Concussion

October 1, 2014 by
Filed under: Case of the month, Cases, Spinewave Bulletin, Symptoms 

concussion head injury TBI

Why concussions require the right treatment, right away.

This article is based on the latest research from 2014.

A concussion, or mild traumatic brain injury, follows any force to the head resulting in changes to brain and cognitive function.

The force can be of varying degrees and affect each person or child very differently. While concussions share common characteristics – such as headache, dizziness, fogginess, confusion, fatigue, poor sleep, irritability, sensitivity to light or sound – each concussion is unique. There are many factors that contribute to symptoms and recovery based on each individual’s neurological make up, academic load, extra-curricular activities, and history of trauma to the head and neck; whether it be one new blow to the head or lots of minor falls.

If you are a parent, you know your child better than anyone. You will be the first one to notice symptoms after a hit to the head in the first 24 to 48 hours and it is important to get the right treatment as soon as possible.

Obvious major symptoms within the first 48 hours are disorientation and confusion immediately after the event; impaired balance within 1 day of the injury; slower reaction time within 2 days of the injury; and impaired verbal and learning memory within 2 days of the injury1.

These major symptoms can sometimes recover quickly but individuals are frequently left with other lesser symptoms: dizziness, brain fog, vision problems, difficulty reading, poor concentration, headaches or even eye pain.

pursuit accommodation convergenceThe lesser symptoms are often missed because most “side-line” or medical testing only assesses one aspect of function, balance; and balance is not the whole picture.

The vestibular (balance) system is a complex network that includes small sensory organs of the inner ear and connections to the brainstem, cerebellum, cerebral cortex, ocular system and postural muscles of the spine.

There are two parts to the vestibular system: the vestibulo-ocular system and the vestibulospinal system.

The vestibulo-ocular system maintains visual stability during head movements, whereas the vestibulospinal system is responsible for postural control and balance. The vestibulospinal system often recovers within 3 to 5 days of injury but the person is still left with symptoms related to the vestibulo-ocular system2.

Ocular motor impairments may manifest as blurred vision, double vision, impaired eye movements, difficulty reading, dizziness, headaches, ocular pain or poor visual-based concentration.

Current medical testing and treatment does not account for ocular motor impairments.

There are 5 different types of concussion:

  1. Vestibulospinal (balance).
  2. Vestibulo-ocular (ocular motor impairments).
  3. Mood and anxiety.
  4. Headaches or migraine headaches.
  5. Upper cervical or neck problems.
concussion chiropractic upper cervical

Chiropractic neurologists are trained to assess each type of concussion and provide the most appropriate treatment.

The kind and degree of symptoms dictate the length of recovery. Concussed individuals often get medical clearance even though the lesser symptoms persist. This is because many people don’t understand the link between concussion and trauma to the upper neck, brain and vestibular system.

As with injuries to other parts of the body, concussions can leave scars on the brain3. Getting the right treatment, right away, can greatly improve recovery time4

As a parent we all want the very best for our child. In my case, I have had a crazy run of things with two very sporty boys who are 12 and 9 years old.

This year alone I have had the older one with a concussion, broken nose, whiplash and constantly getting sick. My youngest is a bit of a daredevil and has just recently been knocked out cold at Snowplanet.

Chico 2He split his helmet and was out for about 4 minutes; I thought he was dead. It was my worst nightmare. After getting the “all clear” from the hospital, they said he will be OK, but was not able to play contact sports for 6 months. I was so relieved that I caved and got him the puppy the little guy had been begging me for, for years (lucky kid). But before I could go puppy shopping there was one thing on my mind: that was to get him to Spinewave and check his neck and spine.

This turned out to be the best thing I could do as a parent. Neil checked him so thoroughly and carefully, with only little adjustments at a time. After our visit to the concussion clinic, they couldn’t believe that he had no symptoms of concussion and asked his school teacher to monitor this as well. I believe getting him sorted a few days after the accident really helped him on his road to recovery. It also gave me the piece of mind that he was going to be OK. He recovered so much faster than they had ever seen before. The hardest thing now is to keep him from doing flips on the trampoline and playing rugby at lunchtime with his mates! How hard can that be?

My second story is my older boy, who only a few weeks ago went go-karting. When he came home on Sunday night he told me he was tired and just wanted to go to bed. I thought that was weird. After an hour he started to vomit. Oh no! I thought he had the vomiting bug that was going around as it has been such a nasty winter for bugs.

Jordan Warren 1He was meant to be running the interzone cross-country the next day. I had to phone the sports teacher at school to let them know no running for him as he was so sick. He was also going to leave straight from cross-country to Whakapapa to compete in the North Island Snowboard Champs, which I also had to cancel. He hated letting his school team down; he was so sad.

The next day I clicked: maybe it wasn’t a bug. Maybe it was whiplash? I rang Neil and he answered his mobile. He made a spot for him and saw him straight away. His C1 was out at the top of his neck, which can cause nausea and vomiting. After being adjusted he felt instantly better. We went home hoping for a miracle so he could still compete with his snowboard team.

We had a phone call from one of the team that the mountain was closed on the Tuesday; we had the window we needed to still get him down there! Neil had adjusted him and he felt amazing, so my husband and I decided to drive down at 3am to make it for the first day of the competition.

He made the starting line up and skied amazingly – the school team came 3rd! This would not have been possible without Neil. A massive thank you from all of us to you Neil. He couldn’t have competed if it wasn’t for you.

Since these accidents I have been getting the boys adjusted regularly. I believe it helps them in so many ways: general health, school work, focus with exams, and life as a whole.

warren family 2Hopefully that’s enough drama for one year. Let’s trust the rest of the year is as smooth as the boys seem to be running now. Thanks to Spinewave for keeping them on a straight path to general well being – they are getting amazing results. It’s a parent’s dream to have healthy well balanced children.

Kyria Warren

© 2014 Spinewave

References:

  1. Carney, N, et al. Concussion guidelines step 1: systematic review of prevalent indicators. Neurosurgery. 2014 75: S3-S15.
  2. Mucha, A, et al. A brief vestibular/ocular motor screening (VOMS) assessment to evaluate concussions: preliminary findings. American Journal of Sports Medicine. 2014 DOI: 10.1177/0363546514543775.
  3. Blamire, AM, et al. White matter correlates of cognitive dysfunction after mild traumatic brain injury. Neurology. 2014 83 (6): 494-501.
  4. Schneider, KJ, et al. Cervicovestibular rehabilitation in sport-related concussion: a randomised controlled trial. British Journal of Sports Medicine. 2014 doi:10.1136/bjsports-2013-093267.
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