[43F] Post-motorcycle accident with multiple symptoms including cognitive and urinary issues

Patient Description

A 43-year-old female was involved in a motorcycle accident a week ago and has since experienced significant road rash on her left arm and leg, major bruising on her left leg and buttocks with hard knots under the bruises, and a constant throbbing headache on the left back side of her head, rated 9/10 in intensity and worsened by sitting. She reports feeling very out of sorts, having trouble focusing, and experiencing memory issues, which started suddenly 3 days post-accident and have persisted for 5 days. She also experienced confusion immediately after the accident. Additionally, she has blood in her urine (pink and red) for 7 days, discomfort in her back between the shoulder blades, double vision, difficulty focusing her sight, and feeling very unbalanced. She has sensitivity to light and noise, increased fever and chills, and swelling in her hands and ankles for 8 days, which feels soft. She also reports weakness and numbness in her arms and legs. Her menstrual cycle started out of cycle the day after the accident. She has had a double mastectomy and is not taking any medications other than ibuprofen 800mg once a day. She has no history of head injuries or concussions, no chronic illnesses, and has not consumed alcohol or recreational drugs since the accident.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

Concussion or Traumatic Brain Injury (TBI)

  • Rationale: Your symptoms of severe headache, trouble focusing, memory loss, confusion, dizziness, double vision, and sensitivity to light and noise are consistent with a concussion or more severe traumatic brain injury. These symptoms can occur after a head injury, such as from a motorcycle accident.
  • Typical Treatments/Testing: A healthcare provider would likely perform a neurological examination and may order imaging tests like a CT scan or MRI to assess the extent of the injury. Treatment often involves rest, avoiding activities that could worsen symptoms, and sometimes medications to manage pain and other symptoms.

Soft Tissue Injuries and Bruising

  • Rationale: The road rash, deep bruising with hard knots, and tenderness are indicative of significant soft tissue injuries. The swelling in your hands and ankles could be related to the trauma and subsequent inflammation.
  • Typical Treatments/Testing: Treatment usually involves wound care for the road rash, pain management, and monitoring for signs of infection. For the bruising and swelling, rest, ice, compression, and elevation (RICE) are commonly recommended. A healthcare provider might also check for any underlying fractures or more serious injuries.

Urinary Tract Injury or Infection

  • Rationale: The presence of blood in your urine (hematuria) could indicate a urinary tract injury or infection, especially following trauma. It could also be related to kidney or bladder issues.
  • Typical Treatments/Testing: A healthcare provider would likely perform a urinalysis and possibly imaging studies like an ultrasound or CT scan to determine the cause. Treatment would depend on the underlying issue but could include antibiotics for an infection or other interventions for more serious injuries.

Post-Traumatic Stress

  • Rationale: The sudden onset of feeling out of sorts, trouble focusing, and memory issues could also be related to psychological stress or post-traumatic stress disorder (PTSD) following the accident.
  • Typical Treatments/Testing: A healthcare provider might recommend counseling or therapy to help manage these symptoms. Medications might also be prescribed to help with anxiety or depression if present.

What you can do

Concussion or Traumatic Brain Injury

  • Seek immediate medical attention: Given the severity of your symptoms, it's crucial to see a healthcare provider as soon as possible. They can perform the necessary tests to diagnose and treat a concussion or TBI.
  • Rest: Avoid activities that require intense concentration or physical exertion. Rest is essential for recovery.
  • Monitor symptoms: Keep track of any changes in your symptoms and report them to your healthcare provider.

Soft Tissue Injuries and Bruising

  • Wound care: Keep the road rash clean and covered to prevent infection. Follow any wound care instructions provided by your healthcare provider.
  • Pain management: Continue taking ibuprofen as directed, but do not exceed the recommended dose. You can also use ice packs on the bruised areas to reduce swelling and pain.
  • Rest and elevate: Rest the affected areas and elevate your legs to help reduce swelling.

Urinary Tract Injury or Infection

  • Hydrate: Drink plenty of water to help flush out your urinary system.
  • Seek medical attention: It's important to see a healthcare provider to determine the cause of the blood in your urine and receive appropriate treatment.

Post-Traumatic Stress

  • Seek support: Talk to a mental health professional about your feelings and symptoms. They can provide strategies to help you cope.
  • Self-care: Engage in activities that help you relax and reduce stress, such as deep breathing exercises, meditation, or gentle physical activity.

General Tips

  • Use MDandMe: Journal your symptoms, track your progress, and get insights. This can help you and your healthcare provider understand your condition better and make informed decisions about your care.

What you should look out for

Given the severity of your symptoms and the possibility of life-threatening causes, you should seek medical care as soon as you can. Reasons to seek care even more urgently include:

  • Worsening headache: If your headache becomes more severe or is accompanied by vomiting, seizures, or loss of consciousness.
  • Increased confusion or memory loss: If you notice a significant decline in your cognitive abilities.
  • Severe swelling or pain: If the swelling in your hands and ankles worsens or becomes extremely painful.
  • Signs of infection: If the road rash becomes more red, swollen, or starts to ooze pus.
  • Persistent blood in urine: If the blood in your urine does not improve or worsens.

Remember, while I can provide information and suggestions, it's essential to consult with a healthcare professional for a

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4 mo ago

People Also Ask


What are the symptoms of a concussion or traumatic brain injury?

Symptoms of a concussion or traumatic brain injury can include severe headache, confusion, memory loss, dizziness, double vision, sensitivity to light and noise, and difficulty concentrating. These symptoms can vary in severity and may require medical evaluation and imaging tests for diagnosis.


How should road rash and bruising be treated after an accident?

Road rash should be cleaned and covered to prevent infection, and pain can be managed with medications like ibuprofen. Bruising and swelling can be treated with rest, ice, compression, and elevation (RICE). It's important to monitor for signs of infection or more serious injuries.


What could cause blood in urine after a traumatic event?

Blood in urine after a traumatic event could indicate a urinary tract injury or infection, or issues with the kidneys or bladder. A healthcare provider may perform a urinalysis and imaging studies to determine the cause and appropriate treatment.


What are the signs of post-traumatic stress disorder (PTSD) following an accident?

Signs of PTSD following an accident can include feeling out of sorts, trouble focusing, memory issues, anxiety, and depression. These symptoms may require counseling or therapy, and sometimes medication, to help manage them.


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