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What Causes Headache,difficulty Hearing And Pain In Ears And Jaw After A Head Fall?

Posted on Mon, 3 Mar 2014

Question: My mother fell and hit the back of her head. She was unresponsive at first but then came to. She is on Coumadin. She came to the hospital in an ambulance. They sent her to the waiting room. We have been waiting for an hour even for triage. She has a headache, difficulty hearing and her ears and jaw ache. We have expressed our concern of internal bleeding with the staff but we keep waiting. What should we do?

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer: Need more info Detailed Answer: Hello Thanks for the query Being on coumadin definitely puts her at risk for internal bleeding. However to be more accurate I need more info 1. How long was she unresponsive? 2. Once she came back to her counsiousness was she fully aware of her surroundings? Talking fluently? and moving all 4 limbs without paucity? 3. What is her blood pressure right now? ( if they have checked) Please get back to me, I am awaiting your reply Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (15 minutes later)

We have finally gotten to a room. Her BP is 161/75. She was only out briefly and was incoherent for about 15 min- unable to talk or answer questions. She was helped into a building to get her out of the freezing temps .

Answered by Dr. Rakesh Madhyastha (11 minutes later)

Brief Answer: Hello Detailed Answer: Thanks for the quick reply The fact that she was briefing about it herself and she has been able to move all her limbs it is unlikely that there has been a large bleed. However a small bleed still has to be ruled out by a CT scan of the brain.A small bleed usually resolves by medical management and no active intervention is required. I am sure it will be hospital protocol to do so in any patient who has become unconscious following a fall I hope I was of help regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (16 minutes later)

Thank you. She just got back from a CT. She is still in terrible pain. Now with nausea .

Answered by Dr. Rakesh Madhyastha (2 hours later)

Brief Answer: Hello Detailed Answer: Thanks for getting back Pain is because of the fall, CT brain is an excellent choice of investigation to rule out fracture of the skull as well. Intra venous analgesics like paracetamol infusion or opiod analgesics like tramadol is good. Intra muscular painkillers should be avoided as she is on warfarin. Please let me know what the CT brain shows. Even if the Ct brain is normal I highly recommend hourly checking of GCS for the next 24 hours. I hope I was of help Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (3 hours later)

She has a simple linear fracture and two small bleeds. She has been transferred to a hospital with a neuro-surgeon to be watched .

Answered by Dr. Rakesh Madhyastha (2 hours later)

Brief Answer: Hello Detailed Answer: Thanks for the update I am glad it is not anything major, small bleed will only require monitoring and no surgical intervention. Neuro surgeons are the ideal doctors for this Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar