Brief Answer:
Sounds as if you are describing symptoms of a POSTCONCUSSIVE SYNDROME

Detailed Answer:
Good morning.

I've reviewed your query regarding the concussion you suffered approximately 2 months ago that included the presence of a bleed. You did not specify whether it was a SUBDURAL bleed, parenchymal (within the substance of the brain), or subarachnoid bleed. A recent CT is reported as "all clear all good." I wouldn't be surprised if in fact, there is still the presence of blood in the brain as reabsorption can literally take years and even then, sometimes never becomes fully sponged back up. The problem with any amount of residual blood is that those areas can become foci of epileptic discharges. Blood is one of the most irritating substances to the brain and it doesn't take much to trip off seizure episodes.

You've not mentioned anything in what you wrote as to whether or not your doctors chose to put you on any type of antiepileptic medication (as we often do in a concussion incident where bleeding into the brain is an issue). You mention some symptoms such as nocturnal fatigue, which I presume is more than just the old run of the mill tiredness after a hard day's work.....brain bleeds are well known with causing people to feel tired and fatigued until there is full resorption of the blood...and so this particular symptom may be explained by virtue of any residual blood that may be present.

BTW, if a CT scan was obtained for followup purposes then, depending upon how big the residual bleeds may be they may not be captured fully on the scan. MRI (when read by an experienced radiologist) can actually identify much much smaller areas of brain bleed in even more acute and subacute stages of evolution. If symptoms for some reason don't seem to continue to stay at least steady or improve over the next few weeks/months then, an MRI may be worth obtaining to see if any residual areas of bleeding may be present that were never picked up by the CT scan.

The headaches or head PAINS you describe are not infrequently seen in the POSTCONCUSSIVE SYNDROME (PCS). It 's good that you are not describing the presence of post-traumatic MIGRAINE or MIGRAINE TYPE HEADACHES. If the spotty headaches/sensations at night persist for the next several weeks to several months then, if I were in your neurologist's position I might begin to consider a type of TRIGEMINAL AUTONOMIC CEPHALGIA (TAC) only because short duration JABS or JOLTS are not uncommonly seen following concussion and they can often times be treated fairly effortlessly with either INDOMETHACIN or CALCIUM BLOCKERS or even a 1 time high steroid burst with a 3 week taper down to zero.

Your symptoms of POSTCONCUSSIVE HEADACHES or symptoms in general are felt to be largely SELF LIMITED (meaning they are expected to subside completely) and typically take weeks to months to completely resolve. There are times that a person may still be suffering from up to 2-3 years of symptoms before things really calm down or even subside. I would not recommend taking very much in the way of over the counter (OTC) medications since the risk with these drugs is what we refer to as MEDICATION OVERUSE headache. In other words, you don't want to extend or expand the lines of headaches you now have by having taken TOO MUCH ANALGESIC medication (called MEDICATION OVERUSE HEADACHE (MOH). We typically counsel patients to take NO MORE THAN 15 DOSES of any form of ANALGESIC RELIEF or sometimes only up to 10 if the drug turns out to be more complex types of drugs such as TRIPTANS or controlled substances.

These short duration and "spotty" head sensations may actually be TRIGEMINAL AUTONOMIC CEPHALGIAS (TAC's) as I'd mentioned above and these are frequently found in the setting of traumatic brain injury (TBI).

However, in general, if you are exhibiting signs and symptoms of PCS (and that is exactly what I believe you are demonstrating) then, I expect that so long as you can avoid any future concussions (at least for several years while your brain cools down from the latest event) that you will finally and completely or nearly completely improve and virtually regain your previous baseline....hopefully, WITHOUT HEADACHES or other odd sensations.

If I've provided useful or helpful information to your question and you have no further inquiries or comments at this time then, could you do me the utmost of favors in CLOSING THE QUERY along with a few POSITIVE WORDS of feedback and maybe even a 5 STAR rating if you feel it is deserving? I am definitely interested in getting updated information on how things are going in the next few days or weeks if you'd drop me a line at www.bit.ly/drdariushsaghafi

You can always reach me at the above address for this and other questions. I wish you the best with everything and hope this conversation has helped you give you a little more direction as to what you may wish to do as well as things you can discuss with your doctors.

This query required 32 minutes of professional time to research, assimilate, and respond in complete form.

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