How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Eric Your Own Question
Dr. Eric
Dr. Eric, Doctor (MD)
Category: Health
Satisfied Customers: 251
Experience:  9 years of experience as board certified internist, pediatrician. Specialize in Adolescent Medicine.
8773812
Type Your Health Question Here...
Dr. Eric is online now
A new question is answered every 9 seconds

I hit my head 26 hours ago and I am on coumadin. I talked ...

Customer Question

I hit my head 26 hours ago and I am on coumadin. I talked to my doctor and one on here. They both said I should be fine, but what symptoms should I look for and for how long do I worry? I'm a severe worry wart. I have a slight headache, but my sinuses have been bothering me also. I fell, hit my head on the table, got up, and went out to eat. I had a goose egg which has gone down but it's still sore. I need more information. Being on coumadin, if I had a bleed wouldn't it make symptoms appear sooner than normal? Please give me as much info. as you can
Submitted: 9 years ago.
Category: Health
Expert:  Dr. Saha replied 9 years ago.
Hello
I feel you are thinking of symptoms which may occur in case of intracranial bleeding or bleeding within the skull.

The common symptoms include
Headache
Vomiting
Drowsiness
Altered consciousness
Loss of memory
Weakness of any part of body
Unconsciousness

The time to appearance of these symptoms varies depending on the site of bleeding

within the skull or in which part of the brain it occurs,

It may be immediate , may be days or weeks also .

Some tests may help to determine the occurence & site of bleeding like CT scan or MRI scan .

If you need further clarifications, I will be happy to explain further.

If you find this information helpful, please press the ACCEPT button.

Bonus is always appreciated.

Your Positive Feed back is important to me.

Thank you for contacting Just Answer.

Customer: replied 9 years ago.
I knew all that information already...I wanted to know if being on coumadin would speed up the process. I hit my head on the right side near the temple. I swelled, but the swelling is down now. If I had a bleed "on coumadin" wouldn't it get serious sooner than days or weeks? It seems that symptoms would appear within hours.
Expert:  Dr. Saha replied 9 years ago.
Coumadin increases the chances of bleeding , But the bleeding tendency may be affected by INR level. It has been seen when the INR is more.
Customer: replied 9 years ago.
Ok, I don't mean to be rude, but I certainly know about inr levels. I guess I know as much as you do. I was hoping for more information. So, from what you said, even being on coumadin...if I hit my head I could still bleed days or weeks from the time I hit my head. That doesn't make sense to me because coumadin increases a bleed. Therefore, if I bleed wouldn't it bleed sooner than later. Wouldn't I experience headache, vomiting, etc... within hours of the hit to the head? I think you are thinking that I'm a person who knows nothing about coumadin. I'm very up to date on this. I wanted "more."
Expert:  Dr. Eric replied 9 years ago.
Hi!

I agree with Dr. Saha - those are indeed the symptoms of a head bleed. Yes, you are correct that the coumadin reduces your natural clotting cascade, so it is possible that symptoms could appear sooner. If you are noticing any of the symptoms he mentioned, you should go to the emergency room and ask them for a CT scan.

Do you know what your most recent INR was?

The reason he mentioned that the symptoms could occur in days to weeks is that sometimes someone will develop a subdural (underneath the lining of the brain, but not in the brain) hematoma. These type of bleeds will compress the brain, but if they stop, may leave some residual effects like headaches that don't seem to get better, or confusion.

Let me know if this is helpful, and if you have any further questions.

Dr. Eric
Customer: replied 9 years ago.
This bump to my head was now 51 hours ago. I still have some headaches, but I am having sinus problems also. Everything else is normal. My inr usually stays around 2.5. I am a worrier...I don't want to think that I have to worry about dying for 5 weeks! I am only 45..so are the chances of a chronic subdural hematoma still possible?
Expert:  Dr. Eric replied 9 years ago.

First of all, subdurals are rarely fatal except when they are very large. The bleeding would have stopped now, even if your INR was very high.

If the headaches persist, it would be worthwhile to ask your physician if they can do a head CT in a week or so to see if you had a small subdural. Most of the time, with a small subdural we would only watch and your body would gradually reabsorb the blood - much like any other bruise.

The bigger concern would be that if you were to have ongoing headaches, problems with your balance, confusion and you were to keep falling (and perhaps not remember it), that larger subdurals could accumulate.

Here is a good article on subdural hematomas - http://www.nlm.nih.gov/medlineplus/ency/article/000713.htm

At this point, I am not worried that you have a large acute subdural, and I do not think you are going to die - so don't let me make things worse by giving you something more to worry about. The reason I'm sending the link is that what Dr. Saha was talking further out is the chronic subdurals. This article has a nice list of symptoms that you can watch for.

 

Does this help?

Let me know if you have any further questions.

Dr. Eric

Dr. Eric, Doctor (MD)
Category: Health
Satisfied Customers: 251
Experience: 9 years of experience as board certified internist, pediatrician. Specialize in Adolescent Medicine.
Dr. Eric and other Health Specialists are ready to help you
Customer: replied 9 years ago.
Thank you for replying. I am a hypochondriac in a sense, but I have real problems with the Factor V Leiden. I talked to my doctor and she said she could order a CT but she really didn't think it was necessary. When I sleep I wake up with absolutely NO headache. I forget about it. Would I still have a headache when I sleep if I had any bleeding in the brain? I'm afraid the headache is just stress and sinus. I had a beer last night and the headache went away. Thank you so much for trying to help me. I'm struggling with the coumadin issues. So, if I had a chronic subdural hematoma, would I have symptoms or would I be fine for weeks and then have symptoms?
Expert:  Dr. Eric replied 9 years ago.
No - if there was a significant amount of bleeding, the headache would most likely be continuous. I understand your worries - it's okay.

I think you would have symptoms from the beginning if you had a subdural that was of any consequence, it's just that people often don't recognize it as such. I had a gentleman who slipped taking out the trash and became confused. He didn't realize that his symptoms were because he hit his head - he didn't remember hitting his head.

Write me back if any further symptoms develop that you are worried about.

Dr. Eric
Dr. Eric, Doctor (MD)
Category: Health
Satisfied Customers: 251
Experience: 9 years of experience as board certified internist, pediatrician. Specialize in Adolescent Medicine.
Dr. Eric and other Health Specialists are ready to help you