Discussions By Condition: I cannot get a diagnosis.

Do I have a head injury?

Posted In: I cannot get a diagnosis. 1 Replies
  • Posted By: seattleinjury
  • March 22, 2009
  • 05:15 AM

Three years ago I fell forward and smashed my nose on the side of a tub in a hotel. I broke the outside skin open and broke the bones inside. It bleed forever and I was really confused. I tried to call a friend and could not rememebr anyone's phone numbers. I did not 911 because I didn't think it was an emergency. I now know that I definitely had a concussion.
The problem now is that I get really bad headaches in my temples and right across my nose bone where it was broken. I get them the worst when I do yoga or pilates, but not running or walking for exercise. I think it has something ot do with my head being down and then coming back up to standing because i'm fine unless i do like a downward dog and then come up or am lying down doing some exercises and then stand up. It POUNDS.
Also, I have torticollis that is getting a little better with time. Is this all related? The doc just suggested physical therpay, but I think I may have a head injury.
I have noticed some personality changes like my monotone as someone called it. I am also a lot less outgoing. I though maybe I was just having a rough time, but these things are persisting and the exercise headaches are weird and now the neck?

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  • Okay, first of all, from the instance described it's highly unlikely that you actually fractured the bone structures related to the nasal area but rather the cartilage extending downward from the nasal bone that gives the nose it's characteristic shape. The cartilage is quite easily broken and often occurs from the type of low-impact injury described. Although mild concussion at best may have resulted, realize that "head injury" of the extent being suggested is extremely remote. In cases where pain is experienced on changes in head position due to gravity, such as bending over and then standing erect, the problem is most often due to sinus conditions, which can produce pain very similar to what you are describing. The ethmoid sinus runs transverse across the face from cheek to cheek and would be the most likely origin of your pain. Sinus problems would not be related to your slip and fall circumstances. You mention torticollis and I would ask whether you're suggesting it's related to the impact injury at all? If so, then I would state here that acquired torticollis from such an instance would not be the case because actual subluxation occurs and would require force far greater than that described. Neck tension from stress has often been mislabled torticollis, mostly by the chiropractic industry, but there is a substantial difference and there are characteristic features observed which actually denote the presence of torticollis that is supported by evidence of ligamental injury. In sum, your nose injury was somewhat superficial in nature and subsequent sinus problems or "toricollis" would be entirely unrelated. Incidentally, changes in personality would also be entirely unrelated to the original injury, particularly where associated with being less outgoing. In actual cases of personality change, severe brain trauma has occurred that is most often the result of object penetration into the skull and brain tissues in the frontal and pre-frontal area of the brain. Falling forward and breaking the nose cartilage on the tub would fall a great deal short of the impact required to sustain brain injury. My suggestion is that cause and effect thinking is at work here and you should take caution in the sometimes natural tendency to associate all subsequent observations in your health to the instance described. The circumstances described are unrelated. Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
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