023/11/30

Dr. Zhang Junwei reply Neurosurgery

It is indeed important to be cautious.
If there are persistent headaches and dizziness, it is recommended to seek treatment at a neurosurgery outpatient clinic.

Reply Date: 2023/11/30

More Info

After a head injury, it is crucial to monitor for any delayed symptoms that may indicate complications such as intracranial bleeding. In your case, you experienced a minor head trauma when you bumped your head against a door handle. Initially, you did not have any immediate symptoms such as pain, swelling, or loss of consciousness, which is a positive sign. However, the onset of pain several hours later, particularly radiating from the impact site to your neck, warrants careful consideration.

Delayed intracranial bleeding, often referred to as a subdural or epidural hematoma, can occur after a head injury, even if the initial impact seemed minor. Symptoms of delayed bleeding can include:
1. Headache: A worsening headache that does not improve with over-the-counter pain relief.

2. Nausea or Vomiting: Feeling nauseous or actually vomiting can be a sign of increased intracranial pressure.

3. Confusion or Altered Consciousness: Difficulty concentrating, confusion, or changes in alertness.

4. Weakness or Numbness: Any new weakness or numbness in the limbs or face.

5. Seizures: Experiencing seizures after a head injury is a serious concern.

Given that you experienced pain radiating from the impact site to your neck, it is essential to consider the possibility of a neck injury as well. The cervical spine can be affected by head trauma, leading to muscle strain or nerve irritation, which could explain the pain you are feeling.

In your situation, while you do not have any alarming symptoms at this moment, it is advisable to err on the side of caution. Here are some recommendations:
1. Monitor Symptoms: Keep a close watch on any changes in your condition. If you notice any of the symptoms listed above, seek medical attention immediately.

2. Rest: Ensure you get plenty of rest and avoid any strenuous activities that could exacerbate your symptoms.

3. Pain Management: Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage your headache, but avoid taking them in excess.

4. Seek Medical Attention: If your symptoms worsen or if you develop new symptoms, it is crucial to seek medical attention promptly. A healthcare provider may recommend imaging studies, such as a CT scan, to rule out any serious complications.

In conclusion, while your initial symptoms may not seem severe, the delayed onset of pain and the nature of your injury suggest that you should remain vigilant. If you have any doubts or if your condition changes, do not hesitate to consult a healthcare professional. It is always better to be safe and ensure that there are no underlying issues that require treatment.

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