Are these symptoms normal during recovery?

August 10, 2006 10:12 AM

Is brain pressure a normal symptom during the months of recovery after a head injury?

My dad had an accident at work earlier this year and is still feeling the effects from the skull fracture and small hematoma. I don't know if all of them should be expected, or not. I'm concerned that the medical staff aren't giving them as much attention as they should.

Mom tells me that they have to go through one person to okay any tests or office visits having to do with this. She's called the person a few times to let her know that dad has been feeling dizzy, vomitting, has headaches, and has been feeling a pressure on the side of the head where the brain hit (opposite the site of the skull fracture).

It seems reasonable to expect headaches and dizzyness for a long time after a concussion, but I'm alarmed about the sense of pressure he describes.

I know that it is easy for me to be critical of the care he is getting when I'm not there to get the whole story, and I'm trying to keep that in mind.

posted by bleary to health & fitness (16 comments total)

IANAD, but my understanding is that the brain does not like pressure. Even if your doctor thinks that there's nothing to worry about, you should at least get an explanation from him or her about why your dad is continuing to experience discomfort from his contrecoup injury.

If this was my father, I'd get a second opinion or change doctors. Brain injuries are nothing to screw around with, and you should at least get into a health system that will respond to your concerns.
posted by christinetheslp at 10:28 AM on August 10, 2006

Your dad needs to be seen by a brain specialist as soon as possible!

Brain injuries on the opposite side of an impact are very common because of the way the brain sloshes back and forth, and sub-dural hematomas can appear weeks or even months after the initial injury.
posted by jamjam at 10:32 AM on August 10, 2006

I'm pretty concerned, just reading your description.

I don't know who this person you have to go through is--an office manager, a nurse, an HMO pre-approval manager--but your dad's symptoms, especially the vomitting, worries me. Demand to speak to a physician; make sure the person on the phone knows your father had a HEAD INJURY and SKULL FRACTURE.

Your father really needs to see a doctor as soon as possible, and if it's really like it sounds, probably a head CT, too.

(This could also be totally unrelated, but medical types are trained to assume the worst.) (I am not a doctor. This is not medical advice, just my personal opinion.)
posted by gramcracker at 10:36 AM on August 10, 2006

If your dad had a head injury *and is vomiting*, run do not walk to a neurosurgeon. Presumably one was already involved; if not, I suspect one is necessary.

IANAD, but Derek Shepard would be screaming bloody murder by now. ER/ambulance if necessary; this is *critical* stuff.
posted by baylink at 10:46 AM on August 10, 2006

The nurse definitely knows he had a head injury and skull fracture. He has to go through her to get anything approved to get covered by workman's comp

He did have scans immediately after the injury.

I find the symptom of pressure really alarming. I want mom to call and press for an appointment with a neurologist. I asked many times if she had specifically mentioned the pressure to the nurse.

Thanks for the replies. I don't know how pushy I should be. I am not a nurse, etc. My reaction is to jump and down and ask them to make an appointment to talk to a doctor.
posted by bleary at 11:15 AM on August 10, 2006

Go with your gut. Ghey are there to serve you. Don't be rude/offensive, but don't be intimidated.
posted by lyam at 11:17 AM on August 10, 2006

*They
posted by lyam at 11:18 AM on August 10, 2006

baylink: Yes, a neurosurgeon was involved before this. He was in the hospital for a week. The nurse definitely knows this.

...My typical reaction to medical questions is that the person should be talking to a professional and not mefi, but in this case they are talking to professionals. grr.
posted by bleary at 11:20 AM on August 10, 2006

Continued vomiting not readily explained by something else should be immediately explored.
posted by rmhsinc at 11:28 AM on August 10, 2006

Just checked with my mom and she said he hasn't continued to vomit, but still experiences nausea. The nurse says that nausea is normal after a head injury.
posted by bleary at 11:34 AM on August 10, 2006

Oh my god, please get some answers already. If they are not answering you to your satisfaction then there needs to be a second opinion from another doctor, not a post on
AskMe.
posted by agregoli at 2:27 PM on August 10, 2006

Bleary - BE A PUSHY JERK. Be a bastard to the doctors and an angel to the nurses and therapists doing the hands-on care with your father and things will get done.
posted by christinetheslp at 2:37 PM on August 10, 2006

Just to add a bit more to this - just because something is "normal" does NOT mean it is "good" - I had nurses telling me my mother's reaction to anasthesia was "common"; but I pressed on and finally found someone who said ..."Well, that's not good! We'll change her meds immediately." That's the reaction you're going for.

Be a strong, empowered, pushy advocate for your father! If you don't hear the answer you want, ask someone else, or ask to speak with the supervisor. Go with your mom, you can give each other moral support - and it's harder to "no" to two people than it is to one.
posted by dbmcd at 4:00 PM on August 10, 2006

I can't go with my mom right now. They live in Texas; I live in Illinois.
posted by bleary at 4:31 PM on August 10, 2006

IANAD at all but that's pretty common after a head injury in my experience. I am involved in a sport where lots and lots of people get head injuries and a really bad one (a week in hospital definetely qualifies) is going to have lasting effects. Often the dizziness, headaches and nausea go on for years.

HAVING SAID THAT your Dad needs to be under the ongoing care of a neurologist with experience with trauma. There are all kinds of medications and other things he should have access to. He needs to know if he's OK to drive, watch flickering lights etc. He needs his meds monitoried and tapered off over time if possible. He needs immediate care in the case of any further injury however slight. As an example, my roomate who had a traumatic brain injury 3 years ago is still on pain killers, anti inflammatories and seizure medication. She has been tapered off the anti nausea stuff only recently. She sees her doc every month or so and she appears OK, can work full time and drive a car.

If this is a workers comp case get an attorney right now. You need to ensure ongoing care down the road.
posted by fshgrl at 9:58 PM on August 10, 2006

Following up--My mom convinced the nurse in Houston to schedule Dad for an MRI and an appointment with the neurologist. And she'll lean on Dad to be completely open about his symptoms. He doesn't like to be. (some people are like that.)
posted by bleary at 9:32 AM on August 15, 2006