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Do I have a brain injury? Fatigue, blurry vision, memory lapse, emotional trouble, CT scan normal, blood test normal

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Neurologist, Surgical
Practicing since : 1997
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Do I have a brain injury?
Hi, my name is XXXXXXX I am 19 years old. I am asking for your opinion on my situation for my own piece of mind. My situation is as follows; I had 4 wisdom teeth removed 7 months ago (under general anaesthesia and a breathing tube), and 5 days later I bumped my head. [I hit my head on a steel support beam as I was turning around from a standing position]. - After the operation I was feeling 'out of it' for days, I didn't feel right, and I think my perception was off, I was overly emotional.But I don't think I had any kind of infection. I also remember forgetfulness and having difficulty with writing an email. - The night that I hit my head, I had a panic attack, my heart rate increased, and I ended up having a ringing in my ears. Another issue I had in the same week was becoming very upset and angry, which goes against my personality. However, I don't think I had other symptoms of concussion, and the following day, I cannot even recall having a headache. And I know I spent the day on the laptop/ waching movies. I didn't have real or immediate symptoms of concussion, so it's hard for me to blame all my problems on that, and if I could it would be regarded as a post concussion syndrome, and I just find that hard to believe if there was only a very slight concussion or no concussion to begin with, especially since it's lasted so long. So I've assumed my issues have some relation to the operation. The reason for my concern is that I have not been asymptomatic of a brain injury of some type, and my symptoms have lasted for almost 8 months. I will describe the symptoms and issues I have experienced.

Fatigue has been a major issue and it still continues. 2 weeks post op I complained to a GP about mental fatigue, I had blood tests which were normal. The reasons for my complaints were that I had blurry vision and I felt I was experiencing memory lapses, for example, I would forget that a person had entered into a room within the same minute. I had environmental over stimulation which caused anxiety, I was having trouble returning to study at normal levels, and I was forgetting what I had just read or not even processing written material/ having a hard time communicating and writing. I also felt my depth of thought had deminished. I was also noticing repetitive behaviour, with immature emotions and difficulties with decision making. These symptoms showed in the first 2 weeks onwards. From then on I had waited for them to pass. For the following weeks, my academic achievements dropped, I could not complete assignments, I noticed I was thinking differently and still having a hard time taking notes. I developed panic attacks and concentration issues, along with noise sensitivity. I dealt with these symptoms until 10 weeks post op when I complained again to a doctor who sent me for a CT scan. It came back normal and he blamed everything on anxiety and did nothing further for me. For most of the duration I had a feeling of pressure within my head, without any headaches and for a number of months I was pain free.

I am still high functioning so my family and friends haven't noticed a real difference in me, and to doctors I appear normal. I feel like I had enough inteligence beforehand to compensate for any losses I had. It does not make it any easier to accept especially without anything to explain why it happened. I'm asking for your opinion on whether there may be a brain injury. I don't drink alcohol and I have never smoked or taken drugs. Thank you for your time.
Posted Sat, 21 Apr 2012 in Brain and Spine
Answered by Dr. Shivakumar S. Kupanur 6 hours later

Thanks for posting your query.

I appreciate your effort of describing symptoms.

According to your history, your symptoms started after teeth extraction procedure and intensity has increased considerably after head injury.

Some sort of discomfort, heaviness in head and varied perception to the surrounding is expected after anesthesia which usually last till the drug is completely metabolized within the body which will be few hours to 2-3 day.

Regarding your head injury, you didn't have loss of consciousness as per your history. It might have had retrograde amnesia (Patchy loss of memory to the events just prior to head injury).

Anyway, as CT scan is normal and there is no definite history of loss of consciousness, I don't think head injury is significant here. However, mild discomfort is expected due functional disturbance which will not be detected in CT scan. CT scan will show only structural defects.

After analyzing your history and events, definitely there is component of anxiety which may be due to events (surgery and head injury). Head injury/surgery alone can not be blamed for your symptoms.

I would suggest you to see a neurologist for detailed neurological examination. This problem can be tackled with certain medications like Amytriptiline. He may suggest you functional radiological studies and neuropsychological analysis.

I hope, I have answered your query to your satisfaction. I will be available for follow up queries if any.

Above answer was peer-reviewed by
Follow-up: Do I have a brain injury? Fatigue, blurry vision, memory lapse, emotional trouble, CT scan normal, blood test normal 9 hours later
hi, thank you for your reply. So, basically any problems related to the anaesthesia can be ruled out, and the head injury was not significant. so what can explain my symptoms? I am still finding myself extremely fatigued in the evenings and after a long day/ or attempting to study.
Answered by Dr. Shivakumar S. Kupanur 13 hours later

Thanks for writing back.

Definitely, I find some element of anxiety as a culprit in your case. This can be confirmed by neuropsychological analysis. Try some relaxing techniques like yoga, meditation, exercises to relieve your anxiety.

Another possibility could be nutritional deficiency which existed simultaneously. You need to get yourself evaluated by physician to rule out nutritional deficiency like Anemia which can present with fatigue and loss of concentration.

You can consider getting complete health check done after consulting your good health.

Above answer was peer-reviewed by
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