Head Injury Specialist Bangkok Area?

[schmutzie]

Hi,

I'm posting on this forum as my Thai girlfriend recently was the victim of a hit and run motorbike incident. She has subsequently been suffering from severe headaches and as far I can understand, doctors in two different hospitals have confirmed that she some sort of serious problem.

Because I was out of the country when the incident happened and because she has not been given a proper diagnosis/treatment plan I'm investigating somewhere in Bangkok that I can take her for a thorough check with me present.

However, I have to be honest that I can not afford a hospital bill that runs in the tens of thousands of baht (as in Bumrungrad) at present, but I would like for her to see a specialist or somewhere with a dedicated clinic for head injuries and at least I can have some idea of what can/cannot be done for her and at what cost.

If anyone has similar experience and subsequent advice I would be grateful to hear about it. I'm quite concerned that if she does not receive some sort of proper treatment that she could potentially die from this injury.

[Boater]

the private hospital on soi 3 Sukhumvit has, but bewatr it is very very expensive

[Sheryl]

Has she had a CT scan?

In this situation the concern would be that she might have a slow bleed taking place within the skull which would increasingly put pressure on the brain tissue. (She does not have a rapid bleed, if she did she'd be unconscious or dead by now. But a slow bleed is possible. ) It is also possible that she merely has a concussion, which would also cause headaches that might last for some time.

If just a concussion, the headaches will persist for some time but gradually disappear.

But if there is a bleed, it will put pressure onto brain tissue. The problem beling that the skull is a fixed space so unlike bleeding elsewhere, it can't swell outward, only push down onto the brain tissue, which can cause serious damage or even death.

So what she needs is a CT to rule out a bleed. Or if one was already done, then tget a copy of the film and bring it to a good neurologist to read.

Sometimes a CT will be normal initially if there is little blood accumulated at the time it was done and then due to slow but steady bleeding, a hematoma may develop subsequently. So if a normal CT is followed by any change for the worse in terms of intensity of headache, consciousness/mental status, speech, or if vomiting occurs, then a repeat CT needs to be done at once.

If there is a hematoma, surgery might be required to evacuate it. It is actually a fairly simple procedure, they literally drill a hole and suction out the blood. Usually a fairly short hospital stay. Mediations would also be given to decrease general swelling in the brain.

Now in terms of where to go: given your cost constraints best options are either Chulalonghorn (a government hospital) or St Louis, the latter being a nonprofit. The following doctors on staff at St Louis have had training in the West, are well l respected in the field of neurosurgery with a number of professional publications to their credit:

Dr. Voravut Chanyavanich , MD.

DR. KRISHNAPUNDHA BUNYARATAVEJ

DR. PAKRIT JITTAPIROMSAK

Dr. Montri Luxsuwong

DR. TEERADEJ SRIKIJVILAIKUL

Problem will be getting to see one of them in a timely manner as except for the first doc listed they are "vsiting"at St Louis i.e. hasd privileges there but has to be called in, no regular hours. Therefore suggest you not try to book online but rather call and be persistant. 02-210-999 or 675-5000.

If it does not prove possible to get an appointment with one of the above at St Louis in a timely manner, then you had best go to Chula. (Be prepared for long waits/red tape initially)

If she already has a CT film and if her condition is stable, i.e. just headaches but no change in their intensity, no slurred speech, vomiting or change in personality etc, you could consider going to one of the upscale places for a simple consultation as it might be that she has only concussion, a consultation only will set you back just 1,000 baht or so and may be worth it for the peace of mine. If however she has not yet had a CT that's another matter.

Lastly - should she at any time develop slurred speech, vomiting, change in personality or level of consciousness, or if the headaches become much greater in intensity, then just go at once to Chula ER. In an emergency situation the red tape and other delays don't apply and they will certainly know what to do.

[schmutzie]

Thank you for your very comprehensive reply.

Fortunately she recovered fairly quickly from the last incident and has told me that it was much "lighter" than last time, which would simply indicate a concussion and longterm headaches as you imply.

CT scan I agree is the way to go and your contacts are invaluable. I cannot thank you enough for taking the time to post this and it should, I hope, be helpful to others also.

[wasabi]

I had a serious head injury when I was younger (Which may explain the content of many of my posts) this required the fluid evacuation Sheryl mentioned. One thing you need to look out for is dilated pupils in addition to what Sheryl wrote. You simply can't just hope this will heal on it's own. While it's likely nothing it could be life threatening and a CT scan is required to rule out a slow bleed at the time of injury and later if conditions worsen. Sorry about your limited finances but this is not a sick buffalo call and merits digging deep into the pockets if possible.

[snuggzzz]

Well done Sheryl, a spot on piece of medical advice.... reading your vital contribution must bring some comfort to the OP...

[schmutzie]

Well done Sheryl, a spot on piece of medical advice.... reading your vital contribution must bring some comfort to the OP...

I am the OP and as I would like to thank Sheryl and others again.

I'm now out of the country again, but my girlfriend has had a CT scan today at her local hospital in Korat. I have asked that she make sure she gets a copy of this and we will now move forward, in terms of evaluating what to do next. I'm preparing her for the fact that she may need surgery (this is a challenge as she doesn't even like needles) but we will see. FYI, the CT scan was 3500 baht, which I believe includes the consultations etc.

Once we have the CT scan and the current specialists evaluation I will try and make the call together with her on whether to have her continue to see one of the specialists in Korat or whether she'd be better of taking this to Bangkok.

If I understood her right, one of the current doctor's concerns was that the fluid might be too deep or something, but I'm not sure what the scenarios are with that. Right now I'm just happy that things are moving in the right direction.

As for the money, I don't have a problem with 'digging deep' but understand please that I'm from a country where good health service is free and whilst I'm happy with the professionalism of the medical services in Thailand I am struggling with going into a hospital and having to worry about what the final bill will be and the motivation by some of the treatments. So far, my girlfriend has been serviced with tablets that only relieve the pain and some pretty useless x-rays (useless because she doesn't have copies nor written statements from any of the doctors/hospitals where she has been given treatment). The main problem is that I guess I'm used to being quite well-informed, but in this case a lot of the vital information has been passed onto family members that have accompanied her to the hospital(s), so I feel quite out of the loop.

But the CT scan was definitely the way to go.

It's a learning process for me. Thank you for your help.