Below are a few examples of patients who have suffered from head injury symptoms. These cases are based on the stories of several patients seen by the authors of this website. Links to relevant parts of the website are provided throughout the stories.
Concussion with Headache, Vertigo, Double Vision and Fatigue
Paul is a 21-year-old student, who sustained a concussion whilst playing a game of rugby. After a blow to the head, he was unconscious for several minutes. When he came round, he looked dazed had trouble getting up. His teammates were very concerned and Paul was taken to the Emergency Department, where he was examined and had a CT scan. These did not show any abnormalities, so he was discharged home. In the days after the accident, Paul had a severe headache. He also suffered from dizziness and double vision. At times, it felt like the whole room was spinning. He felt awful and couldn’t be bothered to get out of bed. After spending three weeks at home, Paul felt like his symptoms hadn’t improved at all. Even watching TV seemed like too much of an effort. He was getting worried, especially since he heard a lot of frightening stories on rugby players suffering from long-term brain damage due to concussions. Paul was afraid his life would never be the same again, so he visited his GP. The GP reassured Paul that there were no signs of brain damage. She explained to Paul that the episodes of dizziness he suffered from were called ‘benign paroxysmal positional vertigo’ (BPPV). Paul was referred to a physiotherapist, where he learned exercises to treat these episodes of vertigo. At first, Paul didn’t like them, because they made him feel even worse. But after a while, he noticed he was getting less and less episodes of vertigo. The double vision improved as well. Paul’s GP had also encouraged him to slowly get back to his daily routine and advised him to try and get out of the house more often. Even though he still felt extremely tired, Paul tried to get up each morning and go for a short walk. Paul used to be a very busy and active person, so he felt like he was making little progress. Despite this, he kept on going and after three months gradual increase in activity levels he was able to return to normal activities including playing rugby.
Minor Head Injury with Fatigue, Insomnia, Dissociation and Irritability
Jenny is a 38-year-old single mother of three, who tripped over on the street and hit her head on the pavement. She didn’t lose consciousness and could remember everything that had happened but remembered feeling in shock as if she was in a movie. It felt somewhat unreal. Jenny was taken to the hospital. Apart from some bruises, they did not find much wrong with her, so she was allowed to go home. By the time she got home, Jenny felt exhausted and sore.
She carried on feeling like this in the following week. In order to be able to take care of her children, Jenny took naps when they were at school. This did not really help, since she was then finding it hard to get to sleep at night. Laying in bed and not being able to sleep really upset Jenny. In the morning, she found herself to be snappy and irritable with her kids. Sometimes, she experienced episodes where she felt ‘spaced out’, as if she wasn’t totally present. These made her worried that she must have experienced some kind of brain damage at the time of her head injury. After four weeks, Jenny felt so drained, she visited her GP. He told her that although she had experienced an unpleasant knock to the head, this wasn’t the kind of accident that caused damage to her brain. He explained that her symptoms of fatigue, sleep disturbance and irritability were quite common after a head injury like this and were related to her body’s response to the injury rather than damage. He also explained that her experiences of feeling spaced out and distant were called ‘dissociation’. He gave Jenny a leaflet with information to improve her sleep pattern. Jenny stopped taking naps during the day and started doing relaxation exercises before going to bed. She found these really helpful and noticed that practising deep breathing could also help when she was feeling wound up and irritated. She started to be able to do more physical activity. After two months, her sleep pattern had returned to normal and she was feeling more calm. She still felt tired, but was able to perform her every-day tasks without feeling overwhelmed.