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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Stabbing Pain In Head Along With Vomiting After Head Injury?

Hi. Three weeks ago my 22 year old son fell down his slippery deck steps, 2 flights, and hit his head. He was sore for a few days and a bit nauseated, but did not go to the doctor...he is in college and did not want to miss classes. Yesterday he called and said he had a terrible headache that had persisted since the night before, that hurt whenever he tried to move (sharp, stabbing pain). He never gets headaches, ever. I told him to go the the local ER, where they did bloodwork and a ct scan and gave him an injection of Torodal (?). He called me again this morning about 5:30 AM still with the terrible headache, but was now vomiting as well. I sent him back to the ER where he was reassured of normal tests done earlier, given another shot of pain meds and a shot of something to help with the nausea. He is feeling better right now, but I am wondering if this could be related to the fall 3 weeks ago, and even if he feels better should I have him re-evaluated at a larger hospital.
Wed, 6 Jan 2016
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Neurologist, Surgical,  's  Response
Hello. Thanks for asking from HCM.


I can understand your concern. Complaint of headache with vomiting could be due to

: Head injury - Head injury can cause it even after 3 weeks, if he is having chronic subdural hematoma. But it is uncommon in 20-30 year age group and his CT scan is normal. But CT scan is not 100% sensitive, MRI brain is a better option. Other symptoms of chronic subdural are heaviness in head, forgetfulness, imbalance while walking.

If his symptoms are correlating with above, consult doctor and ask about MRI brain to rule out it. Usually large hematoma needs surgical evacuation.

: Migraine - Migraine is a type of hemicranial headache (half of head), throbbing type, associated with nausea, vomiting, photophobia (fear from light), usually occurs for few minute to hours and spontaneous relief.

If he is having migraine like symptoms, ask him to consult doctor. He will evaluate him and prescribe medicine like NSAIDS or Triptans. For vomiting, he might prescribe Domperidone-Pantoprazole combination. Aak him to avoid dairy products, chocolate, citrus fruits like lemon/avacado/orange, stress, bright light.

: Mass lesion - It means some mass in brain causing pressure effects leading to headache, vomiting, blurring of vision, focal deficit like weakness of limbs.
It is usually detected by CT head but can be missed. MRI brain is better investigation to detect it.

If symptoms are correlating with above, consult doctor. After full evaluation, treatment will be decided.

You can reach upto some conclusion and consult doctor accordingly. Hope it will help you. Take care.
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Critical Care Specialist,  Dr. Muneeb Ali's  Response
Hi.This is Dr Muneeb Ali. I am here to help you regarding this problem. i am very sorry to hear about the accident happened 3 weeks ago. The history which you wrote clearly shows that your son needs to get consult of some neurosurgeon as well as re-evaluation of the CT scan as well as the MRI brain with contrast would help to rule out any cause which is aggravating his pain and discomfort.
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What Causes Stabbing Pain In Head Along With Vomiting After Head Injury?

Hello. Thanks for asking from HCM. I can understand your concern. Complaint of headache with vomiting could be due to : Head injury - Head injury can cause it even after 3 weeks, if he is having chronic subdural hematoma. But it is uncommon in 20-30 year age group and his CT scan is normal. But CT scan is not 100% sensitive, MRI brain is a better option. Other symptoms of chronic subdural are heaviness in head, forgetfulness, imbalance while walking. If his symptoms are correlating with above, consult doctor and ask about MRI brain to rule out it. Usually large hematoma needs surgical evacuation. : Migraine - Migraine is a type of hemicranial headache (half of head), throbbing type, associated with nausea, vomiting, photophobia (fear from light), usually occurs for few minute to hours and spontaneous relief. If he is having migraine like symptoms, ask him to consult doctor. He will evaluate him and prescribe medicine like NSAIDS or Triptans. For vomiting, he might prescribe Domperidone-Pantoprazole combination. Aak him to avoid dairy products, chocolate, citrus fruits like lemon/avacado/orange, stress, bright light. : Mass lesion - It means some mass in brain causing pressure effects leading to headache, vomiting, blurring of vision, focal deficit like weakness of limbs. It is usually detected by CT head but can be missed. MRI brain is better investigation to detect it. If symptoms are correlating with above, consult doctor. After full evaluation, treatment will be decided. You can reach upto some conclusion and consult doctor accordingly. Hope it will help you. Take care.