Fatigue After a Fall: When to Seek Medical Attention

Q: Fatigue After a Fall: When to Seek Medical Attention

Hello, sir： Based on your description of the symptoms, it appears that your wife has not exhibited any signs of central nervous system injury. <br>Essentially, the brain should be largely unharmed. <br>However, since she did sustain a direct impact to the forehead, there is a pos

Fatigue after an injury?

Hello, doctor.
My wife fell while walking on the evening of the 15th of this month, landing face-first on the ground.
She sustained a laceration above the bridge of her nose, creating a "V-shaped" wound, which bled profusely and required emergency medical attention, resulting in sixteen stitches.
Additionally, her right elbow was dislocated from the impact with the ground, and the bruising has not yet subsided, causing persistent pain and difficulty in using her arm.
She also has multiple contusions in other areas.
Fortunately, within a week, she has not shown any significant signs of a concussion (such as headache, vomiting, drowsiness, etc.), and her consciousness and memory remain clear.
However, she does get easily fatigued, needing to rest intermittently throughout the day, and after waking, she feels tired after just two to three hours.
Her voice also appears noticeably weaker.
I have searched online for information regarding concussions, but due to my limited medical knowledge, I only have a partial understanding.
I am unsure if it is appropriate to let my wife recover naturally or if I should heed some friends' advice and take her to a major hospital for a brain examination.
If an examination is necessary, which department would be most appropriate to consult? I would appreciate your guidance.
Thank you.

Nan Hua, 50~59 year old female. Ask Date: 2009/09/28

Dr. Chen Wayda reply Rehabilitation

Hello, sir: Based on your description of the symptoms, it appears that your wife has not exhibited any signs of central nervous system injury.
Essentially, the brain should be largely unharmed.
However, since she did sustain a direct impact to the forehead, there is a possibility of delayed intracranial bleeding, which may occur around a week later, during which the patient's consciousness could change.
It would not be inappropriate to have some brain imaging done at a major hospital.
I recommend that you first consult a neurosurgeon.
Wishing you well.
Sincerely, Chen Wei-Da, Rehabilitation Department, Taipei Hospital.

Reply Date: 2009/09/28

More Info

Hello,
I'm sorry to hear about your wife's fall and the injuries she sustained. It sounds like a very distressing situation for both of you. Based on the details you've provided, it’s important to understand the implications of her injuries and the symptoms she is experiencing.

Firstly, the fact that your wife suffered a significant injury to her forehead, resulting in a laceration that required sixteen stitches, is concerning. While you mentioned that she has not shown signs of a concussion, such as headaches, vomiting, or excessive drowsiness, it is still crucial to monitor her closely for any delayed symptoms. Symptoms of a concussion can sometimes take time to manifest, and fatigue can be a common symptom following a head injury.

The fatigue your wife is experiencing could be attributed to several factors. After a traumatic event, the body goes through a healing process that can be physically and mentally exhausting. The stress of the injury, the pain from her elbow dislocation, and the emotional toll of the incident can all contribute to her feeling more fatigued than usual. Additionally, the body requires energy to heal, which can lead to increased tiredness.

Given that she has multiple injuries, including the elbow dislocation and bruising, it is essential to ensure she is managing her pain effectively and is following up on her recovery. If her elbow is still painful and she is unable to use it properly, it may require further evaluation by an orthopedic specialist. They can assess whether there are any complications from the dislocation that need to be addressed.

Regarding your concern about whether to seek further medical attention for her head injury, it is advisable to err on the side of caution. If she continues to feel excessively fatigued, or if you notice any new symptoms such as confusion, persistent headaches, or changes in her behavior, it would be prudent to take her to a hospital for a thorough evaluation. In this case, you would want to see a neurologist or an emergency medicine physician, as they can conduct the necessary imaging studies, such as a CT scan or MRI, to rule out any serious complications like a hematoma or other intracranial injuries.

In the meantime, ensure that she gets plenty of rest, stays hydrated, and follows any pain management protocols prescribed by her healthcare provider. Encourage her to engage in light activities as tolerated, but also allow her to rest when she feels fatigued. It’s important to listen to her body during this recovery phase.

Lastly, consider discussing her emotional well-being as well. Traumatic events can lead to anxiety or stress, which can also contribute to feelings of fatigue. If she seems to be struggling emotionally, it may be beneficial for her to speak with a mental health professional.

In summary, while it’s good that she hasn’t shown immediate signs of a concussion, continued monitoring is essential. If her fatigue persists or worsens, or if any new symptoms arise, seeking medical attention is the best course of action. It’s always better to be safe and get a professional opinion when it comes to head injuries.

Take care, and I hope your wife has a smooth and speedy recovery.

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