Hi- I Fell Friday Morning On My Head And Received

Posted on Sun, 23 Sep 2018

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 23 Sep 2018 Answered on

Last reviewed on

Question : Hi-
I fell Friday morning on my head and received 13 stitches to my forehead. My left eye is now swollen almost completely shut and all shades of color with a lot fluid. I have a massive headache and nausea along with the fact I have been on a baby aspirin and given heparin for 2 days injection for a surgery I had prior to the fall. Should I be doing back to the ER?

Answered by Dr. Dr.Arnab (14 minutes later)

Brief Answer:
need some further evaluation regarding...

Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service...
I've gone through your query in details...
I can understand your concern...

I've checked the attached image, yes, it seems like a pretty bad laceration...

However, all those black and blue shades over the left eye seems to be secondary to a collection of clotted blood and fluids(hematoma).

Now the fact that you've already received heparin injection (I wouldn't be too worried about the baby aspirin, although along with heparin it can certainly increase the risk of bleeding), warrants further investigations.

Additionally, since you've also headache along with nausea, it's necessary to evaluate it further with a prompt clinical check-up (blood pressure, pulse and other hemodynamics) along with a CAT-scan of the brain (to rule out any internal bleeding and pressure effects) as well as hemogram, electrolytes, KFT, blood coagulation profile as a basic work-up.

So, yes, please refer to your nearest ER in order to get these done...

Let me know if I can assist you further.

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr.Arnab (15 minutes later)

Thank you for your response.
They did an initial CT scan at ER when I fell showing nothing. Do you think a follow up CT scan along with the follow up blood work, check up etc. is necessary? There is a lot of pressure in my head. I have had 3 brain surgeries for Chiari Malformation 10 years ago. (All in the back on my head) but anything with head/brain makes me nervous. Thank you for your response.

Answered by Dr. Dr.Arnab (9 minutes later)

Brief Answer:
a follow-up CT is needed to be on the safer side...

Detailed Answer:
Welcome back,

It's good that the initial CT showed nothing...

However, since it's been almost 2days, from your description, it seems like some pressure symptoms building up (feeling of pressure, headache along with nausea), which may not necessarily be due to any active bleeding but could even be due to post-traumatic swelling and internal fluid collections also.

Which is why to be on the safer side a follow-up CT should be done along with these few blood works. If found to be having any obvious pressure symptoms, necessary decongestant and anti-inflammatory medications will be advised along with, so please don't worry.

Please do mention regarding the recent history of Heparin and Aspirin therapy to them also so that they'll run those additional tests for complete evaluation.

Nothing to worry as of now, but do get these done in order to be completely assured. Meanwhile, continue to apply ice-compression (better to avoid warm pack, for now, take painkillers as in ACETAMINOPHEN rather than Ibuprofen)...

Let me know if I can assist you further.

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee