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Swollen eye,concussion,numbness in face,X-ray,CT scan

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my child (13) 1.7m tall and 59kg, was hurt in a rugby match two days ago. We took him for x rays, which showed nothing, but not a CT scan yet. His eye is swollen and blue, the left part of his face is numb, and he can't chew on the left side of his mouth He also has concussion, and the left side of his face looks out of proportion. is a child with concussion supposed to do any contact sport within the next 3 weeks?and will the concussion have any effect on his exams at school?
Please give me advice.
Posted Sun, 15 Apr 2012 in Vision and Eye Disorders
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

The face has loose tissue around the eyes and the collection of blood and inflammatory fluid will make the tissue around the eye swollen and blue. This should settle down.

However if his facial numbness is more in the left cheek (infra orbital nerve / Trigeminal Nerve), or there are any visual problems, blurring,double vision or an inability to move the left eye in any particular direction, I would definitely get a CT Scan with coronal sections to rule out a blow out fracture through the floor of the orbit. (This may also happen medially because the bony lamina between the eye and nose is extremely wafer thin).

1. Is there any bleed in the eye itself?

2. Does he have pain, fever? He may not be able to chew on the left side due to pain.

3. Was there any nasal bleeding or a history of unconsciousness?

If his face looks out of proportion, and he has difficulty in chewing I would get a Facial nerve injury ruled out.

He should definitely avoid any contact sport for four to six weeks. The concussion should not have any effect on his studies or exams at school. You may request your doctor to prescribe painkillers and anti-inflammatory agents like Trypsin & Chymotrypsin. You may also give hot fomentation to the affected eye.

You may send a photo to YYYY@YYYY with 'Attn: Dr. Sumit Bhatti' in the subject line.

Further discussion will be easier after you answer these questions,

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