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What Causes Pain In Jaw And Temple Area Post Head Injury?

Posted on Wed, 20 Aug 2014

Question: I had a head injury - blow to the middle of my forehead - went to ER - they did neuro checks and sent me home. I noticed on the way home I could not open my mouth very much without a lot of pain to my left jaw and into the left temple area. Also have nausea and clear nasal drainage which they knew about in the ER. They can't answer my question about the mouth problem over the phone. Should I be concerned?

Answered by Dr. T Chandrakant (19 minutes later)

Brief Answer:
Visit ER

Detailed Answer:
Hi,

How was the blow done ? If the blow was close to the left temple or jaw there may be trauma to the temporalis muscle there by going into spam and causing painful opening of the jaw.

At this point of time, I am more concerned about the clear nasal discharge. In this context leakage of CSF (cerebro-spinal fluid - from the coverings of the brain) through the breach between the nose and the interior of the skull needs to be rule out. If you haven't discussed about it with ER doctor, you may perhaps consider doing it again.

In the meanwhile do not blow nose. Try ice and warm compresses alternatively to the jaw and see if you feel better. Visit the ER if symptoms worsen.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. T Chandrakant (42 minutes later)

I did discuss the nasal drainage at the ER. He said if there were no blood I didn't need to worry (that's not what I learned as a nurse). He felt since all my neuro checks were OK I did not need a CT. I have already blown my nose several times. He asked if I had allergies. I think he was a nurse practitioner actually. I really don't want a second ER charge unless absolutely necessary. Can I buy those dip sticks OTC to see if there is sugar in the drainage? Would that be advisable?

Answered by Dr. T Chandrakant (51 minutes later)

Brief Answer:
Confirmation / ENT Endoscopy

Detailed Answer:
Thanks for your feedback.
Very true, the way he explained is wrong. You are absolutely right, he must be a trainy only. ( It is possible that he did not knew that you know this).

Neuro check-ups will be normal even though you have CSF Rhinorrhea.
OK- but please stop blowing the nose now. The history of nasal discharge on head-injury that too in the forehead has to be investigated and the best way to have a final diagnosis by contrast CT Cysternography and MRI.

This is a good idea to check for the sugar in the discharge but this is only indicative and since CSF Rhinorrhea can have dreaded complications, it is better to rule out this at the earliest. You may consult an ENT or NeuroSurgeon to get the best diagnostic facility.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari