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Head Injury / Post-concussion Syndrome


Concussion is a mild traumatic brain injury, usually occurring after a blow to the head. Post-concussion syndrome is a complex disorder in which a variable combination of symptoms, such as headaches and dizziness, last for weeks, months, or even years after the injury that caused the concussion. Loss of consciousness is not required for a diagnosis of concussion or post-concussion syndrome. In fact, the risk of post-concussion syndrome does not appear to be associated with the severity of the initial injury. During motor vehicle and sports accidents, concussion may occur concurrently with whiplash, in which case the individual may sustain both brain and cervical injuries.

The most common symptoms of brain injury include:1-21

Traumatic head injury (and the resulting upper neck injury) also has been implicated as a cause and/or risk factor for the onset of many neurological diseases, including but not limited to:22-58

How Upper Cervical Care Relates to Head Injury / Post-concussion Syndrome

Following the head injury (concussion, whiplash, blow to the head, etc.), symptoms can be triggered immediately or can take months or years to develop.

The purpose of upper cervical chiropractic care is to reverse the head trauma-induced upper neck injury; thereby reducing irritation to the nerves in the brain stem and spinal cord that can trigger pain and neurological symptoms. After head trauma, an evaluation is necessary in each individual's case to assess whether an upper cervical injury is present and whether benefit from upper cervical care can be achieved.

Case Studies

View Case Studies related to Head Injury / Post-concussion Syndrome

Research Articles and Publications
  1. Foletti G. Chronic pain sequelae after trauma of the cervical spine. Z Unfallchir Versicherungsmed 1994 Sep; 87(3): 192-9.
  2. Mallinson AI, Longridge NS. Specific vocalized complaints in whiplash and minor head injury patients. Am J Otol 1998 Nov; 19(6): 809-13.
  3. Mallinson AI, Longridge NS. Dizziness from whiplash and head injury: differences between whiplash and head injury. Am J Otol 1998 Nov; 19(6): 814-8.
  4. Fitzgerald DC. Head trauma: hearing loss and dizziness. J Trauma 1996 Mar; 40(3): 488-96.
  5. Hornibrook J. Immediate onset of positional vertigo following head injury. NZ Med J 1998 Sep 11; 111(1073):349.
  6. Said J, Izita A, Gonzalez A. Tinnitus and post-traumatic vertigo- a review. Int Tinnitus J 1996; 2: 145-50.
  7. Merior P, Marsot-Dupuch K. Imaging of post-traumatic tinnitus, vertigo and deafness. J Radiol 1999 Dec; 80(12 Suppl): 1780-7.
  8. Solomon S. Posttraumatic migraine. Headache 1998 Nov-Dec; 38(10): 772-8.
  9. Margulies S. The postconcussion syndrome after mild head trauma part II: migraine underdiagnosed? J Clin Neurosci 2000 Nov; 7(6): 495-9.
  10. Bettucci D, Aguggia M, Bolamperti L. Chronic post-traumatic headache associated with minor cranial trauma: a description of cephalalgic patterns. Ital J Neurol Sci 1998 Feb; 19(1):20-4.
  11. Lemka M. Headache as the consequence of brain concussion and contusion with closed head injuries in children. Neurol Neurochir Pol 1999; 33 Suppl 5:37-48.
  12. De Souza JA, Moriera Filho PF, Jevoux CD. Chronic post-traumatic headache after mild head injuries. Arq Neuropsiquiatr 1999 Jun; 57(2A): 243-8.
  13. Packard RC. Epidemiology and pathogenensis of posttraumatic headache. J Head Trauma Rehabil Feb; 14(1): 9-21.
  14. Tobe EH, Schneider JS, Mrozik T. Persisting insomnia following traumatic brain injury. J Neuropsychiatry Clin Neurosci 1999 Fall; 11(4): 504-6. 14.
  15. Patten SB, Lauderdale WM. Delayed sleep phase disorder after traumatic brain injury. J Am Acad Child Adolesc Psychiatry 1992 Jan; 31(1): 100-2.
  16. Fictenberg NL, Putnam SH, Mann NR. Insomnia screening in postacute traumatic brain injury: utility and validity of the Pittsburgh Sleep Quality Index. Am J Phys Med Rehabil 2001 May; 80(5): 339-45.
  17. Fichtenberg NL, Millis SR, Mann NR. Factors associated with insomnia among post-acute traumatic brain injury survivors. Brain Inj 2000 Jul; 14(7): 659-67.
  18. Quinto C, Gellido C, Chokroverty S. Posttraumatic delayed sleep phase syndrome. Neurology 2000 Jan 11; 54(1): 250-2.
  19. McAllister TW. Neuropsychiatric sequelae of head injuries. Psychiatr Clin North Am 1992 Jun; 15(2): 395-413.
  20. Parker RS, Rosenblum A. IQ loss and emotional dysfunctions after mild head injury incurred in a motor vehicle accident. J Clin Psychol 1996 Jan; 52(1): 32-43.
  21. Barrett K, Buxton N, Redmond AD. A comparison of symptoms experienced following minor head injury and acute neck strain (whiplash injury). J Accid Emerg Med 1995 Sep; 12(3): 173-6.
  22. Sayal K, Ford T, Pipe R. Case study: bipolar disorder after head injury. J Am Acad Child Adolesc Psychiatry 2000 Apr; 39 (4): 525-8.
  23. Gupta S, Sharan P. Seasonal recurrent mania following head injury. Natl Med J India 1998 Nov-Dec; 11(6): 300-1.
  24. Hibbard MR, Uysal S, Kepler K. Axis I psychopathology in individuals with traumatic brain injury. J Head Trauma Rehabil 1998 Aug; 13(4): 24-39.
  25. Mitrovic D, Misic-Pavkov G, Ivanovic S. A manic syndrome after cerebral trauma: case report. Med Pregl 1997 Sep-Oct; 50(9-10): 391-3.
  26. Lim LC. Mania following left hemisphere injury. Singapore Med J 1996 Aug; 37(4): 448-50.
  27. Herskovits EH, Megalooikonomou V, Davatzikos C. Is the spatial distribution of brain lesions associated with closed-head injury predictive of subsequent development of attention-deficit/hyperactivity disorder? Radiology 1999 Nov; 213: 389-394. 9.
  28. Max JE, Arndt S, Castillo CS. Attention-deficit hyperactivity symptomatology after traumatic brain injury: a prospective study. J Am Acad Child Adolesc Psychiatry 1998 Aug; 37(8): 841-7.
  29. Max JE, Lindgren SD, Knutson C. Child and adolescent traumatic brain injury: correlates of disruptive behavior disorders. Brain Inj 1998 Jan; 12 (1): 41-52.
  30. Henry GK, Gross HS, Herndon CA. Nonimpact brain injury: neuropsychological and behavioral correlates with consideration of physiological findings. Appl Neuropsychol 2000; 7(2): 65-75.
  31. Barrett K, Buxton N, Redmond AD. A comparison of symptoms experienced following minor head injury and acute neck strain (whiplash injury). J Accid Emerg Med 1995 Sep; 12(3): 173-6.
  32. Mayou R, Bryant B, Duthie R. Psychiatric consequences of road traffic accidents. BMJ 1993 Sep 11; 307(6905): 647-51.
  33. Scheutzow MH, Wiercisiewski DR. Panic disorder in a patient with traumatic brain injury: a case report and discussion. Brain Inj 1999 Sep; 13(9): 705-14.
  34. Piccinielli M, Patterson M, Braithwaite I. Anxiety and depression disorders 5 years after severe injuries: a prospective follow-up study. J Psychosom Res 1999 May; 46(5): 455-64.
  35. Bryant RA, Harvey AG. Postconcussive symptoms and posttraumatic stress disorder after mild traumatic brain injury. J Nerv Ment Dis 1999 May; 187(5): 302-5.
  36. Thurber CA. Anxiety and closed head injury in young people. Pediatr Rehabil 1998 Oct-Dec; 2(4): 149-55.
  37. Guilleminault C, Yuen KM, Gulevich MG. Hypersomnia after head-neck trauma: a medicolegal dilemma. Neurology 2000 Feb 8; 54(3): 653-9.
  38. Clear D, Chadwick DW. Seizures provoked by blows to the head. Epilepsia 2000 Feb; 41(2): 243-4.
  39. Schutze M, Dauch WA, Guttinger M. Risk factors for posttraumatic fits and epilepsy. Zentralbl Neurochir 1999; 60(4): 163-7.
  40. Chadwick D. Seizures and epilepsy after traumatic brain injury. Lancet 2000 Jan 29; 355(9201): 334-6.
  41. Singer RB. Incidence of seizures after traumatic brain injury-a 50-year population survey. J Insur Med 2001; 33(1): 42-5.
  42. Asikainen I, Kaste M, Sarna S. Early and late posttraumatic seizures in traumatic brain injury rehabilitation patients: brain injury factors causing late seizures and influence of seizures on long-term outcome. Epilepsia 1999 May; 40(5): 584-9. 4.
  43. Buskila D, Neumann L. Musculoskeletal injury as a trigger for fibromyalgia/posttraumatic fibromyalgia. Curr Rheumatol Rep 2000 Apr; 2(2): 104-8.
  44. Keefover RW, Privite J. Adult-onset tourettism following closed head injury. J Neuropsychiatry Clin Neurosci 1989 Fall; 1(4): 448-9. 5
  45. Alegre S, Chacon J, Redondo L. Post-traumatic tics. Rev Neurol 1996 Oct; 24 (134): 1280-2.
  46. Beis JM, Andre JM, Paysant J. Motor and vocal tic after severe head trauma. Rev Neurol 2000 Mar; 156(3): 289-90.
  47. Gaul JJ. Posttraumatic tic disorder. Mov Disord 1994 Jan; 9(1): 121.
  48. Adeloye A, Kouka N. Gilles de la Tourette's syndrome associated with head injury: a case report. J Natl Med Assoc 1991 Nov; 83(11): 1018-20.
  49. Ellis SJ. Tremor and other movement disorders after whiplash type injuries. J Neurol Neurosurg Psychiatry 1997 Jul; 63(1): 110-2.
  50. Factor SA, Weiner WJ. Prior history of head trauma in parkinson's disease. Mov Disord (NIA) 1991; 6(3): 225-9.
  51. Factor SA, Sanchez-Ramos J, Weiner WJ. Trauma as an etiology of parkinsonism: a historical review of the concept. Mov Disord (NIA) 1988; 3(1): 30-6.
  52. Doder M, Jahanshahi M, Turianski N, Moseley IF, Lees AJ. Parkinson's syndrome after closed head injury: a single case report. J Neurol Neurosurg Psychiatry (JBB) 1999 Mar; 66(3): 380-5.
  53. Plassman BL, Havlik RJ, Steffens DC. Documented head injury in early adulthood and risk of Alzheimer's disease and other dementias. Neurology 2000 Oct 24; 55(8): 1158-66.
  54. Lye TC, Shores EA. Traumatic brain injury as a risk factor for Alzheimer's disease: a review. Neuropsychol Rev 2000 Jun; 10(2): 115-29.
  55. Nemetz PN, Leibson C, Naessens JM. Traumatic brain injury and time to onset of Alzheimer's disease: a population-based study. Am J Epidemiol 1999 Jan 1; 149(1): 32-40.
  56. Christie B. Multiple sclerosis linked with trauma in court case. BMJ 1996 Nov 16; 313(7067): 1228.
  57. Poser CM. Trauma to the central nervous system may result in formation or enlargement of multiple sclerosis plaques. Arch Neurol 2000 Jul; 57(5): 1074-7.
  58. Poser CM. The role of trauma in the pathogenesis of multiple sclerosis: a review. Clin Neurol Neurosurg 1994 May; 96(2): 103-10.

The content and materials provided in this web site are for informational and educational purposes only and are not intended to supplement or comprise a medical diagnosis or other professional opinion, or to be used in lieu of a consultation with a physician or competent health care professional for medical diagnosis and/or treatment. All content and materials including research papers, case studies and testimonials summarizing patients' responses to care are intended for educational purposes only and do not imply a guarantee of benefit. Individual results may vary, depending upon several factors including age of the patient, severity of the condition, severity of the spinal injury, and duration of time the condition has been present.