Have you ever “banged” your head from falling? For those playing backyard football, soccer, hockey, or baseball as kids or adults, it’s really quite common. So, how can we tell when the “bang” is dangerous vs. not? And, how does a concussion occur?

What is a concussion? A concussion is “traumatic brain injury” (TBI) where the brain is “jarred” and literally bruises as a result of some sort of trauma (a “bang”).

What causes a concussion? Causation is usually from some sort of trauma either by being hit by a moving object (like a ball), from hitting the head during a fall, and even without a direct strike if the head is violently moved back and forth (such as in a “whiplash” injury resulting from a car accident). When there is no direct strike of the head and in the absence of being “knocked out,” the person may not be aware that they have a concussion.

What are the symptoms associated with concussion? Immediate symptoms usually include a headache and a reduced level of alertness or consciousness. A concussion temporarily interferes with the way the brain works and as a result (depending on the specific location and degree of the “brain bruise”) it can affect memory (short term the greatest), levels of awareness, judgment, feeling “spacey,” reflexes, speech, balance, coordination and sleep patterns. Other symptoms may include nausea and/or vomiting. Most people describe the experience as an abrupt injury where a bright flash of light occurs in the visual field that blocks the vision temporarily. Many do not actually become unconscious but may say they “blacked out” for a second or two. When unconsciousness does occur, the length of time they are “out” may be a way of determining severity. Symptoms can vary from mild to severe and the following are EMERGENCY symptoms where immediate health care provision is necessary: significant changes in alertness and consciousness, convulsions or seizures, muscle weakness on one or both sides, persistent confusion, persistent unconsciousness (coma), repeated vomiting, unequal pupils, unusual eye movements and walking problems. Neck injury is often associated with a head injury, which is why the injured person is stabilized on a board before being transported. Symptoms during recovery include being withdrawn, easily upset, confused, having a hard time with tasks that require memory and/or concentrating, having mild headaches and sensitivity to noise.

What tests are commonly performed on the post-concussive patient and, what is the treatment? A physical exam can include a careful evaluation of the cranial nerves such as pupil size and eye movement, as well as assessment of one’s thinking ability, coordination and reflexes. Special tests may include an EEG (brain wave test), especially when seizures are involved. A head CT scan or head MRI. Treatment may require a hospital stay if severe signs are present. A “wait & watch” approach is often practiced but prompt gentle chiropractic approaches often facilitates healing and should strongly be considered. Refraining from rigorous sports is strongly advised.

We realize that you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for headaches, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Many of us have had sinus related headaches, right? You know, these are the headaches that hurt over the sinuses (above the eyes or in the cheek bones next to your nose) and, when you blow your nose, it’s not pretty! Sinus infections often lead to sinus headaches – wouldn’t you say that’s a true statement?

A recent November 2011 study begs to differ. Researchers took 58 patients with a diagnosis of “sinus headache” made by their primary care physician and asked them the following questions:

1. Have you had a previous diagnosis of migraine or tension-type headache?
2. Is their clinical evidence of a sinus infection during the past 6 months?
3. Is there the presence of “mucopurulent secretions” (that’s the “not so pretty stuff” when we blow our nose)?

All 58 patients clearly seemed to have chronic sinusitis with an acute flair up and were given complete thorough examinations by a neurologist and an ears, nose, throat specialist (otolaryngologist) on a monthly basis for 6 months during treatment. The surprising results showed that final diagnosis in these 58 cases were 68%, 27% and 5% of the patients really had migraine, tension-type headache and chronic sinusitis with recurrent acute episodes, respectively. Treatment during the 6 months included antibiotic therapy in 73% of the patients with tension-type headache and 66% with migraine. Sinus endoscopy (taking a look up the sinuses with a scope – ouch!) was performed in 26% of the patients, and therapeutic nasal septoplasty (surgery!) was performed in 16% of the migraine patients and 13% of patients with tension-type headache (a pretty BIG mistake, wouldn’t you say?). The conclusion was that many patients with self-described or primary care physician diagnosed “sinus headaches” have no sinonasal abnormalities but instead, met the criteria for migraine or tension-type headache.

So, what does this mean? Well, for one thing, too many antibiotics are prescribed for tension-type or migraine headaches and have no place in the treatment process of these two common headache categories. Side effects of antibiotics include (but are not limited to): stomach and intestinal irritation, nausea, and if one is allergic to the antibiotic, a potentially life-threatening condition call anaphylactic shock. Let’s not forget to mention that sinus surgery was performed in 29% of the cases where the sinuses were NOT causing the headaches and we all know the risks of undergoing anesthesia and surgery can include death and infections, among other problems.

Chiropractic was reported to be a wise choice in the treatment of headaches by several publications, one of which provided a large review of the literature on the “Effectiveness of manual therapies: the UK evidence report,” released in 2010 (http://chiromt.com/content/18/1/3). In this report, both migraine and cervicogenic-type (headaches that start in the neck) headaches were found to have strong research support for manipulation or, chiropractic adjustments. In this day and age, you can be very confident that choosing chiropractic services for headache treatment is a wise, safe, and very cost-effective approach for a very disabling condition.

We realize that you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for headaches, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.