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Concussion after falling, dizziness, slurred speech, difficulty concentrating, no vomiting. Do you know what the symptoms may indicate?

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Hello, I (32 year old male) received a mild concussion four weeks ago, after falling backwards and hitting the back of my head on a concrete wall. I experienced dizziness, slurred speech, and difficulty with concentration afterwards, however I did not vomit. I have since been on sick leave.
I have two sets of questions:
(1) Being in a state of denial I worked for three full days after the event (computer programming) while taking strong nicotine products. I have periodically been under stress causing lack of sleep. I have not been able to rest fully, and have listened quite extensively to podcasts throughout this four week period. Lastly, I was forced to travel six half days during this period, during which I endured strong headaches during several hours. (a) Is there a risk that I have caused irreversible damage to my cognitive skills throughout this four week period? (b) Is there some kind of test that can be made to test for cognitive brain damages? I took an MR scan ten days after the concussion, which showed no signs of edema.
(2) Yesterday, I received a 90 minute massage (harder than I had wished for) in order to relieve muscle tension in neck, shoulder and legs. At that point, I felt that all symptoms were very mild. I got extensive massage on neck. I am now worried the massage was a very bad idea, since I noticed strong dizziness, slurred speech and tingling feeling in both hands, right after the massage. The tingling feeling endured for a few hours. Today, the day after, I've been quite dizzy, and headache appears sooner during the day than what it did prior to the massage. Do you know what the symptoms may indicate, and why a massage could have caused them?
Thank you!
Posted Tue, 17 Jul 2012 in Brain and Spine
Answered by Dr. Pratap Sanchetee 8 hours later

Thanks for the query.

In all probability you have post-traumatic concussion disorder. I am sure before doing Magnetic Resonance Imaging (MRI) scan, your doctor must have done a thorough clinical examination and it was normal. This condition is usually benign and rarely complications follow.

My answers to your individual queries are as follows:

1. Massage at neck and surrounding structures was not a right option. Sometimes vigorous massage may disturb vertebrae alignment and cause more dizziness and other harm. If dizziness persists, consider X-ray of cervical spine.

You need a good amount of rest for 7-10 days both physical and mental. In addition, your doctor may consider some symptomatic treatment and tranquillizers for short period.

2. It is too early to predict if you'd develop irreversible damage. However the possibilities are rarer.

3. To test for cognitive functions, simple tests by treating doctor is sufficient during acute stage.
After few weeks we can consider psychometry if you continue to be symptomatic.

Hope I have answered all your queries. Let me know if you need any more information.

Dr. Pratap
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