A post concussion syndrome is an injury to the brain resulting from a direct impact to the head or an indirect impact on the body causing a rapid movement of the brain. It can lead to a wide variety of non-specific neurological impairments, such as dizziness, headaches, light sensitivity, nausea, difficulty focusing, transient memory loss, increased irritability or sadness, or change in appetite, sleep or digestive function. Every year, there are millions of post-concussion that are reported, however, because the majority of head injury doesn’t present with any abnormality on a brain scan, it is thought that larger amount remains undiagnosed. Furthermore, many symptoms won’t manifest immediately but can take up to a few weeks to present, making the link with the head injury even harder to correlate. Most of the head injuries are sport-related and affects children and teenagers. Because their brains are not fully mature yet, they also have the most risk to have long-lasting symptoms.
What happens when you hit your head
After a head injury, there is a cascade of inflammatory reaction that take place at the cellular level of our brain. The glial cells, whose role is to provide support and insulation for the neurons, start to change their behavior in order to heal the tissue damages caused by the head injury. A prolonged activation of those glial cells can have a negative effect on the nervous system, causing prolonged inflammation in our brain and leading to suboptimal of its basic functions. In addition to that, a head injury can cause direct damages of the cell wall and blood brain barrier, allowing excessive molecular exchange between the brain cells and the blood flow, which will disrupt the chemical and ionic balance of our nervous system. This loss of chemical balance will lead to abnormal use and release of the neurotransmitters increased energy consumption in order to restore that osmosis, and possible death of some of our brain tissues. The major issue is that, in opposition to other tissues in the body, the brain has only limited capability to regenerate is structures.
Diagnosis
Because those reactions occur at a molecular level, it won’t necessarily be seen on a CT scan or MRI of the brain, making a post concussion difficult to diagnose. Some other imaging techniques such as the brain SPECT might be more helpful in the diagnosis, but they are not commonly done in hospitals or urgent care centers. The best diagnosis criteria remains an experimented clinician who is capable to identify any deficits in the brain function with a throughout history taking and neurological examination.
Treatment
Until recently the treatment for a concussion syndrome consisted of rest and medication to alleviate distinct symptoms such as headache or nausea. However, new studies have shown that the brain has the capability to adapt and create new neural pathways. This phenomenon is called neuroplasticity, and it opens the door to a vast array of new types of therapies which aim to enhance the neurons to create new connections, which constitutes the baseline to re-learn a function or a task. This method is particularly efficient knowing how hard it is for the brain to regenerate new tissues after it has been damaged. Our treatment consists of finding which neural pathways are damaged and facilitating the brain to create new pathways and hence fully recover.
After my first of many concussions at age 15 I have been dealing with impaired vision in one eye and nearly blind by age 21. After 13 years without any treatment, I’m amazed to say that after about 5 sessions I can finally see clearly and feel confident about my well-being. Dr. Tanaka is not only extremely skilled and knowledgeable in his field, but never gives up on patients. He always believed I would get better, even when I stopped believing in myself. I’m extremely grateful to you and the […] profession!-KH
