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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What causes black eyes and bruising on the face after a head injury?

Answered by
Dr.
Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3650 Questions

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Posted on Thu, 1 Sep 2016 in Brain and Spine
Question: I fell and hit my head on a bench chair. I have a large bump under my right eyebrow, two black eyes and bruising down the right side of my face. What do I need to do to heal this mess?
doctor
Answered by Dr. Olsi Taka 22 minutes later
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I understand your concern.

Regarding what to do to heal the bruises I am afraid that the only medicine is time. Like any bruise it will take some time to heal, at least a few weeks, until the blood has been absorbed. In the first hours after the event applying ice to the area will help to contain it but afterwards it would not be of much use I am afraid.

What you should worry about now is that the consequences are limited to the exterior and that there are no brain lesions. So you should be careful for manifestations such as increasing headache and vomiting, double vision or other visual changes, weakness of the limbs on one side, abnormal behavior noticed by you or those close to you etc. Those are manifestations of brain lesions which would require urgent imaging.

The fact that you have two black eyes worries me a little about it being the so called raccoon eyes sign, a manifestation of fracture of the skull base which requires imaging and a neurosurgical consult. So if both your eyes are black and it is not justified by a direct hit (it is unusual to hit both eyes at once) I would suggest to be seen at the ER for the possibility of the type of fracture I mentioned.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka 8 minutes later
Thank you for your response. How is a skull fracture treated?
doctor
Answered by Dr. Olsi Taka 7 hours later
Brief Answer:
Depends...

Detailed Answer:
Hello again! Sorry if I am answering a little late.

Treatment of skull fractures varies depending on whether there is displacement of the bony fragments and whether there are other complications such as hemorrhage meningitis etc. So management may vary from not doing anything at all, simply observing for compications, to having to undergo surgery or antibiotic treatment.

In your case I am hoping that it is a case of not having to do any intervention since you do not describe any other symptom and since you're able to communicate with me and interact with a computer your mental status seems to be intact. Hopefully there is no fracture at all, the entity of the trauma you describe doesn't seem to be that big to cause a trauma. However because of that bruising in both eyes I didn't want to take any chances and wanted you to have it checked.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 1 hour later
Thanks. I did get a cat scan tonight, and everything looks fine. Just have a nasty hematoma ender my eyebrow. Should I keep iceing it?
doctor
Answered by Dr. Olsi Taka 10 minutes later
Brief Answer:
Read below.

Detailed Answer:
Ah so you've had a Cat scan, I am much more relieved now.

After the first 24 hours ice doesn't have much value, the blood should have clotted so no more bleeding to stop.

Actually after that phase heat may be applied in order to increase circulation and speed up blood absorption. Its effect is modest though and I don't usually use it in the face where the skin is more delicate, it will make its own course anyway.

Hope you'll be back to normal soon.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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