Persistent Dizziness and Headaches One Month After Head Injury

Q: Persistent Dizziness and Headaches One Month After Head Injury

Hello Ms. <br>C： You mentioned that "while receiving back massage, one side of my nose suddenly started bleeding significantly, and I have been experiencing persistent dizziness and headaches (a feeling of tightness on both sides, not pain from an injury). <br>I wonder if this is

Persistent dizziness and headaches one month after a head injury to the occipital region?

At the end of February, I slipped in the bathroom and hit the back of my head against the faucet.
There were no external injuries, and I remained conscious without vomiting.
After applying ice for three days, the swelling subsided, but there is still pain when touched, so I have been applying heat for several days.
A few days ago, while receiving a back massage in a prone position, I suddenly had a significant amount of nosebleed from one nostril.
Recently, I have also been experiencing persistent dizziness and headaches (a tight sensation on both sides, not pain at the site of the impact).
I am unsure if this is a consequence of the injury.
Should I seek medical evaluation? Thank you!

Ms. C, 30~39 year old female. Ask Date: 2024/04/11

Dr. Jiang Junyi reply Neurology

Hello Ms.
C: You mentioned that "while receiving back massage, one side of my nose suddenly started bleeding significantly, and I have been experiencing persistent dizziness and headaches (a feeling of tightness on both sides, not pain from an injury).
I wonder if this is a consequence of the injury? Do I need to seek medical examination?" Generally speaking, if there is no loss of consciousness, no use of anticoagulants, or obvious local hematomas, head injuries are mostly minor.
Your symptoms of nosebleed are likely unrelated to the fall, as they are typical of non-severe head trauma.
The most common causes of nosebleeds are excessively dry nasal mucosa and injuries caused by nose-picking, which usually resolve on their own.
If you experience recurrent nosebleeds or significant bleeding, it may be necessary to consider abnormalities in the nasal structure or issues with coagulation function.
As for the persistent dizziness and bilateral headaches, it may be worth considering tension-type headaches or dizziness caused by inner ear imbalance.
Common conditions such as anemia or autonomic dysfunction could also contribute to your symptoms.
First, it is essential to rule out anemia or dehydration that could lead to insufficient cerebral circulation.
Symptoms of dizziness and headaches can be improved by rehydrating and replenishing electrolytes.
Blood tests can assist in evaluating your condition, including identifying possible complications (anemia, hyperthyroidism/hypothyroidism, diabetes, recurrent vestibular neuritis, autoimmune diseases, neurosyphilis, and central nervous system disorders).
I recommend consulting an otolaryngologist or a neurologist to discuss further examination and treatment.
Thank you for your inquiry, and feel free to discuss further.
Wishing you good health and peace.
Dr.
Jiang, your caring neurologist.

Reply Date: 2024/04/11

More Info

Experiencing persistent dizziness and headaches a month after a head injury can be concerning and warrants careful consideration. Based on your description, it seems you sustained a head injury from a fall in the bathroom, which resulted in a hit to the back of your head. Initially, you did not experience any external injuries, and your consciousness remained intact, which is a positive sign. However, the ongoing symptoms of headaches, dizziness, and the recent occurrence of nosebleeds suggest that further evaluation is necessary.

Head injuries can lead to various complications, including post-concussion syndrome, which can manifest as persistent headaches, dizziness, and cognitive difficulties. The symptoms you describe, such as the "tight band" sensation around your head, are not uncommon in individuals who have experienced a concussion or mild traumatic brain injury. It is also important to note that the absence of external injuries does not rule out the possibility of internal injuries or complications such as a concussion or even more serious conditions like intracranial hemorrhage.

The nosebleed you experienced during a massage could be coincidental, but it may also indicate increased intracranial pressure or vascular changes resulting from the head injury. While nosebleeds can occur for various benign reasons, in the context of a recent head injury, it is essential to consider it seriously.

Given the persistence of your symptoms, it is advisable to seek medical attention. A healthcare professional, particularly a neurologist, can perform a thorough evaluation, which may include imaging studies like a CT scan or MRI to rule out any serious complications such as bleeding or swelling in the brain. They can also assess for signs of post-concussion syndrome and provide appropriate management strategies.

In terms of treatment, the management of post-concussion syndrome often involves a multidisciplinary approach. This may include rest, gradual return to normal activities, physical therapy, and possibly medication to manage headaches and dizziness. Cognitive rest is also crucial, meaning limiting activities that require intense concentration, such as prolonged screen time or reading.

As for your question about whether you should seek medical attention, the answer is a resounding yes. Persistent symptoms like yours, especially after a head injury, should not be ignored. It is better to err on the side of caution and have a healthcare professional evaluate your condition to ensure that there are no underlying issues that need to be addressed.

In conclusion, while many individuals recover from head injuries without significant complications, your ongoing symptoms suggest that further investigation is warranted. Please consult with a healthcare provider as soon as possible to ensure your safety and well-being.

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