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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Solution For Headaches, Tiredness And Short Term Memory Loss After Head Injury

Hello, I hit my head a week ago. I was swimming backwards and ran my head into the side of the pool. I went to the doctors 4 days ago, and he said I probably have a concussion, and things will get better. I have occasional head aches, more tired than normal, I can t put thoughts together very well, and my memory is somewhat lacking, especially short term memory. I don t want to get a cat scan, because of the excessive radiation, and after a week everyone including the doctor says I am most likely fine, just have to give my brain time to heal. What do you think, am I probably fine? What advice would you recommend? Thank you.
Fri, 19 Jul 2019
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Neurologist 's  Response
Hi,

Your symptoms do appear to be consistent with what is generically called a POSTCONCUSSIVE SYNDROME (PCS). As the name implies it is a constellation of symptoms which can occur together or at separate times after a person has suffered a CONCUSSION to the brain. Most symptoms are selflimited which means they typically resolve on their own without any specific treatment in a matter of a few weeks to few months but there can be protracted cases of PCS lasting much longer....just depends on the individual.

I can understand your reticence in getting a CT of the head (and agree that it is a lot of radiation) but following an injury to the brain of that force (though it may not SEEM that much of a bang....just look at your symptoms and how you felt before running into that wall at "ramming speed!" HA!) it is always advisable to get an MRI of the brain.

In that case no CT would be needed but you are free to do as much or as little as you'd like. If you're having memory issues then, it may also be advisable to get a NEUROPSYCHOLOGICAL battery of tests done so that a nominal baseline of capacities can be concluded. This will serve as a basis to know how things are progressing in the future especially you are still not feeling 100% over the next few months.

Since I'm a neurologist I'm always worried about damage flying under the radar after concussions....BECAUSE IT IS VERY COMMON...."feeling fine" and "appearing fine" are easy things to do if you were perfectly healthy to begin with....but the idea of getting tested and examined by people WHO ARE SPECIALISTS in those areas (TBI medicine) is so that a solid baseline can be developed for your current brain function JUST AFTER the accident and then, to follow that serially (at least every 3-6 months) for 1 year (which is typically what I do) since some dysfunction can be very subtle and not appear for a bit of time due to the nature of how nerves die and nerve connections decay in the brain.

Docs who are not deeply rooted in the discipline do not always see it that way and of course, everyone likes to feel fine and be told that they're fine but wouldn't it be nicer if someone could genuinely say that after going through a standard workup? Then, you'd really have a good REASON to say you felt fine, right?

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Dariush Saghafi, Neurologist
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Suggest Solution For Headaches, Tiredness And Short Term Memory Loss After Head Injury

Hi, Your symptoms do appear to be consistent with what is generically called a POSTCONCUSSIVE SYNDROME (PCS). As the name implies it is a constellation of symptoms which can occur together or at separate times after a person has suffered a CONCUSSION to the brain. Most symptoms are selflimited which means they typically resolve on their own without any specific treatment in a matter of a few weeks to few months but there can be protracted cases of PCS lasting much longer....just depends on the individual. I can understand your reticence in getting a CT of the head (and agree that it is a lot of radiation) but following an injury to the brain of that force (though it may not SEEM that much of a bang....just look at your symptoms and how you felt before running into that wall at ramming speed! HA!) it is always advisable to get an MRI of the brain. In that case no CT would be needed but you are free to do as much or as little as you d like. If you re having memory issues then, it may also be advisable to get a NEUROPSYCHOLOGICAL battery of tests done so that a nominal baseline of capacities can be concluded. This will serve as a basis to know how things are progressing in the future especially you are still not feeling 100% over the next few months. Since I m a neurologist I m always worried about damage flying under the radar after concussions....BECAUSE IT IS VERY COMMON.... feeling fine and appearing fine are easy things to do if you were perfectly healthy to begin with....but the idea of getting tested and examined by people WHO ARE SPECIALISTS in those areas (TBI medicine) is so that a solid baseline can be developed for your current brain function JUST AFTER the accident and then, to follow that serially (at least every 3-6 months) for 1 year (which is typically what I do) since some dysfunction can be very subtle and not appear for a bit of time due to the nature of how nerves die and nerve connections decay in the brain. Docs who are not deeply rooted in the discipline do not always see it that way and of course, everyone likes to feel fine and be told that they re fine but wouldn t it be nicer if someone could genuinely say that after going through a standard workup? Then, you d really have a good REASON to say you felt fine, right? Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist