Brain injury -TBI question

3 weeks ago I have been diagnosed with the following: left frontal bone fracture extending around left orbit and maxillary sinus fracture. The secondary diagnosis was : "small amount of extra-axial blood - which been told is not from the brain but from the skull bone" found on CT.

The word Brain Injury was not mentioned at any point on the diagnosis hospital discharge letter and am currently being followed up by the maxilla-facial department.

Should I be worried about brain injury or TBI?

11 Replies

  • With my limited understanding of physics it sounds like the bones absorbed most of the force of the blow and the energy release was in the fracture. How fast was the bus travelling when it struck you? I imagine the CT would have highlighted any bleeds on the brain (assuming they were looking out for that, of course - I had many CT scans when I was in intensive care) but I would remain vigilant if I were you!

  • On the CT they didn't find any other fractures except the ones I mentioned: upper left frontal bone, left orbital wall and floor and maxillary sinus.

    The cheek bone never hurt so to speak and neither did the left eye area although there was some swelling in the first 5 days however the forehead area has been sutured and had my stitches removed on the 19th of July- the skin still healing and had a little infection just 2 days ago which got cleansed by the max fax doctor.

    As a secondary diagnosis on the letter sent to the gp/the same discharge letter I got myself it reads "frontal laceration and small amount of extra-axial blood found on CT".

    It is the extra axial small amount they found that worries me- Read many articles about this and all state that the blood comes from outside the breain, from the skull bone so to speak.

    Would this still count as a brain injury?

  • And to answer your question, the CT scan didn't seem to indicate any "bleeds on the brain"

  • Well brain injuries can be caused by seemingly innocuous blows, and since you lost consciousness that doesn't seem innocuous to me. But then I'm not a medical professional. If you're concerned I definitely think you should mention it, not sure whether you have cognitive symptoms as such but lightheadedness is still disconcerting, although that could equally be caused by an inner ear infection or some such.

    Not being much help here perhaps, but I would definitely speak to a doctor about this if I were you, if only for reassurance.

  • Been pestering the doctors with all sorts of question eg. "Am I likely to develop a brain tumour, any complications?" Been told there's "no risk of developing cancer or tumour" and that in 6-8 weeks time the bone will heal as for the scar this shall fade in the next 2-3 months.

    I'm 3 weeks on and some people at work told me that "it's barely noticeable" although still get on and off burning sensation.

    Apart the fact that I do not remember the moment of the accident, I wouldn't say I ever had cognitive problems in the sense that I remember all my passwords , dates etc.

    Never took me a long time to find things around me, it's just the mild lightheadedness element that concerns me.

    But again knowing myself as suffering from anxiety I don't have the heart to pester the gp all over again as been to the practice twice in 48 h this week and both doctors assured me that the lightheadedness is part of the healing...

    I'm just afraid of things getting worse in the next weeks...I just keep reading things etc but then again I never had surgery and only been in hospital 2 days...the issue with me is the more I worry about it the worse I feel- think this is why I struggle with nausea for the past few days as it might be linked to anxiety.

  • Any impact to the head can result in concussion which could explain your light headedness and nausea. Your word recall and unimpaired memory, along with results of investigations must obviously rule out brain injury.

    Plenty of rest is probably what's needed whilst your facial and skull injuries heal and your symptoms subside.

    Give it time Alex ; your injuries, possibly nerve, tissue and bone damage won't heal overnight & might take several more weeks before you're fully mended. x

  • Hello Cat and thank you for your kind words. This morning at 08:30 is 3 weeks since the impact. The nausea has subsided and am still able to read without glasses, didn't experience any vomiting since the day of the impact and could walk without aid again from Day 1, crowds never bothered me. Not sure if I still feel lightheaded though but again the world is never spining.

    I always been treated by the max-fax department at Queen's Medical hospital and as far as I know they deal with bone fractures around the skull area and not directly with brain injury. Like I said except the moment of the impact I remember passwords, names, numbers.

    Would I be right to assume that if it was a brain injury I would have been seen by neurosurgery instead?


  • Cat, do you think they would have put "brain injury or TBI" as a diagnosis on the letter to my GP if that were the case?

  • Alex, I'm sure the doctors would have been quite 'up-front' about it if they suspected TBI and it would certainly have been mentioned on your discharge notes.

    An impact to other parts of the body can cause the brain to jolt against the skull which can cause bruising to the outer area involved. But even this usually results in more symptoms than you're having.

    So you may actually be suffering from the emotional aspect of the accident. Let's face it, it was a pretty shocking, almost bizarre event which might easily result in PTSD. So it will take time for your wounds to heal fully and even longer for the memory to fade from your brain.

    I'm not surprised you've been so badly affected by this Alex, I know I would have been. But give it time, and try to banish those worrying thoughts about other possibilities ; you don't have symptoms of brain injury and there's no evidence of it, but you do have symptoms of extreme anxiety which can take you to some very dark (and implausible) places.

    I'm sorry you're so stressed ; maybe you'd consider asking your GP for meds to help you cope better, just 'til your fears subside ?

    Sincere best wishes for better days to come, Cat xx

  • I do agree with what you said. Just rang the Major Trauma unit from the hospital and asked to speak to a doctor on call who confirmed that I haven't been diagnosed with TBI or brain injury. Kinda put my mind at rest for a while yet do still feel worried about any possible complications down the line. I asked them if it's only the frontal bone and maxillary sinus that are fractured and they said yes.

    Sometimes it is hard to tell if what I feel is lightheadedness as the scar area on my left forehead is kinda burning on and off and when it does I start to worry and I may get the feeling I feel lightheaded for 5-10 seconds or so (again very different from vertigo as things are not spinning, sometimes I'd feel like the ceiling might be bit too high or the bed may be sinking in for a matter of seconds especially when I wake up as I sleep on the right side just to avoid sleeping on the left which is the affected area).

    No longer feeling nauseous though which is good thing but been losing weight since the accident-which I tend to associate with the constant anxiety and fear of possible complications.

    I do agree with you if brain injury was there, this should have been listed on the discharge letter.

  • Remember Alex that one of the first physical symptoms of anxiety is light-headedness, caused by shallow breathing which often accompanies stress.

    Try as many distractions as you can find to keep yourself away from this negative way of thinking. I downloaded 'Netflix' last night (so easy & costing £6 per month) and watched a wonderful film ; a great way to stave off unhelpful thoughts.

    Hope you can get past this before too long ! Cat xx

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