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Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Hitting Your Head

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A reader writes: "Can you tell me what type of head injuries you can have if you were standing, then fell and hit the side of your head on a table on the way to the floor?

I have dizziness and when I look down to get something out of my pocket, for example, I get very dizzy and it is a lot harder for me to write this because my hands are weak. Can you tell me what you think I have?"

With the usual caveat that I am not trying to practice medicine over the Internet without the benefit of a full history and physical examination, this question is important, both for persons indoors and outdoors, because falls occur in all settings. First, one must ask if the victim was knocked unconscious during the event, in which case the diagnosis of concussion must be considered. Second, whenever someone strikes his or her head, the rescuer must assume that there may also be a neck injury. I would be particularly worried about that possibility in this circumstance, given the report of weakness in the hands, which might represent a spinal cord or nerve root injury, along with a possible bony spine or ligamentous injury.

The dizziness presents another set of possibilities, including concussion, contused (bruised) brain, blood clot within or outside the surface of the brain, and/or skull fracture. The dizziness and other symptoms might also be due to something entirely unrelated to the fall.

So, my advice is for this correspondent to be thoroughly evaluated by a physician trained to recognize the problems associated with head, spine, and nerve root injuries possibly associated with a fall.

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About the Author

Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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