Head Injury/Coumadin - Help!

[Shelba]

My daughter swung her back right into my brow bone this morning. It HURT sooo bad that I started crying instantly. My poor kid ( years old) started crying as well, so we both sat there crying, and patting eachother on the back to console one another.

Anyway, it has been over 12 hours now and I have a slight bruise, that area is painful to the touch and I have a headache.

I had my inr tested today and it was 6.4. I told my nurse about getting hit in the head and she didn't really seem concerned. Told me to put some ice on it.

And of course, I'm googling head injury and coumadin and it is freaking me out.

What should I do???? Do I need to take a chill pill and see how I feel in the morning? Do I see someone?

I don't know what to do and I'm freaked out. Any advice would be very appreciated.

Michele

 

[DrAllan]

12 hours post injury and only a painful bruise. Most likely just blunt trauma to the forehead. The concern would be a subduaral hematoma. The symptoms usually are headache, lethargy, vomitting. While a subdural can become apparen in a short time, there are instances where it taskes several days to become symptomatic. With your high INR i would have expected you to be in trouble now, Nevetheless, if symptoms develop then you should be seen for evaluaton and a CT scan.

 

[hensylee]

Thank you, DrAllan. We are so glad to have you as a very valued part of VR.

 

[Guest]

It is rare - a hospital the size of Mass General sees less than one per month - but subdural hematomas can be slow to develop even in people with fairly high INRs. I was an expert witness in a case where a man had an INR of about 5.8 fell down and landed in a pile of wood chips. This cushioned his head so that he had no external marks. This happened on a Friday night and early Sunday morning he called the EMTs. Within a couple of hours after the EMTs got him to the hospital he lost consciousness (the neurosurgeon arrived at the hospital in less than an hour after he was called) and died.

The conclusions of the Mass General study were that rushing to the ER is not the answer because these can develop very slowly that you can get a negative CT scan and still have a serious, slow bleed.

It can be as long as 96 hours before serious symptoms develop.

I'm not trying to scare you, just letting you know that you need to be vigilant for about 4 days.

Everyone that I have talked to who had a subdural hematoma described it as the worst headache that you could possibly imagine. They could not even open their eyes.