From: joel@cray.com (Joel Broude)
Subject: Headaches after fall down stairs
Organization: Cray Research Superservers Inc., San Diego CA, USA
Distribution: na
Date: Thu, 12 Nov 1992 18:20:51 GMT

On August 10, my brother, Craig, took a spill down the 
stairs at work (the LA Times), banging his 
head, neck and back.  The Times rushed him to a doctor
on contract with them.  The doctor, after barely touching
him and taking no x-rays, said, 'You're fine, go back to work.' 

The back right side of Craig's neck was swollen and painful,
his back hurt, and he had a headache that wouldn't stop.
So he went to see his own doctor, who
instructed him to take some time off work and see a 
neurologist.  The LA Times then told him that Workers
Comp allowed them to select the neurologist, and
that if he saw a different one, they would not pay for
it.  They sent him to Dr. N.

Dr. N. took x-rays and an MRI.  He found no broken 
bones, but a disk in the neck area was slightly misaligned, 
he said, though not by a significant amount.  He initially
concluded that Craig might have a pinched nerve, then later
decided that he probably didn't.  After a few weeks of physical 
therapy, the back and neck felt somewhat better, but the 
headaches, which are of two types, continue.  One type is
moderate in intensity, and constant; it never completely
goes away.  The other type is frequent and severe.

Still, Dr. N. released Craig, saying he is fine.  Craig 
pointed out that he still has these headaches, and Dr. N. 
said that he sees nothing that would cause the headaches, 
so as far as he's concerned the case is closed, and he told
Craig 'not to worry about them.'  He said that the slightly
misaligned disk could not be causing the headaches.

I'm pushing my brother to see another neurologist, and he 
says he will, eventually.  (The Times is experiencing layoffs 
and he's hesitant to give them any reasons right now for 
possibly letting him go.)

Meanwhile, he asked if I would post some of his symptoms here
for some feedback from the net.docs as to possible 
causes and dangers of delaying more treatment.

Craig describes a throbbing-type headache at the back of his skull,
toward the bottom right, that is almost constant.  

In addition, about once or twice a day he gets sharp headaches that 
start at the same place, then move around in front, between his eyes
and higher.  When he moves his head, it hurts more.  These
sharp headaches usually last only 5 minutes or so, but have
stayed up to about 20 minutes, wavering in intensity.  The pain
is so intense that concentration is impossible, and he finds
himself breathing heavily and sweating.  Pressing hard on
the bridge of the nose or on the temples helps some.  When
the pain passes, he feels exhausted.

He's never experienced migraines or other unusual headaches prior
to the accident.  Dr. N. told him to take a Fiorecet when the 
sharp headaches start, and he's also taking Vicodin when they're
particularly bad or long-lasting.

Is his delay in seeing another neurologist putting him at risk?
Can a trauma to the head and neck trigger migraines in someone
who hasn't had them before?  If the pain is actually caused by
a pinched nerve, is there any effective treatment for that?

Thanks!
Xref: sparky sci.med:20571 misc.fitness:8282