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Head Injury Facial Trauma

2/22/2020

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Last week while getting my "steps" in on the PE field I was hit dead on while completing my crossover near the basketball net.  I am sure you're wondering "Why would you be in such a remote position knowing you have chronic health issues?" 

First let me plead my case.  I have been walking this same circular track for eight years.  I cross over the basketball net area on the backside of the course, and I am always diligent watching what court the team is rebounding.  So I may have looked up in the trees scanning for local birds flocking together in hopes of some early spring weather.  Nonetheless, as I circled the spot, I heard a warning yell and immediately felt the pain in the right side of my face which included the nose.

The sound was deafening.  It was a good, solid shot by a high school senior.  My senses were out of whack as I struggled to regain my composure.  The electrical circuit that our CNS paths run on became heightened.  Pain shot back through my skull.  It pulsed down the neck and spinal cord reverberating through my shoulders.  My arms and hands began to sting and shake uncontrollably.  It's path was relentless, sending tumultuous shocks down to my feet.   

Everything is 100 times worse with fibro.

Swelling began, but not too bad.  By the time I got home I was electrified, nerves pulsating throughout my body.  I was jittery, nervous, agitated, sick to my stomach, and had symptoms of head pressure and congestion on the right side of my face.  I slept 12 hours, woke with the same symptoms and called my doctor.

Because the swelling wasn't in need of ice at this point, I asked about the possibility of a concussion.  I explained my symptoms.  I had no time to circumvent such ideologies on the internet so I relied on my doctor for an explanation.  She said, "Were you knocked out? Well, then you couldn't have a concussion."  She ordered a CT scan that I was unable to get because my insurance regulated a simple xray first.  I knew something was wrong and spent the day arguing with the imagery site and the doctors office to get the approval through.  I did get in the next day for an xray that pointed to a small fracture to my nose.  

But, I had no doctor telling me to take it easy.  I was left with the feeling it may be my overactive CNS that is causing all this.  Meanwhile I slept 10-12 hours each day for the next four days which sustained the same symptoms.  More importantly, I went around my basic tasks, "pushing myself though."

It was during this time a friend who also happened to be a retired EMT said, "You have the classic symptoms of a mild concussion."  I was beyond pissed.   You can be certain I called that doctor's office to voice a complaint.  But in the meantime, Dear Reader, I am going to give you a bit of information in case you come into the same scenario so you will not be ringing you hands wondering what to do because your brain can't focus on the internet.  

​What Are Head Injuries?

Head injuries are injuries to the scalp, skull, or brain caused by trauma. Concussions are the most common type of sports-related brain injury with an estimated 1.6 million to 3.8 million sports-related concussions a year. A concussion is a type of traumatic brain injury (TBI) that happens when the brain is jarred or shaken hard enough to bounce against the skull. This can happen when two athletes collide or when someone falls and hits his or her head. It can also result from being hit in the head with a piece of sporting equipment. In a sport such as soccer, even "heading" the ball can cause a concussion. A concussion causes an alteration of a person's mental status and can disrupt the normal functioning of the brain. Multiple concussions can have a long-lasting, cumulative life-changing effect.

You don't have to be hit in the head to experience a concussion. An impact elsewhere on the body can create enough force to jar the brain. You also won't necessarily lose consciousness with a concussion. Concussions range from mild to severe. The effects may be apparent immediately, or they may not show up until hours or even days later.

Other types of TBIs are a contusion, which is a bruise on the brain that can cause swelling, and a hematoma, which is bleeding in the brain that collects and forms a clot. A skull fracture is another type of head injury that can affect the brain. Sometimes with a fracture, pieces of bone can cut into the brain and cause bleeding and other types of injury.

What Are the Signs and Symptoms of a Brain Injury?

Signs of a TBI include:
  • Confusion
  • Depression
  • Dizziness or balance problems
  • Double or fuzzy vision
  • Feeling foggy or groggy
  • Feeling sluggish or tired
  • Headache
  • Memory loss
  • Nausea
  • Sensitivity to light or noise
  • Sleep disturbance
  • Trouble concentrating
  • Trouble remembering

Indications that a head injury is more serious than a concussion and requires emergency treatment include:
  • Changes in size of pupils
  • Clear or bloody fluid draining from the nose, mouth, or ears
  • Convulsions
  • Distorted facial features
  • Facial bruising
  • Fracture in the skull or face
  • Impaired hearing, smell, taste, or vision
  • Inability to move one or more limbs
  • Irritability, nervousness, apprehensive
  • Lightheadedness
  • Loss of consciousness
  • Low breathing rate
  • Restlessness, clumsiness, or lack of coordination
  • Severe headache
  • Slurred speech or blurred vision
  • Stiff neck or vomiting
  • Sudden worsening of symptoms after initial improvement
  • Swelling at the site of the injury
  • Persistent vomiting
​
Receiving medical attention as soon as possible is important for any type of potentially moderate to severe TBI. Undiagnosed injuries that don't receive proper care can cause long-term disability and impairment. Keep in mind that although death from a sports injury is rare, brain injuries are the leading cause of sports-related deaths.

Symptoms should be closely monitored often with a moderate to severe injury and may require an overnight stay in the hospital. X-rays may be used to check for potential skull fracture and stability of the spine. In some cases the doctor may ask for a CT scan or an MRI to check on the extent of the damage that occurred. More severe injuries may require surgery to relieve pressure from swelling. 

​Guidelines urge doctors to be conservative in treating sports-related brain injuries and to not allow someone who has been injured to return to activity that involves risk of further injury until completely free of symptoms. That usually takes a few weeks. But symptoms of severe injury could persist for months or even years. A person with a moderate to severe injury will likely require rehabilitation that may include physical and occupational therapy, speech and language therapy, medication, psychological counseling, and social support.

It did take a week for symptoms to abate.  But, there is still a sense of fogginess and slight pressure that makes life activities a nuisance.  I'm sure I'd be better off if my prognosis was correct and treatment plan was clear.  ​

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