Head Injuries: When to Seek Medical Attention

The head has previously been injured by someone?

Your question: I have previously sustained a head injury.
On the day of the incident, my scalp felt soft and watery.
Now, the soft and watery area of my scalp has formed a hard bump.
Normally, the head is rounded, but there is now a sudden protrusion.
The affected area is located about 1 to 2 centimeters to the right of the center of my head when viewed from above.
Occasionally, I feel slight pain on the left side, and the affected area sometimes experiences mild pain as well (the midpoint is between my left and right eyes).
Should I get checked? Which department should I consult, and what kind of examinations might be necessary? What could this be? What tests should I undergo?
Response from the physician: Dr.
Ke Fang-Hsu from the Surgery Department suggests that after a head injury, if there is subcutaneous edema or a hematoma, it generally indicates the extent of the injury and is related to the mechanism of trauma.
If there are no symptoms of confusion or limb weakness, it is likely not serious.
However, if you are concerned, you can consult a neurologist.
If you still feel uneasy, a CT scan may be performed, but the physician might require you to pay out of pocket since your level of consciousness does not seem to meet the criteria for insurance coverage.
Response from "Qiu": I have consulted at the hospital, but the doctor only stated that the wound has healed and that it is unrelated to the previous injury.
However, the pain in my head is localized to the area of swelling that has formed a hard mass, causing a deformity.
This is not a typical headache.
I felt that the doctor was dismissive, as there were many patients today, and he laughed while trying to quickly send me away, attributing my pain to poor posture, which he classified as normal headache (meaning: the entire head hurts, similar to a headache from fever).
But how could I only experience pain around the area of the injury? This is quite puzzling.

Qiu Xiansheng, 20~29 year old female. Ask Date: 2012/03/23

Dr. Ke Fangxu reply Surgery

Due to the lack of a physical examination, it is impossible to determine the location, size, and extent of the tear of the wound, so online consultation can only lead to speculation.
It is possible that there is a mild linear skull fracture causing localized headaches, or that a deeper laceration has injured the sensory nerves of the scalp, or that incomplete absorption of a scalp hematoma is causing localized pressure.
Any of these conditions can result in persistent pain around the wound.
However, as long as there is no damage to the brain, none of these situations pose a health risk; the issue is primarily one of pain discomfort.
It is recommended to undergo a period of analgesic treatment and then monitor the subsequent progress.

Reply Date: 2012/03/23

More Info

When it comes to head injuries, understanding when to seek medical attention is crucial for ensuring your safety and health. Based on the information provided, it appears that you have experienced a significant head injury, which has resulted in a soft, swollen area on your scalp that feels fluid-filled and has changed the shape of your head. Additionally, you report occasional mild pain on the left side of your head, near the injury site.

Understanding Head Injuries
Head injuries can vary widely in severity, from minor bumps and bruises to serious conditions such as concussions or intracranial hemorrhages. The symptoms you describe, such as the soft, swollen area and the change in shape of your head, suggest that there may be a hematoma (a localized collection of blood outside of blood vessels) or edema (swelling due to fluid accumulation) in the area of impact. These conditions can occur after trauma and may not always present with severe symptoms immediately.

When to Seek Medical Attention
1. Persistent Symptoms: If you experience persistent or worsening symptoms such as headaches, dizziness, nausea, vomiting, or changes in vision, it is essential to seek medical attention. These could be signs of more serious complications.

2. Neurological Symptoms: Symptoms such as confusion, difficulty walking, weakness in limbs, or loss of consciousness warrant immediate medical evaluation. These could indicate a more severe injury to the brain.

3. Physical Changes: The change in the shape of your head and the presence of a soft, swollen area should be evaluated by a healthcare professional. While some swelling is normal after a head injury, significant changes in the contour of the skull can indicate underlying issues.

Recommended Actions
Given your symptoms, it is advisable to consult a healthcare provider, specifically a neurologist or a neurosurgeon, who can assess your condition more thoroughly. They may recommend imaging studies such as a CT scan or MRI to evaluate for any intracranial bleeding or structural damage to the brain.

1. Consultation: Schedule an appointment with a neurologist or visit an emergency room if your symptoms worsen or if you have concerns about your condition.

2. Imaging Studies: A CT scan is often the first-line imaging study for head injuries, as it can quickly identify bleeding or swelling in the brain. An MRI may be used for more detailed imaging if necessary.

3. Monitoring: If you are advised to monitor your symptoms, keep track of any changes, especially if you notice increased pain, swelling, or new symptoms.

Conclusion
In summary, while some swelling and changes in the scalp can be expected after a head injury, the specific symptoms you describe—particularly the soft, fluid-filled area and the change in head shape—should not be ignored. It is crucial to seek medical evaluation to rule out any serious complications. Remember, when in doubt, it is always better to err on the side of caution and consult a healthcare professional. Your health and safety are paramount, and timely intervention can make a significant difference in outcomes following a head injury.

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