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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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My Daughter Suffered A Frontal Lobe Concussion On 4/16 Having

My daughter suffered a frontal lobe concussion on 4/16 having been hit rather hard in the forehead by her volleyball coach. She has suffered daily headaches since and they increase upon exercise. She had some short term memory issues (unable to retain new information) presented in school and was exempted from exams. She seems to be much better with short term memory issues, but the headaches continue. She has been on many medications. Nortriptalyne for 2 weeks with atenonol, Maxalt for when the headaches were severe; and for swelling, she was on a week of prednisone with the nortriptalyne and atenonol at the same time. She had diclofenac for headache relief or Motrin 800. With continued headaches, she was taken off nortriptalyne (after only 2 weeks) and put on Verapamil SR 120 mg once a day, which is all she is on now.

She stayed out of all sports from April 18 to July 15, including PE, and initially missed 7 days of school. She was an AAU volleyball player and wants to get back into volleyball. Her headaches have gotten to a daily range of about a 2 or sometimes a 3 out of 10 UNLESS she tries to job or work out strenuously with a private coach. Then they spike to a 5 or 6 but subside back to a 3 when she rests afterwards.

She had a private volleyball workout today and did well; but her headache increased to a 5-6 and afterward, her head felt heavy she said and her head hurt on the whole top area. Now it is back to a pain level of 3 and hurts in the usual upper forehead area near the hairline.

It has been 3 months that she stayed out of all activity. I am wondering why her headaches increase with workouts -- could her brain still be swelling 3 months after a concussion??

Should she be back on prednisone for a week ? I read that Verapamil works better as an immediate release 2-3 times per day rather than the extended release version depending upon how your body metabolizes and if you work out hard, etc. I was thinking she might do better with a combination of drugs like Nortriptalyne for serotonin and Verapamil or Depakote as a channel blocker migraine preventor.

Should she get Botox injections since she has tried so many drugs??

She had an MRI of the head and neck on April 25 which showed no bleeding, but I don't know why 3 months later she had the heaviness in her head and the top of her head was hurting after the strenuous workout. She wants to play volleyball so badly. Should she not play??

How long does a person have to sit out?? What if she has long term headaches as a result of this concussion? (BTW, this was her second concussion. The first was 3/2014, last 2 weeks, hit on side of head with volleyball. Then this other concussion, more severe, hit on frontal lobe 4/15/15 for which she continues with the headaches, although milder, she still has them daily and they increase upon strenuous exercise.

She will miss the season as it starts in 2 weeks. What else would you suggest or what combination of medicaines would you suggest?
Sat, 25 Jul 2015
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My Daughter Suffered A Frontal Lobe Concussion On 4/16 Having