Head Injury from Bar Impact: Persistent Dizziness and Pain Concerns

Head injury from hitting a horizontal bar?

Hello Doctor: I would like to ask you about an incident that occurred on May 18 when I accidentally hit the left side of my head (temple) against a horizontal bar (there was no bleeding).
After that, I felt fine from May 19 to May 20, but on May 21, I started experiencing dizziness and pain in my head.
I went to see a doctor and had an EEG, which showed no abnormalities, but I continued to feel dizzy and in pain.
Sometimes, I also feel weakness in my limbs or stiffness in my neck.
On May 26, due to increased dizziness, I went to the emergency room and had a CT scan.
The emergency physician reported no abnormalities, so I was prescribed medication for dizziness and headaches.
Now, it has been 23 days since I hit my head, and the dizziness and pain have not improved.
Should I get another CT scan? Is it still possible to have intracranial bleeding or cerebrospinal fluid leakage after 23 days? How can I differentiate cerebrospinal fluid from nasal mucus?

HOPPY, 30~39 year old female. Ask Date: 2012/06/10

Dr. Ding Xianwei reply Neurosurgery

Based on your concerns, if there is intracranial bleeding or cerebrospinal fluid leakage, it would definitely be visible during examinations.
However, CT scans and EEG tests may not provide any benefit for you.
As for your dizziness and headaches, these are likely sequelae of the head trauma, and it is important to stay hydrated and rest adequately.
Your issues may be related to cervical spine problems, which require further evaluation; however, injuries to the cervical spine typically take about five to six weeks to become apparent.
Additionally, you should wear a cervical collar to prevent further injury to your neck.
It is recommended that you follow up at the outpatient clinic for further diagnosis and treatment.

Reply Date: 2012/06/10

More Info

Head injuries can be quite concerning, especially when symptoms like dizziness, persistent pain, and weakness in limbs arise. Based on your description, it seems that you experienced a significant impact to the left side of your head, specifically around the temple area. While you initially felt fine, the onset of dizziness and pain a few days later raises some important considerations.

Firstly, it is essential to understand that head injuries can lead to various complications, even if there are no immediate symptoms. The brain is a delicate organ, and trauma can cause a range of issues, including concussions, contusions, or even more severe conditions like intracranial hemorrhages. The fact that you experienced dizziness and pain after the injury suggests that your brain may have been affected, possibly indicating a concussion or post-concussion syndrome, which can occur after a head injury.

Regarding your question about whether you should undergo another CT scan, it is important to consider the timeline and your current symptoms. Typically, if a CT scan performed shortly after the injury shows no abnormalities, the likelihood of developing a significant intracranial bleed after 23 days is low. Most intracranial hemorrhages would present within the first few days post-injury. However, if your symptoms are persisting or worsening, it is reasonable to discuss the possibility of further imaging with your healthcare provider. They may recommend a repeat CT scan or other imaging studies to rule out any delayed complications.

As for the differentiation between cerebrospinal fluid (CSF) leakage and nasal mucus, there are a few key points to consider. CSF is typically clear and watery, while nasal mucus can be thicker and may have a yellow or green tint if there is an infection. If you notice a clear fluid leaking from your nose, especially if it occurs after a head injury, it is crucial to seek medical attention, as this could indicate a CSF leak, which may require further evaluation and management.

In terms of your ongoing symptoms, it is essential to follow up with a neurologist or a specialist in head injuries. Persistent dizziness and pain can be indicative of post-concussion syndrome, which can last for weeks or even months after the initial injury. Management often includes rest, gradual return to normal activities, and sometimes physical therapy or vestibular rehabilitation to address balance issues.

Additionally, lifestyle factors such as sleep quality, stress, and overall health can impact recovery from a head injury. Ensuring you get adequate rest, managing stress, and avoiding activities that exacerbate your symptoms (like prolonged screen time or intense physical exertion) can be beneficial.

In summary, while the initial CT scan did not show any abnormalities, your ongoing symptoms warrant further evaluation. Discussing your concerns with your healthcare provider is crucial, as they can provide personalized recommendations based on your specific situation. Remember that recovery from head injuries can vary significantly from person to person, and patience, along with appropriate medical care, is key to a successful recovery.

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