post concussion symptoms after car accident.
 

Hi everyone-Please forgive me if I ramble. I was in a car accident 5 weeks ago that should have ended my life. Instead, I hopped out of the car and ran away from it (I heard someone say that it might explode) I spent 3 hours in the ER where they determined that I could go home. My only injury at that time was deep bruising on my lower legs

About a week later I began to forget things. For instance, I went to the dentist the day before the accident and needed to go back the week after the accident to finish the work; I could not remember where the dentist was-I had to call my husband. There were other incidences as well. I couldn't get words out or remember how to write/type the words. Also at that time, I started having headaches and nausea. The neurologists near me didn't want to take me or couldn't see me until march. The headache got so bad that I went to the ER. They told me that I had post concussive syndrome? They set me up with a neurologist in the area.

After examining me, he ordered an MRI and an EEG. My question; if I start feeling better and my symptoms diminish, or go away should I still have the EEG and MRI done or can I call to cancel them?
Thank you for your help

Welcome to NeuroTalk! I'm sorry to hear about your accident. You came to the right place. There are plenty of good hearted people here to help you with your troubles.

The symptoms your describing sound very much like post-concussion syndrome. If you haven't had any of those tests done, I would get them done just to be on the safe side. You said the accident was pretty severe, so it would be well worth getting the MRI done to check for any bleeding or bruising on your brain. The EEG test would be to check for seizures and abnormal brain waves. I would get that done too just in case.

PCS symptoms tend to come and go. So just because you have a day or two without symptoms, doesn't mean your out of the woods. They can come right back and nip you in the butt.

If you have insurance, it should be no question to whether you get the tests done or not. It shouldn't cost you more than a co-pay.

I wish you the best of luck. Keep posting here, let us know how your doing.

Yes, welcome to NeuroTalk,

Although I agree that you are exhibiting Post Concussion Syndrome, I disagree with nwsmith about the need for an MRI and EEG,

First, if the ER doc had a concern about a bleed causing your head ache, he would have order a CT scan right then.

An MRI is not of much value unless you are exhibiting severe symptoms. They would be a sudden onset of a severe head ache, loss of motor control, serious balance problems, vision disturbances and any kind of imbalance between the right and left side of your body.

Brain bleeds show up best by the third day and the best image for them is a CT scan. The resolution of an MRI is not fine enough to show the microscopic damage of a concussion. If you are not experiencing any type of seizure activity, I don't see why an EEG would be of value.

If the money and inconvenience is not an issue, there is no reason to defy the doctor's request. If you were to get an MRI, it should include a full set of images of your neck, especially your upper neck. Upper neck injuries from vehicle collisions often go undiagnosed until much later if ever.

Some doctors are very concerned about covering their liability issues. This can lead to unnecessary tests. Plus, there are a good many neurologists who don't diagnose anything that they can not image on an X-ray, CT, MRI or EEG tracing.

The week delay in symptoms starting is not uncommon. In fact, it is more common than not for mild to moderate concussions. After the impact, the brain will try to continue functioning with the damaged or weakened brain cells. After a week or so, the brain gives up on those damaged cells and lets them die. In some concussion patients, this late arrival of PCS symptoms can take up to 6 weeks.

As nwsmith said, you PCS symptoms will likely come and go. It can become like a roller-coaster ride. The things you can do to help are simple. Limit any stress in your life. This means quiet rest with minimal auditory and visual stimulation. Plan to have quiet rest periods each day.

Eat healthy. This means no caffeine or alcohol or MSG. Later, a single serving of alcohol or caffeine may be OK. B vitamins are good for brain recovery. B-6 and B-12 are the most important plus a broad spectrum of the normal vitamins and minerals. D3, Omega 3's and folic acid are also good for the healing brain. be sure to get a good dose of all of the anti-oxidants.

To help you understand your condition, watch the YouTube video series by John Byler called "You Look Great" at http://www.youtube.com/watch?v=x9Xso...ature=youtu.be There are 6 segments that take about an hour total. Also, download the TBI Survival Guide at www.tbiguide.com It is full of great information.

Don't expect great things from the neurologist. It is rare to find a neurologist who has a good understanding of Post Concussion Syndrome.

If you are involved in litigation, check out www.tbilaw.com and its sister site www.subtlebraininjury.com.

And, don't have nightmares about the accident. Very few accidents explode in flames. I have extensive vehicle accident training when I was an EMT long ago. I have spent hours in cars helping get passengers out safely. In most accidents, you are safer to stay in the car until help arrives than fight to get out. Even today, I spend hours combing through auto salvage and auction yards and rarely see any vehicles that have burned as a result of a collision.

Feel free to ask any questions. There is lots of experience on this forum.

My best to you.

Thank you for your help. I had an eye exam and there was no damage to my eyes.
I do have nightmares, it's hard not to.

The driver's side compartment was completely intact. there was a Doctor and a nurse on the scene.

I want to say that the doctor order the MRI to check my brain and my upper neck.

thank you for all of your help.

At five weeks post injury, the MRI is statistically, based on research, a waste of time. If you have upper neck symptoms, the MRI can be valuable. It would likely be more appropriate to be ordered by a Physiatrist (specialist in Physical Medicine and Rehabilitation).

Hi Mark,

I had my first CT scan two weeks after the accident even though I went to the ER right after the accident. I went on vacation because the Dr. at the ER said it would be ok and I got much worse, when I returned home I went straight to the ER again because I was getting so much worse and then they gave me my first CT scan. Then I had the MRI about six weeks after the accident.

But I'm very curious about these statistics you are referring to. Do you happen to have any links to them?

I'm wondering if there was a bleed in my brain that didn't show up because it was too late to see it and then that would explain the iicp I experienced for six months until the second neurologist figured out that was what was making me so much worse based on my symptoms.

nightmares
 

I may have said this before--sorry...It's hard not to have nightmares. When the car finally came to rest, there was smoke coming out of at least the roof, I think, of the car, if not other places. There was also someone's child seeing this whole thing. I remember yelling, "why is this child here, don't let her see this."

They did an xray of my neck, that was also one of my issues. Also, even writing this is somewhat difficult-I can't find the words and/or I spell them wrong. Better safe than sorry, maybe I will have the MRI and EEG just for my piece of mind.

Thanks, this info is very helpful.

can you please explain what IICP is? It was discovered by the MRI? Thanks.

Sorry to confuse you with my questions themaidqwuit. I was directing them to Mark since he knows a LOT about this stuff and what he said to you made me sonder more about the information he posted. (I've done a lot of reading myself, but I'm always grateful to be pointed in new directions for more information.)

The iicp I had was not found on the MRI I had six weeks after the accident. It's not always seen on MRI's.

IICP is increased intracranial pressure and it's considered by the experts in journals I've read to be a very rare symptom with concussions. It's pressure that won't go away and actually increases cyclically inside someone's skull and it usually only happens to people who have moderate or severe brain injuries and causes a lot of complications. Please don't concern yourself with it at this point in your recovery; like I said it's very rare.

There have been some studies that associate it with second impact syndrome - so be very careful that you don't hit, or shake your head too hard so you don't further damage your brain. Also they think that second impact syndrome can cause a quick death. But, a lot of experts wonder why iicp doesn't happen more with boxers since they are prone to getting multiple concussions in close proximity to one another.

I'm just trying to figure it all out myself, really. And that's why I asked Mark for links - if he has them.

Anyway, I had a lot of nightmares too, for months after the car accident I was in. They went away.

I'm 18 months out from the accident I was in that gave me the brain injury and I'm doing a lot better. The Dr.'s told me I would be all better within a few hours to a few days when I first went in and I kept getting worse and then they told me I'd be better within a few weeks and I still wasn't and I'm still not all better now. But I'm doing better than I was.

Over time you will most likely get a lot better too. Take care of yourself. Take it easy and rest as much as possible.

thanks. sorry about my confustion to the questions. I am glad you are doing much better.

EsthersDoll,

It appears that your IICP was due to an increase in cerebrospinal fluid (CSF) since a spinal tap drain relieved the pressure. The more common issue is a brain bleed. Minor traumatic brain bleeds show up best at the third day. Later, and the brain usually has absorbed the blood. Earlier, and the blood has not pooled to an observable level. This would be similar to a ruptured aneurism but instead caused by the focused impact.

The axiom of not going to sleep for 12 to 18 hours or longer after a head trauma is to be able to maintain an observation of consciousness in case of a brain bleed. After 18 hours post trauma or longer depending on the source of information, the statistical likelihood of a brain bleed drops.

ICP can increase due to injuries that cause an increase in blood pressure due to a failure of the blood pressure regulating system in the brain, a brain bleed or a failure of the absorption mechanism that handles the overflow of CSF. The critical issue with ICCP is due to Second Impact Syndrome where the brain is impacted before the brain has had time to restore proper blood flow regulation. This can result in a catastrophic rise in intracranial blood pressure that ends up herniating the brain into the brain stem canal with fatal results.

Such increases in ICP especially those associated with high risk of further damage are associated with a severe increase in symptoms. The generic head ache or nausea is not usually associated with high risk.

An ambulatory person without disabling head aches or severe (over the toilet) nausea is rarely at risk.

The MRI may have noted an increase in ICP by noticing a decrease or increase in the fluid filled spaces in the brain. The sinus associated with drainage of CSF may have become engorged due to a failure to drain the CSF. A decrease in these spaces can be associated with abnormally high blood pressure in the brain as brain tissues swell.

Mark, thank you so much for your thoughts about what happened to me!

Unfortunately I did not experience headaches that I would consider "average" in any way shape or form when I had the iicp; they were debilitating to the point that even dilaudid administered through an IV in the ER could not take away my pain - it was truly awful. We assume that the level of pressure inside my skull rose in the cycle associated with it. (I'm sure you know people can live with that cycle for years depending on what level it starts at and how fast it increases until it becomes fatal.) I degraded so much that after six months I could hardly speak and I wasn't even able to maintain a minimal level of personal hygiene. It was a living nightmare. Which is another reason why I'm really trying to figure out more about what happened to me and why. You've really helped me to understand that it could have to do with the injured parts of my brain which I hadn't even considered before and may not have actually been from a bleed or swelling.

Luckily, I did not have a high enough level of CSF or IICP to herniate my brain to travel into the brain stem canal, but the Dr.'s wonder if it did cause further damage than the initial injury - however there is no way to tell and I'm still getting better.

Interestingly enough, when I was in the ER the first time, they told me that they allow people to sleep after head trauma - my boyfriend had tried to keep me awake during the whole ride there. And they recommended that I sleep when I felt like it and not to worry about it. They said that keeping people from sleeping is old school thinking and not recommended as much anymore.

I don't know much about MRI or EEG but the tone of this question reminds me of the confusion and lack of insight which I had at near the beginning of my recovery and the month or two after. I mean not being sure what is or isn't a symptom, thinking I was getting better or was going to get better very soon when I didn't really have any evidence for this and therefore trying to do things that I really shouldn't have.

Like you my symptoms took a week to kick in which just added to the confusion and lack of insight, since neither myself, those around me nor my General Practitioner had any idea that this could happen.

It particularly reminds me of being offered appointments with professionals and wondering whether I should accept them, since I was 'worried' I might be better by then and would therefore be inconveniencing them. The same attitude I think contributed to those around me not taking my injury seriously enough, since I kept implying that I was better than I really was, or that I would be better soon.

This was obviously a complete lack of insight on my part since I am still recovering after 10 months. Hopefully you'll be better well before then, but don't take it for granted and get all the help you can, from professionals, friends and family who need to understand from you that this is a serious and potentially long term injury.

Like I say this doesn't necessary include those particular tests, but the way you phrase things suggests you have a slight lack of insight which I recognise from my own experiences. Be careful, I found that over-optimistic, confused thinking like this was one of the symptoms of early PCS.

That said, many do get better in a relatively short time. Hope you're one of them!

EsthersDoll,

I would not be surprised if your symptoms are similar to chemo brain or the diffuse axonal injury common to concussion. Global injury even if the IICP was not at a dangerous level, can be frustrating since it mildly but consistently effects all of the brain functions. Any IICP will alter the blood perfusion. The lack of good oxygen levels and good removal of toxins released after metabolism can be problematic just like chemo brain.

Hello themaidquit
 

All ramblings are allowed here. Welcome to Neuro Talk. I am sorry to hear of your accident, and the resulting issues. People who have had this occur will be here to answer some questions, and maybe direct you to another forum. If I were in you situation, and had the insuance of course, I would probably go ahead and have the tests done. It is my understanding that some of these brain injuries can give a person the type of trouble you are experiencing. I hope you can find resolution in the near future, and that your symptoms go away. I am glad you found this site. Lots of nice folks here. ginnie

My tone has a lot to do with the fact that no one really knows how to treat this. my primary care doctor didn't have a clue and the neurologist didn't seem to have a lot of knowledge about "head injuries". I just needed to make sure that I wasn't having test that were being performed just to appease me and my concerns to the doctor. I asked this question here, from people that are going through this, as a "second opinion" of sorts.

Sat. I felt great, did all sorts of things, thought I was going to heal quickly and on my way. Sun. through today=all the symptoms came back withour mercy. Somedays I feel with it, and other days, I have trouble finding words, spelling and other such activities. As stated, I do not want my neurologist to order test or think I am, one of those people that thinks they have everything ( sorry could not think of the word. Please fill in the blank when you read this.)
Thank you, I do value everyone's opinion, since you all have been through this.

TMQ,

You need to remember that your are injured. Just because you feel good does not mean your brain is ready for a busy day. Those busy days will be followed by a crash day or even two.

Learning to pace our days take time and serious discipline. You don't need to be paranoid about activities, just cautious to not get caught up with To Do Lists and other activities.

One of the best lessons learned by many of us with PCS is that much of the stresses of daily life are excessive. We can still be productive with a much lower stress and work load.

When you consider if you are going to submit to these tests and imaging, try to determine if the neuro is just taking shots in the dark. You can even be direct in asking him if he is. Many doctors tend to be that way when they can't understand your complaints.

You and your brain need rest and less stress. Doctors who cannot answer your questions should not be adding to you stress. It is very rare that the doctors can do anything different as a result of these tests.

If you have either, I predict you will need the next day or two to recover from the stress, especially the EEG. EEG's can be exhausting. Been there, done that, did not learn anything worthwhile.

So, maybe you should start keeping a journal. In it, list your activities and any sensations or brain fog. Include how you feel when you first wake up. Could you get right up and be aware of your day or did you need to sort of 'get your head together'? Even note what you are eating. Over time, you will start to see patterns. A busy day will be followed by a poor day, even if the busy day ended on a good note.

Time to go get dinner.

My best to you.

You're not a hypochondriac. (Is that the word you were looking for?)

What you are experiencing is real and like Mark said, it's just going to take you taking it easy in order for you to heal better and faster. Don't have a busy day for a long while. Slow down. I know it's difficult - trust me I know! But doing so will help you to get to having better days for longer periods of time.

I was also very disappointed when I learned that Dr.'s don't have any real treatments to help a person recover from a brain injury. But that's really what it boils down to. They are almost at a complete loss. And every brain injury is unique which makes it even more difficult to treat.


Mark In Idaho -

You're very correct in that I feel as if I have experienced a DAI because the impairments I've been dealing with have effected many areas of my brain and functioning. I don't know if the iicp is the sole reason aside from the concussion or if it just compounded the same effects of the concussion.

I didn't remember knowing what chemo brain is upon reading it here, if I've ever even heard of it before, but I just read about it and it's very similar to what I seem to be experiencing, except I might be experiencing something even more intense or drastic, I don't know enough to compare it. The good news is that I was much worse before now and I still intend to improve. :)

Thanks again!

that's the word-hypochondriac. Thanks. that's the hardest part. I try to talk to the children's parents- and words just don't come out.

Yeah, I totally understand. I work at a university and the people there are used to me being able to say the right words all the time, I used to be very articulate. Now, I have a lot of trouble remembering words and even lose track of what I'm saying mid-sentence.

I'm getting better. You will too!

I was seeing a speech therapist for months and one of the things she recommended for me to do so I could remember words better was to do crossword puzzles and I think it's helped tremendously. Just make sure if you do them, to not do them too much or you'll tucker yourself out and get worse. But do them when you feel like it.

That's what my Dr. told me again today - do what my body tells me to. (In reality I don't want to do what my body tells me to, I want it to do what my mind tells it to! :wink: )

I like to do the word games online. If I play too long my body/mind tell me so.

If you wait for your body to tell you to stop, you likely have gone too long. You should stop at the first sign of needing to refocus on the screen or when you first start making careless errors/typos, etc. This is often long before you crash at the task.

Been there, done that, learned to not do it anymore.

This is a very good piece of advise that I will follow. thank you.

Yeah, that's how I figure out I starting to get tired too. I guess it's not literally my body telling me - but it's the sign I look for. (If I literally waited for my body to tire in order to rest my brain I'd be a wreck all the time!)

Sorry for not being clearer about the signs tmq - as I said, I'm not as articulate as I once was... :wink:

It could be just me, lately my brain has a "mind" of its own:

rear ended car accident
 

Not sure if any of you have any MVC rdata on what speed of rear impact will cause a concussion?There's the NFL settlement now with players who were injured,highlighting concussion issue.

Yet,there's no data on impact speed causing NFL,or NHL concussions. Ask because I was in two accidents,first,it was at about 50-60km while at a dead stop,with ongoing hits due to an unconscious driver's foot still on the gas;two was a direct hit at 60km,or slightly more while at a dead stop again.

Second collision has left me with what has been diagnosed by an Ophthalmologist as a migraine since my vision's fine,yet I get blurred vision,with blaring headaches that include flashing lights,loss of balance, sensitivity to bright lights,constantly ringing ears,loss of focus on things that require it [eg.reading text,movies,television].

Saw one Neurologist who felt there were "no neuro."issues,haven't read a second report from another yet.Concerned I am damaged,and no one is treating the injury to minimize further degradation?

Nomad, I'm going to copy your message to a new thread of your own, this is an old 2012 thread.

Follow this link to find your new thread.
http://neurotalk.psychcentral.com/forum92.html