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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Sana's Head Trauma - No whine this time.
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On 1/23/2007
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Sana,
You don't say if you were knocked out by the accident, but you took a pretty bad hit, even without unconsciousness. I'm concerned as well about the slow blood loss from the nose and where it came from.
If you are being followed medically and nobody is finding anything, and you weren't knocked out, you are probably dealing with the slow recovery of bone, muscle and nerve after being damaged in the accident. If you were unconscious at the scene for more than 20-30 minutes and/or are not being followed medically, and/or if you are having cognitive difficulties that prevent you from doing things you used to do, then it's worth it to see a neurologist and ask if you should have an MRI or other tests. CT's without infusion are not very sensitive to milder brain injuries.
Pain meds like Percoset add their own side effects which dull you out and could contribute to the way you are feeling.
Bottom line: After almost 5 months, it's reasonable to have a neurologist take another look, and possibly a neuropsychologist if you are having significant cognitive difficulty. A pain specialist who can review your pain meds is also a good option. Check this stuff out and let us know. If you have any other questions write again.
Good luck,
DrD.
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head trauma
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On 1/23/2007
sana
wrote in from
United States
(71.142.nnn.nnn)
Bad car crash Sept.1st, 2006 from a lady on her cell phone ignoring the stop sign- broken ribs, pneumothorax, punctured lung, ecchymoses on hipbone; and one of the injuries was front right top of head laceration, severed artery; stitches, right nostril leaking blood for weeks, fuzzy memories. Now, I have bad headaches and it feels like there's a hatchet buried in my head with numbness all around it. I have a long dent where I "feel" the hatchet, and several bony bumps, like pearls. It all hurts constantly, yet is numb. X-rays are normal. Initial CTs were ok. Does this go away? Should I see some kind of specialist or just shut up and quit whining? I have to cancel work a lot because of the nausea and pain. My doc has me taking, nightly, Lyrica; daily, 1 every 4 hours, if needed, Percoset; and Imitrix, as needed.
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Osgood-Schlatter
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On 1/14/2007
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Osgood Schatter, also known as "growing pains" involve knee pain and swelling. You have to at least go to your doctor to make sure that's what you have. If you are playing school-based soccer, they should be able to point you to a school sponsored or approved sports medicine clinic, or someone who will look at your knee for not much fee.
I can't officially recommend a treatment, but here's what you can find on www.emedicine.com about Osgood-Schlatter. They basically recommend conservative treatments (ice, analgesics, activity restriction, stretching, strengthening, or anti-inflammatory medications), are available. Once the diagnosis is made and other pathologies are ruled out, the patient may be discharged with primary care or orthopedic referral. Therapy is conservative.
Initial treatment includes the application of ice for 20 minutes every 2-4 hours. Analgesics and nonsteroidal anti-inflammatory medications (NSAIDs) may be given for pain relief and reduction of local inflammation.
Inform the patient to avoid pain-producing activities (eg, sports that involve excess amounts of jumping). Use of a knee immobilizer for a few days may improve compliance, especially in more severe cases. Pads or braces also can be used for support. Once the acute symptoms have abated, quadriceps-stretching exercises, including hip extension for a complete stretch of the extensor mechanism, may be performed to reduce tension on the tibial tubercle. Stretching exercises for the hamstrings, which are commonly tight, may also be performed. Consultations: Refractory cases unresponsive to conservative treatment should be referred to an orthopedist for possible surgical intervention. However, surgery is rarely needed.
Good luck
Dr. Dave
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Even with a helmet
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On 1/14/2007
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
That's a fantastic picture, because without the helmet, you'd probably be able to see pieces of brain and the picture would be taken from a slab. Yeah, injuries can be gross, but gross is less bad then dead. Think about it and keep the helmet on.
Dr. Dave
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osgood schlateral disease
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On 1/5/2007
john
wrote in from
United States
(70.251.nnn.nnn)
i have osd and i play soccer but sometimes i can't play because of pain, i can't afford doctor visits, any reccomendations to stop pain when im playing
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Even with a helmet
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On 12/28/2006
patrick
wrote in from
United States
(69.242.nnn.nnn)
And he was wearing a helmet.
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oh those attractive scars and slurred speech
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On 12/21/2006 snoball
wrote in from
United States
(72.185.nnn.nnn)
That's right Doc. Dain Bramage not good is.
And btw, that myth about 'chicks digging scars' was, of course, started by guys with scars told to nieve guys without them. Guys, the truth is, it's generally a myth if they're all over your face LOL
Happy Holidays Dr.Hartman and since skaters are not known for always playing by the rules of common sense, including me, it's nice to know that you have made yourself available to the posters here.
And the skate gods shone their face upon him and said unto him: "Dr.Hartman, you rocketh greatly" ;)
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Whatever Works
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On 12/19/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Snoball,
If the idea of saving your brain doesn't do it for you, saving your pretty face for the gender of your choice just might. .. :) Chicks may dig scars, but they don't dig brain-damage drool. . . .and definitely won't dig you looking like somebody stuck an apple corer all over your face. . .You could pour a bucket of Axe over your head and it won't get you squat if you don't protect the goods. Save Face. Wear the Helmet.
Dr. Dave
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poster
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On 12/17/2006 snoball
wrote in from
United States
(72.185.nnn.nnn)
Ha ha that's pretty funny...'stay pretty'....who'd a thunk appeals to ego would be more effective than appeals to survival instincts? for the brain bone, i guess it's whatever works, right?
Right.
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Stay Pretty
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On 12/12/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
check this out: :) drdave
http://www.roadsafety.qld.gov.au/qt/LTASinfo.nsf/ReferenceLookup/Skateboards_metrolite.pdf/$file/Skateboards_metrolite.pdf
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passing through
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On 10/11/2006 snoball
wrote in from
(72.185.nnn.nnn)
Just wanted to say 'hi' Doc.
So..Hi Doc.
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Dumb
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On 10/11/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
There's nothing I can add to that. There's a reason why boarding is 'extreme' and it's not because of the advertising. Falling down a concrete bowl without head protection can kill you dead.
Look, there is nothing like the feel of boarding. If you didn't feel that way you wouldn't be at this site. You love it? Wear the right headgear and pads and you can love it for decades. Spread the word.
Dr. Dave
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dumb
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On 10/10/2006 sad
wrote in from
United States
(68.190.nnn.nnn)
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WAT's the problem
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On 10/8/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
O.K. WAT, you don't say what you were hit with, but if its still giving you symptoms several days after, you NEED to get to an ER or a 24/7 doc in the box, who will likely want an x-ray at least. Don't mess around with symptoms that last. If it's not back to normal with ice and rest, and or is getting worse, and/or your balance or vision is affected, a doc needs to look at it. Now. Do it and let us know.
Dr. Dave
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Head Injury
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On 10/8/2006 Worried Athletic Teen
wrote in from
(68.70.nnn.nnn)
Friday night i was at a football game that were two rivals. The one school were throwing things at the other. I was standing talking to people and got hit on the left side of my head just about my temple. As soon as i got hit i got a ringing sound in my left ear that lasted about 1 day after that. My vision got blurry & i could only see the outlines of people & i heard echos of people when i was trying to stand up. I fell over & got back up & still wasnt right. I went over to someone & barely holding myself up started to cry as i put my arms around them. after about 5 minutes i finally got back & realized what happened. I had a lump that swelled partly over my temple.. I went home & iced it knowing i probably got a concussion bc i have gotten one earlier in the summer. Its been two ddays & i cant chew bc it hurts so bad i have the worst headaches & sometimes im not sure where i am. It hurts to lay on that side & i am a cheerleader that does all the gymnastic stuff & i tried tumbling at a football game on saturday & got really dizzy & nacious. I dont want to go to a doctor bc they will tell me something about how i cant cheer for awhile..
-Please help ne
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Armor at Hood River
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On 9/23/2006 Judi O
wrote in from
United States
(68.126.nnn.nnn)
You guys are welcome on the helmet stuff. The body armor is a Fox Racing piece. I'd rather slide at those speeds on the GS that hill is total commitment with the rocks and the cliff. I had a great time. Never thought I'd still be having the need for speed.
Keep asking for the Switchblade at your local bike or skate shop. You never know they might tool up again. That is the helmet. Gareth, Gary Fluitt, Dave Pirnack and I wear. Next best one is the Remedy that Joe and Kyle Mclaren wear.
Thanks,
Judi O
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thx judi
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On 9/13/2006 peters
wrote in from
United States
(64.236.nnn.nnn)
And I want to thank Judi Oyama at Giro for adjusting my helmet straps two Hood Rivers in a row ;-) and explaining the basic reason why -- making sure the straps are perfect triangles so that in case the worst happens your ears help the straps to hold the lid on your head! I'm gonna start looking for a full face...
I'd also like a men's version of that armored Star Trek jacket she wears during races, cool and functional. Don't know the brand name...
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Full Face Helmets
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On 9/13/2006
Gary Fluitt
wrote in from
United States
(192.18.nnn.nnn)
I want to thank Judi Oyama at Giro for turning me on to full face BMX helmets. Not many of use them, and I'm guessing that is because they are a little hard to find and a bit expensive. But when it comes to your noggin', is that really a deciding factor? My full face has taken two good shots to the chin, and in one incident, I was out for about 2 minutes I'm told. That helmet has been retired, but it saved my face and no doubt, my brain, so it was worth every penny.
Just a quick look at the Bell helmets site and I came up with the Bell Ballistic for $79 MSRP
http://www.bellbikehelmets.com/productDetail.asp?prodID=6
and over on the Giro site, the Remedy CF (Cycling helmets pages)
http://giro.com/main.html
I'm no less photogeneic with facial covering (more with my ugly mug) and more confident, Especially in Tight Slalom, where you can get slapped down in a milisecond with no chance of getting your hands out.
cheers
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David's Confusing Concussion
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On 9/11/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
David,
A bump on the head would not cause the symptoms you are describing, so let's consider other possibilities. Have you been worked up for multiple sclerosis? Are there any ususual hereditary or psychiatric disorders in your family? Have you had a really good physical exam with blood work, etc? There are physical disorders which indirectly fog your brain. Are you overweight? Have you been diagnosed with or could you have sleep apnea? That can cause the symptoms you describe. What meds are you taking? Side effects can be mistaken for brain injury as well. Are you "intoxicated" regularly? Ditto for alcohol effects. The jaw issue may be TMJ. Ask your dentist to take a look at it. The brain can be affected by a lot of other things besides a bump. Time to think outside the box, as it were. Let us know what happens.
Dr. Dave
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injury
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On 9/11/2006 David
wrote in from
United States
(216.248.nnn.nnn)
I'm sorry that my injury from the previous post is a little off-topic...but I really just feel lost in being able to figure it out.
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Head Injury
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On 9/11/2006
David
wrote in from
United States
(216.248.nnn.nnn)
Hey Dr. Dave,
I really need some help trying to figure some things out. I have been to two neurologists and my general doctor and I still can't seem to find any answers.
First off let me start with the situation, when I was in college two years ago I was intoxicated and banged my head against a door really hard (I can't really remember why...stupidity.) I can remember feeling right away that something was off. I went to the doctor and my local health clinic at school and he diagnosed me with a concussion.
I was (and still am) experiencing dull ache in the front of my head, and a numb feeling (which I was told might be damage to the nerves in my forehead but nothing serious), have a hard time remembering things, forgetting stuff easily, tiring easily, stumbling over my words, dimming in hearing and overall just feel almost like a walking zombie sometimes.
Last year I saw a neurologist who prescribed medicine for my headaches I have been experiencing, however, that is only one of the problems associated with this.
The latest neurologist I have just seen was recommended to me by my general practiioner and he did a great job in trying to find out what was wrong.
I had a CATSCAN, MRI's, EEG, blood test. He did the before mentioned tests but found nothing other than evidence of a concussion.
It might be worth noting that immediately after the injury, my jaw felt out of place (and still does) and clicks and cracks badly.
I am very worried and find myself out of options. Any advice would be more than appreciated. I am really scared that I will have to live the rest of my life like this.
Thanks,
David
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No Helmet, No Chance
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On 8/16/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Adam is onto something here. Remember, you've got about 3/8" of bone between what makes you unique, and the asphalt. Hammer yourself into the ground without a helmet and if you live, you may not be the same person. You could wind up as a simpler, slower and less interesting person than you were before. You could wind up as a paralyzed person in a wheelchair.
No helmet and all it takes is one second and you will never skate again. If you love boarding, love it enough to keep doing it. Bucket up!
Dr. Dave
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Ncdsa.com's No Helmet campaign goes public
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On 8/16/2006
Adam
wrote in from
United States
(198.144.nnn.nnn)
From the webmaster..
Webmasters wishing to join Ncdsa's No Helmet campaign are welcome to use the animated 160x600 banners on their own web sites, free of charge.
Source code available here
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Steve's Daughter
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On 8/13/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Steve,
Uncomplicated concussion of the type you are describing, without bleeding, fracture etc., generally recovers in a few weeks to months. It is possible to break components of the ear in a fall, but this would likely have been seen in follow-up examination. A neuro-otologist {who are kind of hard to find} might help you explore causes for your daughter's deafness.
As far as seizures, if she hasn't had one by now, it's unlikely she will, so you can breathe more easily on that score.
The other person to consult with if you are concerned that something was missed is a pediatric neurologist, who could order things like an MRI and/or EEG. Best of luck and let us know how it turns out.
Dr. Dave
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Daughter's concussion
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On 8/4/2006
Steve
wrote in from
United States
(70.146.nnn.nnn)
Dr. Dave, my daughter did a head dive from the couch to the terrazzo floor (highly polished hard concrete) in our house when she was about 3 years old while horsing around; she's now almost 8. After she hit the floor she vomited, was pale, and lethargic for what seemed to be an hour or so....the vomiting was intermittent, her eyes were glazed and sleepy looking. We rushed her to the emergency room, where they took a very long time to get around to her. By the time it was our turn with the doctor her color was coming back. She was not going to get into the machine for a cat scan, at 3 years old and cranky it just wasn't happening. My wife worries a lot that she could be affected by this concussion later in life. Is it possible to have problems from this in the future such as epileptic seizures, or other things? She's about 40% deaf, but we believe this is a genetic trait as my side of the family has hearing loss. We did not realize her hearing problem until after the fall. Any chance the fall could cause this?
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