Post-Trauma Neurological Symptoms: When to See a Specialist

Brain..?

Hello doctor, I have a question.
I was in a car accident in the past, and the physician issued a report stating: head trauma, cerebral edema, subarachnoid hemorrhage, and atlantoaxial dislocation without associated nerve root paralysis.
It has been quite some time since the accident.
Recently, over the past 1-2 years, I have noticed significant atrophy on the entire right side of my body, and I have developed a limp when walking.
My right face does not sweat, and sometimes with changes in weather, I experience soreness in my hands, feet, and lower back.
My lower extremities down to my soles become very cold (in winter), and my hands cannot function normally; my feet feel somewhat weak and misaligned, with my soles and knees also appearing misaligned.
These symptoms are only present on the right side of my body.
I have seen a physician and undergone examinations, but nothing significant was found.
Later, the doctor suggested it might be due to congestion affecting the brain nerves.
I would like to ask if this is related to the brain or if there is another cause.
I am considering seeing a doctor again; should I consult a neurosurgeon (or an internist) or go directly to a rehabilitation specialist?

Ya, 0~9 year old female. Ask Date: 2006/12/19

Dr. Qiu Yushu reply Neurosurgery

Please visit the neurosurgery outpatient clinic.
Dr.
Yu-Shu Chiu.

Reply Date: 2006/12/19

More Info

It sounds like you have been through a challenging experience following your car accident, and the symptoms you are describing are concerning. Based on your history of head trauma, including brain edema and subarachnoid hemorrhage, as well as the neurological symptoms you are experiencing, it is crucial to approach your situation with a comprehensive understanding of post-traumatic neurological conditions.

1. Understanding Your Symptoms: The symptoms you are experiencing, such as muscle atrophy on the right side of your body, weakness, and changes in sensation (like coldness in your lower extremities), may be indicative of several underlying issues. These could include post-traumatic neurological deficits, which can arise from damage to the brain or spinal cord due to trauma. The fact that you have a history of brain injury makes it essential to consider that your symptoms could be related to the initial trauma.

2. When to See a Specialist: Given the complexity of your symptoms, it is advisable to consult with a neurologist or a neurosurgeon. A neurologist specializes in diagnosing and treating conditions related to the nervous system, which includes the brain, spinal cord, and peripheral nerves. They can conduct a thorough neurological examination and may recommend imaging studies, such as an MRI, to assess any structural changes in your brain or spinal cord that could be contributing to your symptoms.

3. Rehabilitation Considerations: In addition to seeing a neurologist, you may benefit from consulting a rehabilitation specialist, particularly if you are experiencing significant weakness and atrophy. A physical medicine and rehabilitation (PM&R) physician, also known as a physiatrist, can help develop a tailored rehabilitation program to address your specific needs. This may include physical therapy to improve strength, coordination, and mobility, as well as occupational therapy to assist with daily activities.

4. Potential for Recovery: Recovery from post-traumatic neurological symptoms can vary widely among individuals, depending on the severity of the initial injury, the areas of the brain affected, and the timeliness of intervention. Engaging in rehabilitation early on can significantly improve outcomes. It is also important to manage any secondary complications, such as muscle spasticity or joint contractures, which can arise from prolonged immobility or neurological deficits.

5. Addressing Emotional and Psychological Aspects: It is not uncommon for individuals who have experienced trauma to also face emotional and psychological challenges, such as anxiety or depression. If you find that your mood or emotional state is affected, consider discussing this with your healthcare provider. They may recommend counseling or therapy as part of your recovery process.

6. Follow-Up and Monitoring: Regular follow-up appointments with your healthcare providers are essential to monitor your progress and adjust your treatment plan as needed. If you notice any new symptoms or changes in your condition, be sure to communicate these to your doctor promptly.

In summary, given your history of head trauma and the neurological symptoms you are experiencing, it is crucial to seek specialized care. A neurologist can help diagnose the underlying causes of your symptoms, while a rehabilitation specialist can assist you in regaining function and improving your quality of life. Don't hesitate to advocate for yourself and seek the care you need to address these complex issues.

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