triggers for post concussion syndrome
 

Hi,

I'm a 41 yr old male & I have a very unusual type of post-concussion syndrome.

After my head injury – incurred over 12 years ago playing Australian Rules Football - I recovered fully (my head ‘cleared’ after a couple of months) and a MRI scan showed no problems. And normally, I have no problems with attention, processing and memory.

However, certain types of ‘hard’ vibration (e.g., from riding a bicycle) seem to trigger mild post concussion – my head seems a bit ‘cloudy’ and I struggle a bit with short-term memory, processing and concentration – it is quite noticeable. Fortunately, the ‘adverse effects’ normally wear off after a few days.

This problem has been limiting the activities I undertake, as I have to avoid activities such as running, cycling etc..:

Just wondering what the best course of action would be?

Thank you for any assistance.:D

http://www.round-earth.com/HeadPainIntro.html
Hi Tony, even if you don't have any headpain you might want to look at this article. I'm wondering if your problems could be related to tight muscles, since they can irritate nerves and bloodvessels.

I have a similar problem. My head is also "clear" now for the most part, but when I exercise it will bring back the symptoms. Are you certain this is a result of the vibrations/impact while running or cycling? Could it be just the fact that you are exercising and increasing you heart rate and sending more blood to the brain? Have you tried a stationary bike or other non-impact aerobic exercise and does that result in the same symptoms? I have been trying to figure out why this happens to me for the last year. The doctors I have seen are clueless, but it seems as though it might be a result of something vascular relating to cerebral blood flow which changes with aerobic activity. I am still trying a few things like neurofeedback, although I have only done 5 sessions so far - seems promising for things like controlling anxiety, but I dont know if it will solve my exercise problems. If neurofeedback does not solve this problem, I may eventually look into HEG feedback which measures the blood flow in the brain and allows you to regulate it based on real-time feedback.

Hi YANNIMAC
 

Hi Yannimac Is the neurofeedback helping and are you making progress with this type of therapy?

Checked out your b log and it looks like your making some progress also been checking out Daves b log no new post in the last month or so.

I'm very interested in neurofeedback as a possible treatment plan for TBI and correcting or re building the neuro transmitters, but it does look like this type of treatment needs to do done in a controlled environment, support group and a trainer.

Still researching this type of training before I make the 1200.00 investment and the cost of setting up the assessment. So any feed back on what you have learned so far would be appreciated. jeffn

rules on returning to "normal" activities
 

Hi everyone,

I am new to the board and need a little advice...

My case of PCS isn't nearly as difficult or severe as many of the posts I have read on this site (sending good energy your way) and I hesitated even writing in, but I have had trouble finding answers to some basic questions and hope some of you out there wouldn't mind helping me. Here is my story:

I fell off of my horse a week and a half ago, out for 10+ mins and after two trips to the ER (normal MRI/CT scans) was diagnosed with PCS. Last week i was a mess, depressed, couldnt sleep, ears ringing, difficulty speaking, irritable - classic symptoms, i spent the week literally in a dark room. Today I started feeling a little better, the fog seemed to lift, and I suddenly wanted to get up and go do something (manic is quite normal for me, otherwise I would worry about that). I just can't get a straight answer on what types of activities I am ok to participate in, obviously riding horses is out, I have been warned that another blow would be it for the head, but I have been tucked away in my condo for over a week now and am wondering what is rule on going for a walk, or light jog - is it safe to try? or am I risking a return of/prolonging symptoms? I know if I sit in the condo another week without any exercise I will get depressed, and that would be true without PCS, so i am anxious to return to some activity. I am just worried that if i start doing things i am going to prolong recovery or risk more damage.

Has anyone out there returned to activities after a concussion this soon or is this break in symptoms just that?

The other question I hesitate to mention, b/c it is sooo superficial, but when can i have a glass of wine? The docs said don't drink until you feel better, so i am feeling better, but won't risk it if anyone has experience on alcohol consumption (a glass or two of wine once a week would be all i would want to do) and a negative impact on recovery.

Again I apologize for my "fluffy" questions about a very serious condition, but I would really appreciate any advice you can provide.

horsegal,

first things first. Don't do anything that would increase your risk of hitting your head for a few months. Trust me, if you are feeling concussion symptoms now, then you do not want another one any time soon. The symptoms will persist much longer the second time.

Every injury is different and you need to judge the exercise thing based on how you are feeling. Start walking for a few days and if you feel ok, then start jogging. If you still feel ok after jogging, then maybe you can do more. As soon as you start feeling bad I would take it easy for a few days. "No pain, no gain" does not apply to exercise with PCS. That will just make things worse.

With my head injury I felt terrible for a week like you, then started feeling normal and went back to lifting weights and doing heavy cardio. It made me feel terrible, but I thought I could tough it out. After 2 weeks I was feeling really bad and it is possible that doing too much too soon made my symptoms stick around for a long time.

Hi Yannimac,

There are two reasons why I don't think that exercise (and increased heart rate/blood to the brain) is the trigger for PCS in my case.

First, I don't get any symptoms at all if I do certain types of exercise (eg swimming) which get my heart rate up but don't including any jarring vibrations.

Also, I can get PCS if I am subject to certain types of jarring vibration when I'm not exercising.

I saw a neurophysiologist in Sydney 10 days ago about my problems with PCS.

He wants me to deliberately trigger it, then he'll run some tests (EEG) to determine the impacts on brain function enabling him to consider the best course of action. That is, the results from the EEG will help him design an appropriate cognitive therapy program for me. ... (This is my "lay persons" description of what he was saying - i think i've got it right...)

I am fortunate in the sense that I am able to avoid activities which trigger the PCS, but then again it is getting to the point whereby this is limiting my physical activities a bit too much (not being able to go running or cycling is frustrating to say the least!!).

I have to make a decision as to whether I go down the 'cognitive therapy' track, or simply avoid actions which trigger the PCS.

All the best -

Tony H

re head jarring/vibrations
 

Hi Tony H,

I agree about the jarring - I have had pcs for coming up 7 years now and have found that any shaking, jarring vibration of my head will bring on the symptons. (Excessive exercise has done the same - like extreme excessive like absolutely forcing myself to continue.)

With the jarring - going over a judder bar in the road too quickly has done it for me - I was amazed - it is the first time that I actually "registered" that it caused it. Of course whiplash can cause concussion so this really does follow on from that.

I don't see how any cognitive therapy can cure this so I will be very interested to hear more from you about this. How can changing the way you think help the brains physical reaction? It is like wearing a helmet - a helmet will not stop your brain shaking inside your skull.

For quite some time I have been under the impression that my brain needs a stabiliser. My balance is not what it used to be either.

Another thought that I have had in the past is that I am far more comfortable driving myself than being driven and if I am being driven by somebody in a manual car I find this incredibly jerky (lousy driver maybe) - I am not a control freak and have put it down to the fact that hanging onto the steering wheel is maybe not as jerky or perhaps having more expectation of the jerks - this does sound weird sorry!

I no longer play tennis and don't run. I now do a lot of walking and some gym work is ok.

Lynlee

Hi Lynlee

The neurophysiologist I saw is confident this type of jarring is not physically damaging the brain.

What is happening is that after we damage the brain (initial accident) neurons must communicate in a different way to by-pass the damaged neurons. This method of communicating is, however, less efficient in a brain that has not been damaged.

What is happening is that jarring activity now triggers a change in the way neurons communicate (from efficient to inefficient) even though the activity has not actually caused any physical damage to the brain.

Cognitive therapy encourages efficient communication between neurons and therefore (hopefully) it will reverse the symptoms.

This is just my interpretation of what the neurophysiologist was saying - I think i've got it right but when I summarised what he was saying he looked totally confused!!

Best regards,

TOny H

You wrote: "Just wondering what the best course of action would be?"

Go see your trusted neuroloist right away.

From what I have seen, they are almost useless when it comes to PCS -> Take this anti-depressant and get some rest is the typical answer.

Tony,

Sounds like you are on the right track by seeing a neurophysiologist. Keep me posted, I am very interested in hearing if your EEG changes after jarring your brain.

Yannimac,

I saw the neurophysiologist in early April (a couple of weeks after my first post on this issue) & at this stage I think I'll follow up with the EEG and cognitive therapy.

Happy to keep you posted. However, it'll probably be a couple of months before I go back to Sydney (i live in another city) to do the EEG test.

Tony

agntornge
 

this is the first time ive heard anyone else besides myself describe these types of symptoms. ive had about 11 concussions. the first one that caused pcs was in 2001. it took about 5 years before i was able to run again but eventually i could without problems. now im back in the same boat. i suffered 3 concussions in iraq from roadside bombs, all within 2 months of each other. now i cant do anything "high impact" like running, jumping, contact sports..
docs dont know anything. it feels like my brains loose inside my head and any quick movement or shaking of my head will give me another concussion. im wondering if my problem might be in my brainstem since it feels like my brains just sloshing around inside my skull.. any one know anything about brainstem injuries?? all ct, mri scans ive had have been normal. just curious..

Sorry to hear your situation - it's a tough one and a lot of us here on this board can relate. I appreciated your description (feels like my brains are loose in my head) as I've had difficulty trying to express how this symptom feels. To me, it's like when an elevator stops to quickly, and you get a little "butterfly" in your head...very weird sensation. Not vertigo, not really dizziness, but like you said, like our brains are loose.

I saw a really good vestibular physiotherapist who deals with balance and she explained that when we injure our brains, the information input from our eyes and ears to our injured brain isn't interpreted like it used to be (before injury). And our sense of where we are in space is off. I have been doing "habituation exercises" to retrain my brain where I am, and this is helping, although very slowly. And if I overdue anything, especially driving or being in a moving vehicle too long, this particular symptom comes back with a vengence. I literally have to spend more time resting, with quiet and no visual stimulation, for it to calm down.

Good luck,
MargN

Loose Brain
 

Hi - I feel the same that my brain is loose in my head. I have often joked about needing a stabilizer like a ship. I have been into fast long walks lately and 2x in this last month I have ended up with major headaches and vomitting and then the inevitable jabs in the you know where. I now know for certain that I have to be very very careful about the level of physical exercise I do.

Since purchasing my "black box" which reduces back ground noise I have found the car a lot better as a passenger but sudden bounces or jerky corners give me a headache.

Lynlee

Hi there agntornge. I see that you're new to NeuroTalk so I wanted to extend a welcome to you. 11 concussions is an awful lot of head injuries to go through. I'm sorry that you had all this happen to you.

I went through one nasty head injury with ensuing Post Concussion Syndrome, but mine seems so darn trivial to what you went through.

It's good however to know that you found your way here to this forum. There are a whole heap of wonderful people here.

Welcome again. Please make yourself at home.

agntornge
 

thanks for the welcoming koala. yea i see there are plenty of people here in a similar situation. that makes me feel good. not to see that all these people have to go through this but that there are people out there i can relate to. i know dealing with this sucks.. and im sorry everyone has to deal it with. for those who were just recently injured going through this for the first time, just know that it does get better. time is really the only thing that helps. try not to let your emotions get the better of u. i know it can be hard but itll only make things worse. you will get better..
good luck.

This post strikes a chord with me -

In my case the trigger is:

Either:
• a blow to the head
or
• exposure to sustained vibration (e.g. persistent heavy hammering, using an electric jigsaw, dragging a shopping trolley with hard wheels along half a mile of bumpy pavement, leaning head on the window of a train...)


Symptoms:

• Very blurred vision (sometimes a blind spot), often to lower left of visual field.

• Numbness in (predominantly left) hands, feet and above upper lip.

• Sometimes slightly garbled speech.

• These initial symptoms are always followed (20 minutes to 1 hour later) by a severe headache (above/behind both eyes) which can take days to completely fade.



First happened when I was 24 (following a collision when playing football). After it had happened a couple more times (once after another collision, once after heading a football) I went to see my doctor who said it was caused by temporary interruption to the blood flow to the Ophthalmic nerve. He said there was no lasting damage and I could carry on with football but not to take up greater contact sports such as rugby!

Anyway, after a few more similar incidents I chose to pack in football altogether (because of being completely dehabilitated during the 24 hour headaches).

Ever since, I've suffered occasionally - I'm now 44 and have had probably 12-15 repeat attacks (usually triggered by vibration) of varying intensity.

I'm an otherwise very fit & healthy individual. I do not suffer from headaches other than those that follow these triggered attacks.

The only way I can deal with it is to try and sleep until the headache fades.

Does anyone think these repeat symptoms are really indicative of concussion (rather than migraine with aura)?

If so it would appear that I'm just (since the original incident when I was 24) very susceptible to concussion?

There is a neurosurgeon who used to be a NFL team doctor who calls these sub-concussion impacts. He is the only one who has ever acknowledged this as far as I have seen. Dr. Julian Bailes is at University of Virginia.

I have these same problems. I believe they are concussions to those of us with very susceptible brains. I can get them from riding in a car down a rough road. I have received them from shaky roller coasters. My first was from riding a "Tilt-a-Whirl" at an amusement park.

I have learned how to reduce their likelihood. If I am riding in the car on a rough road or even on a roller coaster, I must not have my back and shoulders, much less my head against the framework or back of the seat. It is amazing how much vibration can be absorbed by the spine, especially if it is hunched or relaxed.

I can get the same concussion symptoms if I shake my head NO or turn my head back and forth to much.

When I go out to pick up after my two dogs, I have learned to turn my shoulders to look for the 'targets'. It slows the speed of rotation of my head.

Be cautious mentioning this to a doctor. They will try to tell you it is impossible and is just 'in your head.' Been there, done that, got a 'somatoform disorder' label in my medical records. "Somatoform disorder' can be the kiss of death in your pursuit for medical help.

I wish they would just say, idiopathic, which means 'of unknown origin.' But doctors do not like to say "I don't know or understand."

They prefer to say somatoform because it puts the burden on the patient, not the doctor.

Lucy,

What is this 'black box" you mentioned in May?
I have horrible problems with background noise.

Regarding these loose brain impacts.

Do any of you ever get the sensation that you were "punched in the nose," when all if was was a shake or mild bump?

How about a metallic taste in your mouth, like you are chewing aluminum foil?

How about a feeling like your eyes are circling?

These symptoms are a good sign that I have suffered a 'non-concussion' concussion or as Dr Julian Bailes calls them, sub-concussion impacts.

Yes - my top front teeth tingle and upper gum goes partly numb

Yes - it tends to produce a fair bit of saliva

No, I get impaired vision as if the lower left of my field of vision had vaseline smeared over the lens

Hi there,

First post... I have the exact same problem. I suffered a few concussions and now any type of slight jarring activity or heavy vibrations seem to trigger a fogginess that lasts for a day or two.

These types of triggers are usually: any rough play, jogging/running, a bump to the head etc...

This condition has lasted for about 1.5 years now and it seems like it's not going to go away at this point. When I avoid these types of incidents, things seem fairly normal and my thinking and functioning seems fine.

It was to the point where even rough sex was making me dizzy... I haven't tried going on a rollercoaster etc... but I'm thinking my life might have to take on a more relaxing type of program avoiding any such incidents. Regardless of what doctors say, I don't think this type of recurring response from the brain can be good long term. In fact, I often wonder how our heads will be 30 years from now.

I find just relaxing and trying to avoid head bumps seems to make things more normal. My balance seems a little off these days, so avoiding collisions with people/things is even harder than usual :)

triggers for post-concussion
 

dear tony,
when you say that hard vibrations trigger your PCS symptoms, I believe what you are really experiencing is the after-effects of a vestibular concussion or fixed vestibular system malfunction due to closed head injury. your vestibular system controls your balance and equilibrium. It is easy to damage and doesnt always heal up in the aftermath of head injury. you should obtain an ENG ( test of vestibular system) and consider vestibular rehabilitation. Brief vestibular-sensory mismatches could easily disrupy attention and concentration, etc.
leepomd, dr of neurology

i recognize these symptoms
 

Hi all of you!

I just can not help but writing this when I hear your stories and symptoms. I understand that you have been wondering a lot about these symptoms and I don't want to sound like I am a smartass, but when I read all your posts it sounds to me that you do, besides from your PCS, also suffer from a condition called Intracranial hypotension.

Around our brains we have a fluid called cerebrospinal fluid that works like a cushion for our brains. Sometimes if a person hurts his neck, back or cranium he/she can get a tear in the dura (sack) that contains this cerebrospinal fluid and it can start to leak. This will cause less volume of fluid around his/her brain and lower than normal pressure inside the cranium. This in turn will make the brain more sensitive to vibrations or impacts.

You can check if you are suffering from intracranial hypotension by holding your breath and increase your abdominal pressure (this increases your intracranial pressure momentarily), while you drive over a bump. If this maneuver helps you take the bump, then you know that you are suffering from too low intracranial pressure.

You typically diagnose this with a MRI with contrast of your skull.
It is treatable, but it will typically not go away without treatment.

I just wanted to point this out to you so that you can get the correct treatment. Since you have suffered concussions it is not so unlikely that you also injured your cranium, neck or back at the same time.

Once again, I don't want to step on anybody's toes here. I just had to write this because I recognize your symptoms.

Best wishes to all of you!

P.S If you feel a metallic taste in your mouth the leak is located in your cranium. D.S

Tony,
I also get a headache from bouncing or vibrating. My heartrate may not increase at all and my breathing be regular, but I still get a headache from bouncing or vibrating. I have not found a cure except accepting the pain afterwards if I want to do the activity enough. If you find an answer let me know!


Horsegal,
First of all you are not silly for asking because you are the one with the courage and there are lots of other people out there without the courage to ask who are wondering the same thing.

I would start walking, just leisurely at first and see how that goes. I have to get out or I get depressed, and you really don't want to do that when there is already this pain and other stuff making you depressed. Indoor rock climbing with ropes is another good one. Low impact, good strength building, you can go as slow as you want.

For the glass of wine, I really don't think it slows the healing process, I think it might actually help because it helps you relax. Not a lot, just a glass with dinner. When I have a glass, I get a worse headache, but despite that I feel more relaxed and less likely to bite someone's head off. After a while it's not the pain that is hard to deal with it's everything else.
I would also say that beer or other alcohol is less likely to give you a headache than wine just from studies I have seen, there is no difference for me.

Good luck to you both!
In Christ,
Margarite

I don't know how to help but I have the same frustrating symptoms. You see, I have gotten multiple concussions from my parents literally slapping my head so hard and multiple times within three months. I think maybe it was 15 times all together. I lost all sense of who I was, had terrible headaches, was drowsy,tired all the time, blurry vision, desensitization, anxious, angry, depressed, cloudy. the works. Then, in my disinhibition, I crashed into the floor with my head, into a staircase, and into a bathtub. Its been several months and I see improvements, some, albeit slow and easily taken away by jolts and the like. They say not to have second impacts after your first concussion. Well I had probably 10 hard impacts after my first concussion. My recovery and PCS seem forever now. my parents had terrible discipline techniques. I would complain, then get hit in the head. Then complain about head hit, then get hit again in the head, then complain about that head hit, and they would hit me even harder in the head. and over and over and over again. It was pure hell. Anyway, I was just sitting in a chair when a math tutor came over and drummed hard with his hands on the back of my chair. All of my thoughts disappeared suddenly and it felt like I had another concussion. Is this possible? Because I am so frustrated with this hell. I tried to be patient, no i was so optimistic even yesterday, and now it all gone suddenly with this chair impact/vibrations. I am so sick of this. how could these vibrations effect my head so much? whatever got to stay possitive

bolderman,

Welcome to NeuroTalk. This thread has not been active for over 3 years.

But, there are plenty of us who can help you. Please feel free to start your own thread by clicking the New Thread button at the upper left.

How long has it been since your abuse and concussions ?

How old are you ?

What level of school are you in ?

Has anybody other than the tutor offered any other help with your studies ?