Post-Head Injury: When to Seek Further Medical Evaluation

Swelling of the head after a head injury?

Doctor, I would like to ask about an incident that occurred a few days ago.
I experienced a direct impact to the floor while wearing a safety helmet, and after an X-ray at the hospital, it was found that there is a slight fracture in the occipital bone.
Due to the compression, there is also some minor damage to the parietal bone.
After three days of rest, I am still experiencing dizziness, nausea, and excessive sleepiness, and I have started to feel a throbbing pain in my head.
Should I go to a major hospital for further evaluation?

Ms. Zeng, 20~29 year old female. Ask Date: 2016/03/03

Dr. Lan Shengxing reply Neurology

Dear Ms.
Tseng, if your skull is truly fractured, it is a serious matter.
Please go to the hospital for an examination immediately.
Lan Shengxing

Reply Date: 2016/03/03

More Info

After a head injury, especially one that involves a fracture of the skull or any significant trauma, it is crucial to monitor symptoms closely and seek further medical evaluation if certain warning signs arise. In your case, you mentioned that you experienced a direct impact to the head while wearing a helmet, which resulted in a slight fracture of the occipital bone and some damage to the parietal bone. Despite resting for three days, you are still experiencing dizziness, nausea, excessive sleepiness, and a feeling of head pressure. These symptoms warrant immediate medical attention.

When to Seek Further Medical Evaluation
1. Persistent or Worsening Symptoms: If you continue to experience symptoms such as dizziness, nausea, or headaches that do not improve or worsen over time, it is essential to return to the hospital. Symptoms like these can indicate complications such as intracranial bleeding or increased intracranial pressure.

2. Neurological Changes: Any changes in your level of consciousness, confusion, difficulty waking up, or changes in vision should prompt an immediate evaluation. These could be signs of more severe brain injury or complications.

3. Nausea and Vomiting: While nausea can be a common symptom after a head injury, persistent vomiting can indicate increased intracranial pressure or other serious issues.

4. Severe Headache: A headache that feels different from your usual headaches, especially if it is severe and does not respond to over-the-counter pain relief, should be evaluated.

5. Seizures: If you experience any seizures or convulsions, you should seek emergency medical care immediately.

Importance of Follow-Up Imaging
Given that you have already had an X-ray and are experiencing ongoing symptoms, it may be prudent to request a CT scan or MRI of the brain. These imaging studies can help identify any bleeding, swelling, or other complications that may not have been evident during your initial evaluation.

Conclusion
In summary, your symptoms of dizziness, nausea, excessive sleepiness, and head pressure after a head injury with a skull fracture are concerning and suggest that you should seek further medical evaluation at a larger hospital or a specialized facility. It is better to err on the side of caution when it comes to head injuries, as complications can arise even days after the initial trauma. Always prioritize your health and safety, and do not hesitate to seek help if you feel that something is not right.

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