Brief Answer: Urgent review, emergency Ct scan advisable. Detailed Answer: Hi and thanks for the query, I do think it is urgent to get a proper clinical review. Considering the fact that there is a notion of trauma, accompanied by headaches and vomiting, it is imperative to exclude bleeding in the brain. Headaches and vomiting are clinical signs of an increased pressure inside the brain or cranium, called intracranial hypertension. Left untreated, this could complicate at times and even lead to death due to what is called coning. Certain important and sensitive brain structures could lose blood supply or be forced into spaces that are unusual to contain them. An urgent CT scan of the brain is needed here. I suggest you get an urgent clinical review by your emergency care doctor, and an emergency Ct scan in the Emergency Room. In case of any abnormalities, diagnosed earlier and treated appropriately could improve outcomes. Late diagnosis could be associated with irreversible complications. It would be prudent excluding a serious neurological problem with an emergency CT scan. Thanks and kind regards. Dr Bain

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Brief Answer: See primary care doctor, follow up Detailed Answer: Hi and thanks for the query, The update information is very useful. It is important however to note if he had similar headaches ever before the incident. This is important to be able to establish the fact that the headache is exclusively due to the trauma. Controlling his blood pressure is very important. In case he had no such headaches before the accident, the headache you describe is compatible with tension headaches. Treatment would entail tricyclic anti depressants like amitriptiline, Acetaminophen and a muscle relaxant for the neck. This is initial treatment and modifications could be made as time goes on. It is not excluded however that after a trauma, long after, secondary bleeds can still be observed. A careful review by a doctor, follow up and taking appropriate decisions, may be with respect to doing a CT scan in case symptoms persist or aggravate would be necessary. Thanks and kind regards as I suggest he sees his primary care doctor for reevaluation and opinion. Dr Bain

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