Persistent Headaches and Dizziness: Seeking Solutions After Injury

Persistent dizziness and headache?

Dear Doctor,
I previously wrote to you regarding my condition, and since there has been no improvement, I would like to consult you again.
On May 18, I accidentally bumped into a horizontal bar while walking, which led to dizziness and headaches.
I have undergone a CT scan of my head and an EEG, both of which showed no abnormalities.
It has now been over a month, but I still continue to experience dizziness and headaches (sometimes quite severe).
I have been returning for check-ups every two weeks, but I am only receiving pain relief and anti-dizziness medication.
Additionally, I have a duodenal ulcer, which prevents me from taking pain medication frequently.

Could you please advise me on how to manage these persistent symptoms of dizziness and headaches? Is it really not advisable for me to take pain medication anymore?

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

Dr. Ding Xianwei reply Neurosurgery

Your issue is actually a consequence of head trauma.
Many of my patients continue to experience dizziness and headaches even after three months, and many also report memory decline! This is an unfortunate reality! In fact, about 5% of patients will suffer from long-term sequelae due to head injuries for the rest of their lives.
What you need is to drink plenty of water and get ample rest, while avoiding stimulants such as tobacco, alcohol, tea, and coffee! Go to bed early and avoid staying up late.
This approach may help you recover more quickly! What may seem like simple treatment methods are actually the most effective solutions! It is important to mention that CT scans and EEGs will not provide any help for your sequelae; if a problem is found, it would likely be a brain tumor or another organic issue, and not finding anything is actually expected! Regarding the issue of duodenal ulcers, current ulcers can heal in a short period, and you can consult a gastroenterologist for more information! If you still need to take pain medication, you can only use Cox-2 inhibitors, but it has been confirmed that these medications can have effects on the heart, and some have even been withdrawn from the market! If the pain is significantly affecting your daily life, it may be necessary to use some opioid pain medications, but this should only be done after a thorough evaluation by a physician!

Reply Date: 2012/06/30

More Info

Persistent headaches and dizziness following an injury can be quite distressing and may indicate underlying issues that require careful evaluation and management. Based on your description, it seems you have been experiencing these symptoms for over a month after hitting your head on a horizontal bar. Despite undergoing a CT scan and EEG, which returned normal results, your ongoing symptoms suggest that further investigation and management may be necessary.

Firstly, it’s important to understand that post-traumatic headaches and dizziness can occur after head injuries, even when initial imaging studies do not show any abnormalities. These symptoms can be part of a condition known as post-concussion syndrome (PCS), which can manifest with a variety of symptoms including headaches, dizziness, cognitive difficulties, and emotional changes. The persistence of your symptoms, especially the severe headaches and dizziness, warrants a thorough evaluation by a neurologist or a specialist in brain injuries.

Regarding your current treatment with pain and dizziness medications, it’s crucial to balance the need for symptom relief with the potential side effects of these medications, especially considering your history of duodenal ulcers. Non-steroidal anti-inflammatory drugs (NSAIDs) and other common pain relievers can exacerbate gastrointestinal issues, so it’s advisable to discuss alternative pain management strategies with your healthcare provider. They may recommend other classes of medications, such as certain antidepressants or anticonvulsants, which can be effective for headache management without the same gastrointestinal risks.

In addition to medication, there are several non-pharmacological approaches that may help alleviate your symptoms. These include:
1. Physical Therapy: A physical therapist can work with you to develop a program that includes vestibular rehabilitation exercises, which can help improve balance and reduce dizziness.

2. Cognitive Behavioral Therapy (CBT): If you are experiencing cognitive difficulties or emotional distress, CBT can be beneficial in managing these symptoms and improving your overall well-being.

3. Lifestyle Modifications: Ensuring adequate hydration, maintaining a balanced diet, and getting regular sleep can significantly impact your recovery. Avoiding triggers that exacerbate your headaches, such as bright lights or loud noises, is also advisable.

4. Mindfulness and Relaxation Techniques: Practices such as yoga, meditation, and deep-breathing exercises can help reduce stress and may alleviate headache symptoms.

5. Follow-Up Care: Regular follow-ups with your healthcare provider are essential to monitor your symptoms and adjust treatment as necessary. If your symptoms do not improve, further diagnostic testing, such as MRI or referral to a headache specialist, may be warranted.

In summary, while it’s understandable to be concerned about the persistence of your headaches and dizziness, there are various avenues for management and treatment. It’s crucial to work closely with your healthcare provider to develop a comprehensive plan that addresses both your pain management needs and your gastrointestinal health. With appropriate care and time, many individuals experience significant improvement in their symptoms following head injuries.

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