Concussion involves compressive, tensile and shear forces to the brain due to head trauma. Fancy words that may be confusing but we’ve all probably had one. Ever have a car accident, fall and hit your head, hit your head on a beam, knock heads with someone else? Most people have hit their heads at some point, felt “dingy” and dismissed it. If that’s you- keep reading.
Head injuries can vary in severity, from skull fractures which can result in bleeds within the brain that also can result in death, to concussion in which an individual may be disoriented, have issues with memory and balance but not have a bleed in the brain or a skull fracture.
Most who suffer concussion “recover” in terms of their symptoms.
Patients with repeated concussions can develop what is termed the post concussion syndrome. Post concussion syndrome is when symptoms of concussion persist and these symptoms can include brain fog, dizziness, light sensitivity, memory loss, and headaches to name a few. Some individuals develop post concussion syndrome even after one concussion, and it has been found that those with pre-injury depression, anxiety and or migraines have an increased chance of developing post concussion syndrome.
The new diagnosis of chronic traumatic encephalopathy(CTE) has gained significant attention. In essence a neuropathologist did brain dissections on sports athletes who had several head injuries, and it was found that these athletes had similar findings under a microscope when looking at the brain cells as someone who has alzheimers.
Though CTE is a relatively new entity, and as a result of the recently publicized accounts of former NFL football players suffering with severe depression and other post concussion syndrome symptoms, it has brought great attention to the issue of long term effects of concussion in everyone.
Because of these findings and the NFL’s campaign to bring awareness to concussion, screening tools on the sidelines of high impact sports are now more readily used by coaches and athletic trainers. However, for most of us, it is our opinion that all who have probably suffered an acute concussion (see symptoms above) be seen by a licensed health care professional (LHP), due to the fact that some head injuries that seem like concussion may in fact have components of skull fractures or brain bleeds, and a LHP is required to make that diagnosis and perform necessary imaging if indicated. Those who have had concussions weeks, months or years before and experienced the above symptoms without resolution with any standard medical interventions should also be checked and treated.
Having said that there is no universally accepted treatment for post concussion syndrome in the medical model. Hyperbaric oxygen has been tried as well as antioxidants, but both of these have produced limited to minimal success. Medical management includes symptomatic management for vertigo, dizziness, migraines and headaches. This means lifetime medication.
In the Functional neurology paradigm post concussion syndrome is however thought to be due to mitochondrial injury or pre-injury problems that then become worse with the head injury.
Functional neurologic treatments center around reprogramming the cerebellum and the frontal lobes, where many of the post concussion syndrome symptoms are located. Dr. Ted Carrick, D.C., D.A.C.N.B., the developer of functional neurology treatment methodologies, pioneered these brain based rehab treatments, and they center around correcting postural responses and eye movements, both neurologic parameters controlled by the cerebellum and frontal lobes. These clinically therapeutic modalities have proven to be consistently successful in improving or resolving and controlling post concussion syndromes and should become the new treatment paradigm for concussion syndromes of all categories. Currently this is the concussion sufferers best bet for partial or full recovery.
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