Managing Dizziness and Fatigue After a Head Injury: What to Do?

Feeling dizzy after a head injury?

Hello Doctor, about a week ago, I was struck in the head by a soccer ball while walking.
After seeking medical attention and getting an X-ray, the doctor said there didn't appear to be any major issues and advised me to monitor my condition at home.
However, I have been experiencing persistent dizziness and excessive sleepiness over the past few days.
Even when I am awake, I feel very groggy, and sometimes I feel nauseous while reading.
The doctor advised me to limit the use of electronic devices, avoid reading, and not to sleep for extended periods.
However, as a student, I cannot avoid attending classes.
I have tried to rest as much as possible during other times, but my condition does not seem to be improving.
Although my symptoms are not severe, they are affecting my daily life.
What can I do to improve my situation, or should I just wait for these symptoms to resolve on their own?

Miss Chen, 20~29 year old female. Ask Date: 2015/10/15

Dr. Jiang Junyi reply Neurology

Hello, based on your description, generally speaking, if there is no loss of consciousness, the use of anticoagulants, or obvious local hematomas, head injuries are mostly mild.
However, if the following conditions occur, delayed bleeding should be considered, and you should seek emergency care: (1) Deterioration of vision, seeing double (diplopia), or unequal pupil size.
(2) Watery fluid or blood leaking from the ears or nose.
(3) Confusion or abnormal behavior.
(4) Numbness or inability to move limbs.
(5) Seizures.
Symptoms of dizziness may be due to inner ear imbalance following the impact; if symptoms persist, it is recommended to follow up with a neurologist or an ear, nose, and throat specialist.
Wishing you good health and peace.
桃醫神內 cares about you.

Reply Date: 2015/10/15

More Info

After experiencing a head injury, such as being struck in the head by a soccer ball, it is not uncommon to encounter symptoms like dizziness, fatigue, and a general sense of malaise. These symptoms can be indicative of a concussion or other mild traumatic brain injury (TBI). While your initial evaluation by a physician indicated no significant issues, it is essential to monitor your symptoms closely, as they can evolve over time.

Understanding Your Symptoms
1. Dizziness and Fatigue: These are common after a head injury. Dizziness can stem from various factors, including inner ear disturbances, changes in blood flow, or even psychological responses to the injury. Fatigue, on the other hand, may be a result of the brain's increased effort to process information and recover from the trauma.

2. Nausea: Feeling nauseous while reading or focusing can be a sign of visual disturbances or vestibular issues, which are not uncommon after a concussion. The brain may struggle to process visual information effectively, leading to discomfort.

3. Cognitive Effects: Difficulty concentrating, feeling foggy, or having trouble with memory can also occur. These cognitive symptoms are often temporary but can be distressing, especially for students who need to focus on their studies.

Recommendations for Management
1. Rest and Recovery: It is crucial to allow your brain time to heal. This means not only physical rest but also cognitive rest. Limit activities that require intense concentration, such as reading, studying, or using electronic devices. While it may be challenging as a student, try to balance your academic responsibilities with adequate rest.

2. Gradual Return to Activities: As you start to feel better, gradually reintroduce activities. Start with short periods of reading or screen time and increase them as tolerated. If symptoms worsen, reduce the time spent on these activities.

3. Hydration and Nutrition: Ensure you are drinking plenty of water and eating a balanced diet. Proper hydration and nutrition can support your overall recovery.

4. Avoiding Triggers: Identify and avoid any specific triggers that worsen your symptoms. This could include bright lights, loud noises, or certain visual patterns.

5. Consultation with Specialists: If your symptoms persist or worsen, consider seeking further evaluation from a neurologist or a concussion specialist. They can provide a more comprehensive assessment and tailored management plan.

6. Physical Therapy: In some cases, vestibular rehabilitation therapy may be beneficial, especially if dizziness is a significant issue. A physical therapist specializing in vestibular disorders can help you with exercises to improve balance and reduce dizziness.

7. Mental Health Support: If you find that anxiety or stress about your symptoms is affecting your daily life, consider speaking with a mental health professional. They can provide strategies to cope with the psychological aspects of recovery.

When to Seek Immediate Medical Attention
If you experience any of the following, seek immediate medical attention:
- Worsening headache or severe headache that does not improve with rest.

- Persistent vomiting or nausea.

- Confusion, difficulty waking up, or unusual behavior.

- Weakness or numbness in any part of your body.

- Seizures.

Conclusion
While your symptoms may be concerning, they are not uncommon following a head injury. Prioritize rest, limit cognitive strain, and monitor your symptoms closely. If there is no improvement or if symptoms worsen, do not hesitate to seek further medical evaluation. Recovery from a head injury can take time, and it is essential to be patient with yourself during this process.

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