Q: About a week ago I fell and struck my head on a concrete floor. I was unconscious for about five minutes. I’ve had a CT scan and X-rays that were normal. Since then, I have had periods of time where my gait is very unsteady and I feel as if I’m drunk. It makes walking very difficult. This lasts for a few minutes but afterwards I’m very lethargic. Any suggestions?
A: My guess is you probably had a concussion when you struck your head; however, with the degree of symptoms you present, you may have a bleed that was not large enough to be detected at the time of the original CT scan. I say this because you had a blow to the head, you lost consciousness, your balance has been affected, as has your coordination. It has only been a week since your accident, which may not be sufficient time to fully recover; however, it may take weeks or longer before your symptoms completely disappear. According to the Centers for Disease Control, as many as 3.8 million sports, recreation-related blows to the head, and work-related head injuries cause concussions every year in the United States.
Signs and symptoms may include headache, ringing in the ears, dizziness, confusion, a temporary loss of consciousness, fatigue, balance and gait abnormalities, and more. Some symptoms may be immediately apparent or may take hours or days to appear. This is normal.
The brain is constantly cushioned from bangs and bumps because it floats in cerebrospinal fluid within the skull. With a blow such as you had, the brain may have slid forcefully against the inner wall of your skull. Traumatic brain injuries can result in bruising, damage to blood vessels and nerve injuries. Severe injuries may cause bleeding into brain tissue or in the layers that surround the brain, Most injuries of this sort occur while participating in contact sports; however auto accidents, falls, being a victim of physical abuse, or having had a previous concussion will raise a person’s risk factor for concussion.
You don’t indicate your age so I cannot comment on the CT you had. The CT is no longer the standard of care for concussions in adolescents; however, it is for the elderly. And, whatever your age, you lost consciousness for five minutes. That is significant and should be medically investigated. You should have had a neurological exam to check your balance, coordination, memory, vision and memory following the incident. If your symptoms continue, you may require a repeat CT or an MRI to rule out bleeding or other injury to the brain not detected on the original CT scan so stay in touch with your physician until he or she gives you the okay to return to normal activity. You should have been given a list of what to do and what to avoid that includes not driving a vehicle or participating in any contact sports until all your symptoms disappear. Above all, give yourself time to heal from this incident. Then, unless you know what made you take the tumble in the first place, perhaps you should have a complete examination and lab testing to assure everything is working as it should.
