I am posting for my dad who is 56. He was involved in a car accident two years ago. He suffers serious head trauma from hitting the back of the driver's seat with his head. The vehicle was traveling approximately 55-65 mile per hour, (approaching highway speed). Since the accident he has had massive headaches that debilitate him. The healthcare provider he has, after filing a complaint, gave him a diagnoses of post concussive syndrome with headaches and analgesic overuse headaches. The research I've done seems to show an incorrect diagnosis since he's had the symptoms for two years. My understanding is that at this stage the symptoms are likely permanent.

If anyone knows of a good neurologist in the Stockton, CA area the referral would be appreciated.

Has he gotten any sort of physical therapy- or a comprehensive evaluation by an advanced PT, DC or osteopath (DO)?
These people study more of how the whole body works together , more than general MDs usually do.

If no one has a referral for your area , searching out experts in the fields I mentioned for your area might be the next step.

I hope someone can help you with some good names for Stockton, CA area.

Other thoughts--
His neck muscles could be in spasms - that could contribute to the headaches. ( muscles would be hard & not pliable like a normal muscle)
Trigger points could be a factor if there are small extremely sore spots/knots in the muscles.
Possibly an expert upper cervical chiropractor would be of help. The c1 c2 could have gotten misaligned and that can upset many things in the whole body alignment.
Also, possible pinching of the vertebral artery by the vertebra, or muscles in spasm pulling on things can contribute to headaches.

The care is very limited. They seem to simply give him medication and hope the problems fix themselves. I will look into the specialties you mentioned. The main issue is that the health care provider has denied any sort of second opinion or outside treatment, which could get costly. I know at one point he had injections in some of his neck muscles which slightly alleviated the pain. I do believe the muscles in the neck are under a lot of spasm. I will look into the trigger points as well.

James,

Rather than a Neurologist, find a Physiatrist listed in the Yellow Pages under Physical Medicine and Rehabilitation. Call them and ask if the doctor has good experience with concussions. The doctor with good concussion experience will hopefully have a Physical Therapist either on staff or in his referral list. As Jo*Mar said, he needs to have his neck, especially his upper neck (C1 and C2) evaluated. He could also have injuries much lower in his spine. Was he wearing a seat belt? This can cause a whiplash type of injury. If he was not wearing a seat belt, the more lower spine and twisting forces come into play.

At two years, some of his symptoms may be permanent. But, if there is unresolved injuries in his spine and upper cervical area, getting these injuries treated can allow for great improvements.

Is there anybody who can watch him sleep? He may not be breathing correctly when he sleeps. This can result in head aches and fatigue and massive mental confusion.

Hope he can find some help.

My best to you both.

Is he still taking analgesics for headaches? Amitriptyline is commonly used for ongoing headache management in concussion and post-concussion syndrome and doesn't have the side effect of creating more headaches.

Yes, amitriptyline is prescribed for PCS head aches. I am very confused about the dosages mentioned on NT. The research on using amitriptyline for PCS suggests much smaller doses that many have been prescribed. Ten mgs is the suggested dosage. Even 25 mgs is quite an increase. I have read where some are taking 100 mgs per day.

Does anybody have any idea why these doctors are prescribing so much?

Yeah, my guess for my doctor is she doesn't know much about concussion. I had two separate conversations about amitriptyline with her AND sent her an article I got on post-traumatic headache before she prescribed it at all.

I can not help you with a nuerologist as I am from canada, but I would like to mention that professional hockey players here in Victoria bc have been helped with post concussion syndrome at the Valentus clinic using a "brain state" therapy. I don't know if there is one in California but you might want to do some investigating. You can check out the website of the one here for information on "brain state" and maybe ask them if they know of any clinics in your area. I hope this helps.

I'd be careful about spending a bunch of money with 'brain state' therapies. The developer is very careful about how they promote and explain it. It is an FDA exempt therapy approved only to enhance relaxation. The predetermined 'program' of multiple sessions is often a give away that it is designed for money first and patient second.

I use music to help my brain relax and restore itself. I have found a few music cd's and dvd's that can put me into a relaxed sleep within 10 minutes. I wake up refreshed and feeling alive. Maybe I have found my own version of brain state balancing.