Question
I'm a 42 year old female who was in a MVA on 6/26. About 4 hours after accident, I had to go to ER where I was diagnosed with a concussion. CT was normal. On 7/4, I was back in the ER with one pupil larger than the other and non-reactive, BP of 200/120 and a temp of 100. CT again normal and sent home with Post-concussive syndrome. Saw a neurologist on 7/7 who did not think anything was wrong. Saw opthamologist on 7/8 who believed I had trauma to the 3rd nerve.

Two weeks later, opthamologist sees some improvement in pupil reaction, but no change in double vision.

In the meantime, my blood pressure is still out of control. Benazepril increased weekly from 10 mg to finally 40 mg when switched to a calcuim channel blocker (4 days now, no improvement to BP)

Fever is still present. At day 9 post-accident 1hite blood count was 11.1 and I started a course of levaquin 750 mg. At 28 days post accident, my white blood count is 13.8 with both basophils and netrophils elevated.
I am now 5 weeks post-accident and things have only gotten worse. My speech is awful with a lot of stuttering. It's not that I don't know what word I want, it's getting the word out. This is more pronounced when stressed. Fever continues, as does the high blood-pressure, headaches Tthough lessened after beginning the calcium channel blocker). I cannot handle too much stumulus (I cannot even eat in a restaurant without sweating, BP spikes, and intense headache). I can no longer add more than 2 numbers and can't even do 2 if there is a decimal involved.

31 days post-accident I had a non-contrast MRI and today learned it was normal. How can it be normal when I have all of these problems?  Could this be diffuse axonal injury?  Is there a point in time in which things stop getting worse and at least stay as they are now?  How can I get this diagnosed when the neurologist talks to me for 15 minutes and declares me fine?  

HELP!?!

Answer
Hi Karl,

One thing they missed is a kidney and adrenal cortex profile. This will definitely cause your present symptoms. Get the blood work done and US of the kindness as well as MRI of same. Then see the best Internest you can find.

Good Luck and God Bless,

Dr. Timothy Durnin