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Are severe headaches common after a head injury?

Q: My sister met with an accident last week and her first CT scan was reported normal. As she was unwell, same evening a second CT scan was carried out with the finding of very thin left temporal subacute haematoma & small cortical contusions injury in the lobe with mild cerebral oedema also (more on left hemisphere). Continuous pain necessitated neurosurgeon to go for MRI 4 days later. Opinion: MR Imaging features are suggestive of bilateral temporal and right basifrontal contusions with thin subacute subdural haematomas - bilateral temporal regions. Doctors feel, as there is no major finding in CT scan and MRI report, there is nothing to worry and these abnormalities (very thin blood clots, mild fracture and multiple injury in the brain - like bruise) could be repaired by medicine (antibiotic). Positive aspect from the patient is her orientation is o.k. (she is able to recollect the past, except how the accident happened) her body is functioning normally till now with oral diet. Negative aspects include - unbearable pain in the head accompanied by nausea - rarely with vomiting. Please help in second opinion whether these medicines are o.k, is she out of danger, or whether she will be having any long term effect etc.

A:It is not uncommon to have severe headaches after head injury. It is probably not related to pressure as the injuries appear mild. While treatment to reduce swelling should continue, my personal opinion is that these headaches sometimes respond dramatically to a short course of steroids and this may be tried if the usual medications have failed.

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