Post-Trauma Complications After a Car Accident

Motor vehicle accident head injury?

Hello, Dr.
Chang.
I would like to ask you about my condition.
I was involved in a traffic accident in June 2023, and the doctor's diagnosis included: 1.
Traumatic subarachnoid hemorrhage and subdural hematoma 2.
Skull fracture 3.
Right lung contusion 4.
Right facial nerve paralysis.
The doctor's notes mentioned significant central nervous system symptoms (headache, dizziness, memory impairment).

Dr.
Chang, although my facial nerve paralysis has improved significantly since the accident, my right eye still appears uneven and tears frequently.
The doctor mentioned that it may not fully recover.
During conversations, I sometimes have involuntary speech differences and experience difficulty expressing myself, which occurs occasionally.
I can feel a significant difference compared to before the accident, and it is something I cannot control.
My temper has also worsened, and I find myself easily losing patience.

At the time of the accident, I fell to the right and sustained multiple abrasions and contusions.
Now, when I sit or lie down and try to get up, I experience pain in my lower back, and bending over also causes discomfort.
I had an X-ray at a follow-up appointment, and the doctor said there were no issues with my bones.
However, I am unsure about the cause of my back pain, which has persisted for over six months without improvement.

Can I request that these residual symptoms be included in the diagnosis? Would this relate to disability issues? Additionally, can I ask the doctor to specify whether the injuries are permanent, or is that something the doctor needs to determine?

lin, 20~29 year old female. Ask Date: 2024/01/17

Dr. Zhang Junwei reply Neurosurgery

Some overly subjective symptoms and neurological issues that cannot be verified through tests can only be determined by a physician.

Reply Date: 2024/01/17

More Info

After a car accident, it is common for individuals to experience a range of post-traumatic complications, especially when there are injuries to the head, neck, and other areas of the body. In your case, the diagnosis of traumatic subarachnoid hemorrhage, subdural hematoma, skull fracture, pulmonary contusion, and facial nerve paralysis indicates that you have sustained significant injuries that can lead to various long-term effects.

1. Facial Nerve Paralysis: The improvement you have noted in your facial nerve paralysis is a positive sign, but the residual symptoms such as the asymmetry of your eyes and excessive tearing can be frustrating. This condition, known as "lagophthalmos," occurs when the eyelids cannot close completely, leading to dryness and tearing. While some patients may experience full recovery, others may have lasting effects. Treatment options may include physical therapy, medications, or even surgical interventions to improve eyelid function.

2. Speech and Communication Difficulties: The issues you are experiencing with speech, such as involuntary sounds and difficulty expressing yourself, may be related to neurological damage from the accident. These symptoms can be indicative of aphasia or dysarthria, which are conditions that affect communication abilities. Speech therapy can be beneficial in these cases, helping you regain control over your speech and improve clarity.

3. Cognitive Changes: The symptoms of headaches, dizziness, and memory issues you mentioned are common after traumatic brain injuries. These cognitive changes can significantly impact your daily life and may require ongoing management. Cognitive rehabilitation therapy can help improve memory and cognitive function.

4. Chronic Pain: Your ongoing back pain, despite normal X-ray findings, may be due to soft tissue injuries, such as muscle strains or ligament sprains, which are not visible on X-rays. Chronic pain can also be a result of nerve damage or referred pain from other injured areas. A multidisciplinary approach, including physical therapy, pain management, and possibly psychological support, can be effective in managing chronic pain.

5. Documentation and Disability Considerations: Regarding your question about whether these conditions can be documented as permanent injuries, it is essential to have a thorough evaluation by your healthcare provider. They can assess your current condition and determine if it meets the criteria for permanent disability. Documentation of your symptoms and their impact on your daily life is crucial for any potential disability claims.

6. Long-term Management: It is important to have regular follow-ups with your healthcare provider to monitor your recovery and manage any ongoing symptoms. They can provide referrals to specialists, such as neurologists, pain management specialists, or rehabilitation therapists, who can assist in your recovery process.

In summary, post-traumatic complications after a car accident can be complex and multifaceted. It is vital to address each symptom with appropriate medical care and therapy. Open communication with your healthcare team about your concerns and symptoms will help ensure you receive the best possible care and support for your recovery.

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