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Dizziness After A Fall. Severe Injury To Head And Fractures On Rib. Blood Clot Found In The CT Scan. Treatment?

Posted on Tue, 3 Jul 2012

Question: Hi, my father fell from the first floor last week and hurt back side of his head, left ribs and waist, he was admitted in hospital for 3 days and doctors said that he has not got any severe injury or fractures after examining the CT scan and x XXXXXXX reports. However, he continued complaining of dizziness while changing position and has pain on left rib cage when we went back to the doctors once again with reports they said he has minor blood clot at the place of injury also hair line fracture on ribs and changed medicine, he is 62 years old but still complains about the dizziness and pain, what should we do, i am worried, any reference to good doctors in lucknow (India) would be of great help, thanks

Answered by Dr. Aashish Raghu (3 hours later)

Hi there.

Thanks for the query.

You have provided somewhat incomplete information, although I appreciate it. In order to guide you appropriately, I will need a few more details regarding your problem, so please answer the following questions in as much detail as possible.

Did your father have any nausea, vomiting, memory loss, unconsciousness after the injury ?

Any pain in the chest while your father breathes, coughs ?

It appears due to the trauma there would have been rib fracture which is causing the pain. A course of pain killers and anti-inflammatory drugs along with chest physiotherapy should be enough for few weeks to recovery.

The dizziness could be part of a mild concussion may not involve brain injury. This may require few weeks to clear up. Keep good follow-up with the Doctor in this regard.

It would be best to consult a Neurosurgeon for dizziness to rule out a hematoma or other causes of chronic dizziness, headache and get him a thorough checkup for best results.

Kindly respond to the above queries.

I hope I have answered your query. I will be available to answer your follow up queries.

Wishing good health.

Regards,

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Aashish Raghu (7 hours later)

Thanks for the information. He was in full sense after the injury and wasn't able to move because of severe pain. His memory and consciousness levels are fine.He is also not feeling any nausea or vomiting sensation. However, when he coughs or even moves slightly the pain is there in the ribs.

Earlier, the spinning sensation was there only when he used to move but since last two days he is continuously having sensation of spinning. His pain in the ribs (and sides) is also increased. Enclosed please find CT scan report.

CT SCAN : HEAD (PLAIN)

Thin contiguous axial were obtained covering entire cranium from foramen magnum to vertex followed by bone zoom reconstruction

SALIENT FEATURES
There is a evidence of small petechial hyperdense (blood density)lesion in left fronto-parietal opercular region suggesting petechial hemorrhagic contusion.Mild sulcal hyperdensity is seen in right frontal parafalcine region suggesting subarachnoid bleed.Similar subarachnoid hyperdensity (likely subarachnoid bleed) is seen in posteroinferior part of posterior fossa.

Rest of the cerebral hemisphere show normal morphology, density and outline.Both lateral and third ventricles are normal in size ,shape and outline.No midline shift is observed.

Brain stem & rest of the cerebellar hemispheres are displaying normal CT morphology and attenuation.Fourth ventricle is normal in Size.

NO OBVIOUS SKULL FRACTURE IS SEEN
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He was being administered with pain killer and saline in the hospital and later on he was prescribed following medicines.

MEDICINES
Glycerine syrup
Tab tegrital
Tab Vertin
Cap Nurokind plus
Tab complamina
Tab Lcin
Syrup Betanin
Tab colpol(In case of more Pain)

Please advice next steps, precautions to undertaken.

Thanks once again

Answered by Dr. Aashish Raghu (5 hours later)

Hi there,

Thanks for the reply.

According to the Computerized Tomography (CT) Scan there is an evidence of slight bleeding in the brain called sub-arachnoid hemorrhage and also mild blunt injury to the brain called contusion due to the trauma.

If the bleed is small, it should resolve within few weeks.

The medication given is for reducing the spinning sensation in the head, also to relieve pain.

Continue giving the medication as prescribed and recovery shall take place soon. Keep good follow up with his Doctor as well.

Precautions to be taken include avoiding improper head support. Make sure he gets comfortable rest for his head and neck. No forceful moving of his head. Avoid putting any sort of weight on his chest.

Give Tab. Colpol as advised by his Doctor for his pain, so that he breathes comfortably. Chest physiotherapy should also be encouraged. Give proper diet and keep him well hydrated. Maintain good hygiene for him as well.

Wishing good health and speedy recovery.

Regards,

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar