Suggest Treatment For Post-traumatic Headaches And Scalp Tenderness

Posted on Sat, 24 Jan 2015

Question: I fell off of a large tow truck (the type that hauls the whole vehicle off of the road). The fall was about 6 feet straight down. I landed right on my back and the back of my head. I blacked out for about 3 seconds and when I got up I was able to say my ABC's and look left and right following the drivers finger. I had light bleeding from the back of my head. My lower back was stiff as hell for weeks. My wife just told me I have bruising on my lower back for the past 2 years. They have never gone away. The bruises are light. My back does hurt after long walks (1 mile or longer). I am 48, 350lbs, 6 foot, German decent, high blood pressure only. I live well and have no other illnesses. I was at the emergency room a while back for something different and told them what happened and how I feeling. They did not show concern and said that I don't have the right symptoms to warrant a MRI. My feel pressure in the back of my head and if I bump my hard against anything it hurts pretty bad. My back is stiff and the lower part is tender. I am spry. I am not fluffy like XXXXXXX Farley I am more slender and denser build. I do not drink or smoke and my teeth are in good dental health. I need glasses for close reading only. Full head of hair also.
Thank you,

Answered by Dr. Ajay Panwar (1 hour later)

Brief Answer:
Post traumatic headache/ Tension headache

Detailed Answer:
Hi XXXX,
Thanks for being here on Healthcaremagic.com
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

The accident you mentioned about,appears to have caused a mild head injury to you(at least clinically mild) because it was not associated with loss of consciousness(but just blackout for a few seconds),although you fell from a good height and had some mild bleeding from the head,too.
Headache and scalp tenderness,you are presently having is likely a manifestation of post-traumatic headache,which is very frequent as a sequelae to head injury.

On the other hand,it can also be Tension headache which is epidemiologically the most common cause of headache with scalp tenderness,and also has association with head trauma.

Medicines like 'Amitriptyline' should provide you benefit(please take under the supervision of your physician).
Low backache and stiffness following that injury should have been investigated with at least a lumbosacral spine X-ray .Please visit a neurologist so that he can examine you for any neurological deficit and depending on it,gets a spinal X-ray or magnetic resonance imaging(MRI),to establish the diagnosis.Please discuss with your physician about taking skeletal muscle relaxant drugs and a physiotherapist for proper physiotherapy lessons.

Hope I answered your query.If you have follow-up questions,I shall be glad to answer them.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ajay Panwar (9 hours later)

Thank you, I concentrated on telling you everything but forgot to ask you the question. Since I am able to function for the last two years just fine but not 100% (stiffness and head pressure). Are my conditions life threatening? That is the question that I was going after. I have to see if my insurance will cover some of this. I was shocked that my family doctor didn't want to do anything when I told him the exact same thing.

Answered by Dr. Ajay Panwar (27 minutes later)

Brief Answer:
It's not life threatening.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
I welcome you again on Healthcaremagic.com.

Coming to your point,

Your likely diagnosis is post-traumatic headache or a Tension-type headache,which by no means can be called life-threatening.I don't think there is an issue here to be covered by insurance,in this.

Please visit a neurologist as I already suggested you,so that he may examine you to screen for any neurological deficit. He will probably decide if your low backache and stiffness,needs some spinal X-Ray or MRI(as discussed above),and advise the same.A thorough examination by a neurologist will rule out any remote possibility of anything serious in your case and will help out clearing your insurance issue,probably.

Hope I have answered your query.If you have any follow-up questions,I shall be glad to answer them,else please close the thread and rate it.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj