New York Times article calling for help diagnosing concussion related problems
 

After a Soccer Ball to the Head, Why Did He Develop ‘Brain Sloshing’? - The New York Times

Intersting... seems this young man has a lot of the same problems we here experience. I am hoping this will help generate more awareness of PCS within the medical world and beyond.

Your thoughts?...

This was a line drive goalie kick to the back of the head and neck. This was not a simple soccer ball pass. I am not surprised he suffered such severe symptoms. The back of the head and neck is easily traumatized. He suffered whiplash and a brain stem concussion, maybe more.

I notice they do not mention any neck diagnostics or therapy.

Inflammation in the upper neck can interrupt many neurological and body systems.

I question the sleep study as accurate. Sleep studies primarily look for Obstructive Sleep Apnea. They are lousy at identifying Central Sleep Apnea. Been there, done that, doc said I do not have Obstructive Sleep Apnea. He is right. I have Central Sleep Apnea. I can even have Central Apneas while awake.

Thanks Mark. I see you mention the upper neck repeatedly on here. While I agree with you that a lot of symptoms we on here encounter can be from the neck, I still don't have a clear picture of what the diagnosis is.

I have seen numerous PTs, cranial sacral therapists, osteopaths, chiropractors, etc.. that have skills in the upper neck area. I have had some improvement from their treatments, but have never really gotten a clear diagnosis of what the problem is and still have a whole host of symptoms on a daily basis.

What is it specifically about the neck area that is causing these symptoms and what is the right treatment? Who is the right practitioner to treat these neck problems? Are there any diagnostic tests that are more uncommon that could help such as upright MRI, digital motion x-ray, functional-MRI, angiogram?...

These are questions that I am still trying to answer for myself. I think others probably are too.

For me, the chiro and PT helped but did not provide a healing treatment. They just helped the C1 and surrounding vertebra settle a bit. I had to learn to be careful with sleep posture 100% of the time. I cannot sleep with my head tipped forward like most pillows do. If I sleep on my back, my pillow just supports the side of my head. If I sleep on my side, I need my pillow to lift my head so my neck stays straight.

For me, it appears that if I sleep in a bad position, inflammation sets in and messes with blood flow and nerve conduction.

What symptoms are you still struggling with?

Here is an idle thought about the connection between the "sloshing sensation" and the trembling of the trapezius described in this article.

The accessory nerve (cranial nerve XI) innervates both the trapezius and the sternocleidomastoid.

Perhaps the original trauma drove the C1 vertebra forward, crushing the accessory nerve between the transverse process of the C1 vertebra and the styloid process.

Accessory nerve damage explains the trembling of the trapezius.

Accessory nerve damage could also explain the sloshing sensation. The sternocleidomastoid plays a major role in stabilizing the head.

Dysfunction of the sternocleidomastoid could create a feeling of wobbling or sloshing, particularly with head flexion or rotation.

What do you think?

My last comment is also consistent with Mark's observation that sleeping in a bad position causes blood flow and nerve issues.

Specifically, sleeping with the head tipped forward could be compressing the vagus, accessory, and glossopharyngeal nerves as well as the internal jugular vein, leading an exacerbation of symptoms.

I too cannot sleep with my head tipped forward. My attempts to sleep in a "normal" position have never ended well.

I spent a couple YEARS learning how to sleep in a safe posture. My best sleeping position is in a recliner. After learning how to sleep on my back and stay on my back, I got good symptoms free sleep on my back. After years of being disciplined, my neck is stable enough that I can sleep on my side if I have set my pillow properly.

I still get my best sleep in a recliner with my head and neck in perfect alignment.

My PT of a decade ago spent many treatments doing gentle traction and mobilization and muscle work.

A PT in Guelph, Ontario has an entire protocol for this. Myoworx.com

When somebody starts throwing around medical terms, my mind spins. I have limited visualization functions.

An image showing the anatomy would help.

Hi Mark,
I am new to this forum, but you seem to be quite knowledgeable on the subject of PCS. I am 2.5 years off a concussion and am still suffering headaches, dizziness, brain fog and short term memory issues. I am approaching the “will try anything” point and am wondering if you have heard anything recent on either MyoWorx or CognativeFX. I have seen the older posts...thanks a bunch,
PCCE