Post-Concussion Syndrome: What You Should Know

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By: Dr. John Conde DC, DACNB Special the Boca and Delray newspapers

Most people within their lifetime will receive several physical blows to the head of varying intensities. Obviously, athletes that participate in contact sports are much more susceptible to head injuries however it is important to note that the majority of head injuries in the world are of the non-contact sports variety. Therefore, it is of paramount importance to understand basic facts about concussions as the first responders are typically friends and family.

A concussion is considered a blow to the head that results in a temporary loss of normal brain function.  In most cases there are no external signs of trauma. Concussions are considered mild traumatic brain injuries as normal neurological activity is disturbed in the brain. A common assumption is that there has to be a loss of consciousness with a concussion however this is false.  Most concussions do not result in loss of consciousness. The most common symptoms include headache, dizziness, nausea, vomiting, memory loss, confusion, brain fog, and fatigue. Quite often people report that they continue to have pain at the site of the impact to the head even though it has been months or years.

Medical care should be sought immediately after alteration of cognitive function is noted following a head injury. Sometimes even a trivial blow to the head may create significant symptoms that really should not equate to the force of the impact. It is important to understand that the nervous system is fragile and once any degree of damage is noted a proper examination and functional assessment should be conducted to determine what is under-functioning.  Similarly, a treatment plan should be established to re-train that deficiency in the brain and restore normal function. Underlying head injuries over time, no matter how small, can lead to more serious complications in the future.

Post-concussion syndrome (PCS) can then be defined as cognitive impairment lasting more than three months after a concussive event. Headache, dizziness, fatigue, irritability, nausea, insomnia, lack of concentration, short term memory difficulty, changes in affect, and changes in personality are the major symptoms reported. Neurophysiologic testing which includes videonystagmography (VNG), posturography (measure of balance), and cognitive assessment tests should be conducted with the persistence of these symptoms and should be best practices in evidence-based healthcare. The results should be interpreted and a proper treatment plan generated.

Prior to the explosion of research into traumatic brain injuries including concussion, the standard of care for a concussion and post-concussion syndrome was a brain-rest approach. This included resting and restricting activities to allow the brain to recover.  While this is still valid, it is only part of the total rehabilitative program that is currently best practices. Similar to a newly operated knee or hip, early and accurately targeted activity is important for the brain to heal properly. This is why an examination looking at function is so important early on as it sets the recommendations for what areas of brain need rehabilitation. Activities such as balancing exercises, specific eye and head movements, timing exercises, and cognitive challenges are all part of the program. Dietary and nutritional recommendations are also included and usually include anti-inflammatory approaches.

Dr. John Conde is a Board Certified Chiropractic Neurologist, one of only one thousand in the country. He holds diplomate status through the American Chiropractic Neurology Board. He provides specialized care for difficult cases of back neck pain, numbness-tingling, vertigo-dizziness balance disorders, fibromyalgia, migraines, AD/HD, autism, and dyslexia. His office is located at the Atlantic Grove in Delray Beach, FL and can be reached at 561-330-6096, drconde@thecondecenter.com, and at www.thecondecenter.com