Bump with cut in head. Symptoms should watch for?

Resolved question:
Standard Head Injury (I believe).

Hello Doctor,

I am using this service in hopes of getting a professional's opinion on a head injury that I incurred this weekend. I woke up this Sunday morning with a decent size bump on the back of my head behind my left ear (about an inch or two in diameter). In the center of the bump/knot there is a small cut or puncture, about .5-1 cm. When I woke up Sunday morning this cut was scabbed, but hasn't been bleeding since. The swelling seems to be pretty standard for a knock like this. Now here comes the main reason as to why I am looking for a second opinion/concerned... I unfortunately have no recollection of what happened/ how it happened. Me and friends were out celebrating and I obviously had entirely too much to drink. I have already asked people if they saw what I might have done, but no one seems to know how I hit my head. I already know that this is incredibly dangerous and irresponsible, so I would appreciate it if we can solely focus on the result of this irresponsibility (the head injury).

I feel like 9/10 times whenever I do go to a doctor it turns out to be nothing that a little ice, rest, and time cant fix. Head injuries are tricky though because anything/everything you read on the internet says seek immediate attention right away (which I understand, but more times than not this is not the case).

So what have I done so far? Sunday I pretty much just purely rested, but did not ice my head too much. Monday (yesterday) I ended up going to work. The head injury felt worse than it did on Sunday and irritated me all day, but overall I was able to do my job (sit at a computer all day). When I got home from work yesterday I went back to resting, and iced my head on and off for a few hours before bed last night. I was assuming that given the situation, and the icing, that this would pretty much be resolved today, but the pain and irritation persists (swelling has gone done a little though). The pain isn't really any better or worse from yesterday. I took the day off today to rest and ice my head, and also to possibly go see a doctor in person.

I was hoping that you could provide me with your professional opinion on the situation. I would like to know what you think?\, what you think I should do, things/symptoms that I should possibly watch for, and what kind of doctor I should go see if I should need to seek more professional help? I would also like to know what the typically diagnosis is given the information that I am able to provide. I am open to answering any questions that may assist you in providing your advice. Please get back to me as soon as possible as it should help me determine if I need to go see somebody today.

Thanks in advance,
Ryan

Submitted: 4 Days
Category: Family Physician-GP

Expert:  Dr. Jaydeep Tripathy replied 4 Days.

Hello Mr. Ryan,
Thank you for your query at Doctorspring.com
I can understand your concern.
So the injury happened last saturday and if there was anything serious like a hemorrhage, it would have manifested by now.
I will list out the symptoms that occurs in a patient with head injury and that also warrants immediate care :
1) Most commonly there will be a generalised headache. Most people ignore this because they think it is part of the injury, and by the time they present to the doctor it gets too serious. Pain in the site of injury and headache is different.
2) In most cases with severe head injury there will be associated nausea/ vomiting.
3) One characteristic change that is found in almost all cases of severe head injury leading to a brain hemorrhage is a characteristic dilatation of the pupils in the eye. Normally when you project light on to the pupil, it should constrict and then gradually dilate, but in cases of head injury, pupils stop reacting to light.
4) In some cases there will be seizures, agitation, confusion.
5) Numbness of the hands or legs associated with weakness.
In absence of any of the symptoms, there is really no reason to worry about.
Mostly patients with brain hemorrhage will start experiencing a combination of the above mentioned symptoms in 24-48 hours. In your case, that interval has passed, so you seem to be fine. You just have a swelling from the injury and it will gradually go down.
However at any point, if you experience any of the above sympoms, you can go to the ER, get a CT SCAN done and have a follow up with a neurologist.
I hope this answers your question,
Feel free to discuss further queries,
Regards.

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