Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 509
Clinical Information CI 80

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

“Concussion & Post-Concussion Syndrome”

  • Concussion is described as an injury to the brain that results from an impact or blow to the head. By definition, a concussion is not a life–threatening injury, but it can cause both short–term and long–term problems. A concussion results from a closed–head type of injury. A concussion results in temporary loss of normal brain function. Cuts or bruises may be present on the head or face, but in many cases there are no signs of trauma. Many people assume that concussions involve a loss of consciousness, but that is not true. In most cases, a person with a concussion never loses consciousness.

  • The formal medical definition of concussion is: a clinical syndrome characterized by immediate and transient alteration in brain function, including alteration of mental status and level of consciousness, Reference: resulting from mechanical force or trauma.
  • People with concussions often cannot remember what happened immediately before or after the injury, and they may act confused. A concussion can affect memory, judgment, reflexes, speech, balance, and muscle coordination.
  • Even mild concussions should not be taken lightly. Neurosurgeons and other brain injury experts emphasize that although some concussions are less serious than others, there is no such thing as a "minor concussion." In most cases a single concussion should not cause permanent damage. A second concussion soon after the first one, however, does not have to be very strong for its effects to be deadly or permanently disabling.
The following are concussion symptoms:
  1. Prolonged headache
  2. Vision disturbances
  3. Dizziness
  4. Nausea or vomiting
  5. Impaired balance
  6. Confusion
  7. Memory loss
  8. Ringing ears
  9. Difficulty concentrating
  10. Sensitivity to light
  11. Loss of smell or taste
People who suffer a head injury may suffer from side effects that persist for weeks or months. This is known as postconcussive syndrome. Symptoms include memory and concentration problems, mood swings, personality changes, headache, fatigue, dizziness, insomnia, or excessive drowsiness. Patients with postconcussive syndrome should avoid activities that put them at risk for a repeated concussion. This can be permanent
  • 850.0 concussion mental confusion disorientation loss consciousness
  • 850.11 concussion loss consciousness 30 minutes less
  • 850.12 concussion loss consciousness 3159 minutes
  • 850.2 concussion loss consciousness 124 hours
  • 850.3 concussion loss consciousness more than 24
  • 850.4 concussion prolonged loss consciousness return preexisting
  • 850.5 concussion loss consciousness unspecified duration
  • 850.9 concussion unspecified
Postconcussion or postconcussive syndrome, first described by Strauss and Savitsky in 1934, is characterized by impairments in memory, attention, and concentration (cognition); emotional state (affect); and behavior following a closedhead injury. In a closed head injury, there is no penetration of the skull, buttraumaresults in the brain knocking against the hard inner surface of the skull. The closed head injury itself may be accompanied by loss of consciousness, loss of memory of the trauma and events immediately following (post-traumaticamnesia), and possibly post-traumatic
seizure disorder. Postconcussive syndrome usually follows mild head injury, in which loss or alteration in consciousness lasts less than 20 minutes.

Cognitive symptoms include:
1.   poor concentration
2.   attention deficits
3.   impaired memory
Affective symptoms may include:
1.   Irritability
2.   Anxiety
3.   Depression
4.   fluctuation in mood (emotional lability)
Physical symptoms can include:
1.   Fatigue
2.   Headaches
3.   Vertigo
4.   intolerance of noise (phonophobia) and bright lights (photophobia).
5.   visual impairment
6.   hearing impairments
7.   loss of the sense of smell (anosmia), which may affect appetite
Its definition as a syndrome reflects a lack of consensus as to the defining factors and validity of the entity as a discrete entity. Rather, it represents a pattern of signs and symptoms that have been given the name.

Incidence and Prevalence: Of the 2,000,000 individuals in the US who suffer mild head injuries every year, 20% to 90% have a symptom of postconcussive syndrome 30 days after their injury; after 90 days, 40% of individuals have three symptoms or more of postconcussive syndrome (Legome).

  • 310.2 Postconcussive syndrome




Adjunct Assistant Professor of Chiropractic, University of Bridgeport, College of Chiropractic
Adjunct Professor, Division of Clinical Sciences, Texas Chiropractic College
Educational Presenter, Accreditation Council for Continuing Medical Education Joint Partnership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences

Academy of Chiropractic
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