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Had accident, blood clot behind cheek. Nerve damage, fractured nose, skull and cheekbone Stitched in ER. What it could be?

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General & Family Physician
Practicing since : 2009
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Three weeks ago Thursday something went wrong in my newly repaired vehicle and while going at least 60 mph on an expressway in Chicago my vehicle pulled left beyond my control (wasn't steering) and I hit the median. My airbags did not deploy. My face split open. I went into shock, muscle was coming out, and I have permanent nerve damage. A plastic surgeon stitched me in the ER. I fractured nose in two places, eye socket in two places, skull in two places, and cheekbone in one place where the surgeon told me my "fatty tissue would fill the hole".

There is a large blood clot behind my left cheek, left nostril and pushes up against left side of my mouth so much I can't open in. He said to massage in and my body will eventually absorb it. It is hard as a rock and I feel the pressure every second of the day. Aside from the loss of feeling on my exterior, I am worried about what this clot and "possible foreign bodies" as ct scan said; is doing to me.

Advice? XXXXXX
Posted Thu, 16 May 2013 in Bones, Muscles and Joints
Answered by Dr. Luchuo Engelbert Bain 4 hours later
Hi and thanks for the query,

I understand this could actually be a worry, especially if one has never been exposed to such a scenario.
The bilateral clots that you have, are certainly going to fade out with time. Generally this should be happening in the next two to three weeks. You need not worry about using any drugs or whatever. Massage however should be sufficient.

I suggest you could associate Vitamin B complex in your management plan. It is important in accelerating nerve regeneration.

You need to however watch out for any signs of intracranial hypertension or secondary XXXXXXX bleeds (headaches, vomiting, blurred vision, fits). In any of these situations, report immediately to your physician.
I suggest you stay calm and watchful, attend your physiotherapy sessions and add Vitamin B complex to your treatment protocol.

Do not hesitate asking further questions if need be.

Best regards,
Luchuo, MD.

Above answer was peer-reviewed by
Follow-up: Had accident, blood clot behind cheek. Nerve damage, fractured nose, skull and cheekbone Stitched in ER. What it could be? 2 days later
Thank you for your response. I have two fractures on left side of nose and left cheekbone. There is swelling going upwards towards my eye and nose from this clot. It is new swelling. I was told use cold for swelling but heat for blood clot. Is that correct. I have terrible head pain but it's hard to tell if it's from concussion.

I can't feel up left side of upper lip and skin between lip and nose because of nerve damage. Pressure from this clot keeps that side of my mouth mainly closed. I can feel myself trying to smile but my left upper lip won't move. I am concerned about my teeth on that side. My sensory nerve to smile should work but do you think nerves on that side of face could deaden nerves to my teeth? I didn't chip any, no pain, none lose. They just feel tighter because of pressure.

Also, what do you recommend I put under eyes and neck. There was so much swelling and blood that skin has stretched. Thanks, XXXXXX
Answered by Dr. Luchuo Engelbert Bain 23 minutes later
hi and thanks for the query,

Its a possibility that you might have incurred some nerve lesions. But its worth noting also that the sensory function might take some time to come back to normal. But however, evaluation by your head and neck surgeon might be necessary.

With respect to the swelling and the clots, I would suggest you do not need anything every special for now. I can assure you what you need as far as that is concerned is staying calm and remaining patient.

Respect your appointments however, noting any abnormal new signs and symptoms and presenting then to your surgeon.

For now I pray you just be calm, but do not asking further questions if need be.

Thanks and best regards,

Luchuo, MD>
Above answer was peer-reviewed by
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