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Bleeding from head and ear due to head injury. CT scan shows blood clot in brain. Difficulty speaking, sleepiness. Suggestions?

Nov 2013
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Practicing since : 1994
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Hi Sir,
I am sending this mail on behalf of my friend.
Patient(male) met with accident(21.07.2013) and on the spot was unconsious. Head injury and blood flow from both head and ear(only right ear). Injury only on right side of head and ear.
was immediately shifted to hospital for first aid, done with it and than upon doctors suggestion shifted to Neuro hospital for further treatment(because of blood flow from ear).
CT scan and whole body x-ray done on the same day. Doctor said no injury detected in the body but CT scan says small blood clot in 3 portions of brain. After diagnosis was patient was immediately shifted to ICU for further treatment.
As the blood clots were small so doctor said surgery not required and can be cured by medicines.
Also said there is no symptoms of paralysis or heart stroke, but there is a result of memory loss and will be correct in short span of time(may be a month or so).

so after 3 days he was removed from ICU.
shifted out of ICU on 24.07.2013.

The present condition of patient,
1. Does not identify anybody, but reponds to our speach.
2. moves all the parts of body hands and legs but not able to stand/sit by own.
3. Urine pipe connected.
4. more sleep/drowsiness.
5. Difficulty to speak and if spoken 1 or 2 words a time, speach is not clear.
6. Food- only liquid and very difficult to feed him.

Doctor suggested us to keep him engaged whole day by talking to him so that he does not sleep in day(and sleep only in night) and help him remember things.
Physio therapy being conducted daily for the movement of whole body.

3 CT-Brain scans done untill now :-
Doctor's say,
1st scan: Blood clots in 3 places found so need to shifted to ICU immediately.
2nd scan: Improvement in the condition.
3rd scan: Improvement in the present condition but small swelling identified in the brain which is leading to drousiness(more sleep day n night). Dosage increased to reduce this one.

forcast by doctors: patient will be able to do physical activity in 10 days but might take 3-5 weeks for memory recall.

And after 10 days of the incident patient is still not able to sit / walk or talk properly, are these any symptioms of mild paralysis?

Hereby mentioned few Medical history for your reference and would like to hear your expert comments and any suggestion like "to-do / not to-do things" or any consultting to specialist carrying all the reports/scans/documents to have a second opinion.
Kindly suggest and guide us.
Thanking you,
Posted Fri, 16 Aug 2013 in Head Injuries
Answered by Dr. Sudhir Kumar 39 hours later

Thank you for posting your query and providing detailed account of his condition, as well as CT scan and other reports.

I must say that your friend is fortunate to survive, as the head injury was quite severe looking at the first CT report.

However, I agree with most of what was told to you by his treating neuro doctors.

The extent of dysfunction in speech, consciousness, weakness of arms and legs, all depend upon the severity and location of injury to brain; as there are specific parts in the brain controlling speech, memory, strength of arms and legs, and consciousness.

Recovery would definitely happen in your friend's condition, however, an exact timeline for the same can not be fixed. It varies depending upon the age of the patient (younger recover faster), severity of head injury (severely injured patients take longer to recover), location of brain injury (patients with brain stem injury take longer to recover), etc.

However, at this stage, physiotherapy and good nutrition are the most important.
There are medications such as citicholine which may help in brain recovery. Piracetam may help in speech recovery. If he is too sleepy, modafinil can be used to increase his wakefulness.

I would be pleased to see the patient and all reports, if you wish so.

I hope it helps.

Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website:
My email: YYYY@YYYY
My blog:
Above answer was peer-reviewed by
Follow-up: Bleeding from head and ear due to head injury. CT scan shows blood clot in brain. Difficulty speaking, sleepiness. Suggestions? 8 hours later
Hi Sir,

Thanks for your valuable suggestions.
I have shared your suggestion with the hospital doctor where the patient is now being treated and they have appreciated your suggestion/advice.
They said they are using the same medications mentioned by you.
Patient is being treated in Gulbarga(Karnataka), Hospital: Cherayu Hospital & they would like to share more info about the present status from the doctors(neuro) point of view and seek you valuable suggestion/advice. Hope it is fine with you.
So they would like to contact you. I had given them the numbers which were mentioned in the website.

Presently the patient is undergoing daily physiotherapy in hospital, so will it be fine if i bring the patient after few days once he recovers more or is it a good idea to bring him immediately. Please suggest.

Thanks a lot for your understanding.

Answered by Dr. Sudhir Kumar 5 minutes later
Thank you for getting back.

It is better to discuss on the email, if they have any specific questions, as talking on phone may not be possible due to my schedule.

He can be brought for a check up after a few days.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
Follow-up: Bleeding from head and ear due to head injury. CT scan shows blood clot in brain. Difficulty speaking, sleepiness. Suggestions? 15 minutes later
Ok Sir i had informed them to send a email instead of talking on phone.

We will definetely bring him for check up after few days with all the reports.

Thank you very much for your valuable suggestion.

Answered by Dr. Sudhir Kumar 12 minutes later
Thank you and best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
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