Yes, the cranial work could have a placebo effect. There are massage points on the skull that could feel good. There was no cranial plate movements. But, the spine, from the bases of the skull down can be manipulated. Unlocking a misaligned cervical vertebra could provide some quick relief.

A chiro who knows upper cervical chiro could help you with your neck and upper back. A physical therapist with the right skills could also. For me, I needed gentle manipulations followed by ice and then I had to be disciplined with posture during sleep. I was a mess from C-1 to T-4.

We have to combine some therapeutic help and our own discipline and patience to see improvement.

Sounds like you are improving.

I was in a car accident back in 2015 and didn't develop any symptoms until 5-6 months after. Long story short, I came home one day and experienced a vertigo attack which lasted around 5-10 minutes and felt like I was having a heart attack. Ever since I've had lite dizziness and brain/eye fatigue. I've been researching more about neck injuries as the main culprit and I stumbled on something called VBI (Vertebrobasilar Insufficiency). Since I'm only 34 and don't smoke and generally in good health I would like to know what other board members think about this condition as a self-diagnosis? I've gone through all of the exams and scans and every time the results came back negative for any problems. I'm 99% positive the whiplash from my car accident is the main cause of all my problems and not so much a neurological manifestation. Should I completely rule out VBI or go back and get another CT and MRI of the brain or just accept that my brain is still healing after 2+ years and it might take many months or years to fully recover? I'm also a strong advocate against taking prescription pills and the first thing my neurologist recommended is amitriptyline which I will not take. I've been seeing improvements with natural supplements and have not yet reached a point where I can't function without meds.

SPNS,

Welcome to NeuroTalk.

You may very well suffer from VBI. But, it is a broad concept. The question is What is causing it? Upper cervical inflammation can cause reduced blood flow.

The subtle neck injuries common to concussions and whiplash are often not visible in images. The radiologists who read the images do not often recognize the fine differences of such injuries as abnormal. Upper cervical chiros may be able to identify them. There is a motion imaging technique that may show instability.

You may have suffered a ministroke when the dizziness manifested. Certain neck movements can cause them. Small pieces of plaque in the vertebral arteries can break free and cause a ministroke. They do not show up on imaging either since they are usually transient. My wife likely had a ministroke last spring and recovered progressively over 24 to 48 hours. She felt like everything was leaning to the left. She passed all the vestibular tests.

A high T MRI angio may show something but it would be very unusual. The treatment would be blood thinners like aspirin to prescription versions. A CT Scan would be minimally useful to rule out a bleed. At this point, any bleed would have healed.

I doubt any doctors will give your complaints much credibility unless they are evident in a neurological exam. Nystagmus, balancing, finger to nose and other tests would be commonly done.

It's a tough problem.

Mark, thank you for taking your time to reply and I hope your wife is doing better. I never thought much of the first and only vertigo attack so far (hopefully non more) but you are right about it being a mini-stroke or "transient ischemic attack". The description is right on makes the most sense "A TIA is like a stroke in that it produces similar symptoms, but it only lasts a few minutes and causes no permanent damage." It's strange that 2 neurologists I've seen did not mention TIA as the reason why I felt vertigo during the first attack. However, one of my neurologists was onto something when he prescribed Nimodipone. After reading your response I believe he was on the right course to treat my symptoms. I guess at this stage any bleeding would have healed by now as well so further tests might not reveal anything new. I will do some further research on taking anti-platelet drugs and possibly an angiogram as a last resort.

I am doing much better I'm not out of the blue yet. I still wake up every hour or more most nights and simple things like unloading the dishwasher completely wear me out. But mentally i feel so much better. I guess accepting it and a 'go with the flow' attitude made it much easier to cope.

When i feel that i'm not progressing i look at things month by month. I wrote all my symptoms down according to each month. First month i could fill a whole page, second month 3/4 of a page, third month 3 main symptoms and some other mild issues that don't bother me so much. I'm also lucky to know someone who fully recovered from pcs after +2.5 years. So there is no real end date to healing.

@Mark I wish you and your wife all the best. You both have to endure so much.

Lebber, If you wake up frequently during the night, this is a common symptom of sleep apnea. Lack of proper breathing causes the brain to struggle and waking up is often part of that as the brain fights for oxygen. Do you wake with stressful dreams? Have you considered a sleep test ? The home sleep test could be worthwhile before doing a sleep lab test.

For me, the dishwasher was a challenge. Too much head and neck movement, especially the tipping the head forward.

SPNS, Yes, a ministroke is often a TIA. But, a ministroke can last longer. TIAs show no symptoms shortly after the event. Neuros often do not mention TIAs because they cause alarm and anxiety and are hard to treat. With proper high resolution imaging, some TIAs are observable as they leave very small pockets of damage or reduced flow. But, the imaging does not change treatment.

It would be important to determine if the stroke is a bleed or a blockage. You can treat a blockage with blood thinners. Blood thinners can be a problem if you have a bleed.

A Doppler ultrasound of the carotid and vertebral arteries could show plaque and blood flow issues.

I'd back away from strong meds until you have a more acute problem with chronic symptoms. There are risky side-effects. OTC blood thinners can be best.

@Mark, i was wondering if i had sleep apnea. I have considered a sleep test. But for now i can't afford much after so many specialized check ups. Didn't know there were home test. Good that you mention.

Well i did have very realistic nightmares at the beginning. But that's gone. Still more nigthmares then usual, but that's all about bumping my head again in my dreams. The dreams themself don't wake me up. I don't know what you can make of it. I don't know that much of sleep apnea.

I do have the idea i sleep much lighter since my concussion. I usually wake up so much because i hear something. Before i could sleep through everything.

There are some nights i sleep semi well. I can sometimes sleep 4 to 6 hours on end. It's difficult to find what's wrong because my sleep patterns has changed many times since the concussion.

The biggest problem is that i don't get quality sleep.

Thank you for your insight Mark! In a short period of time you've been more helpful than most specialists I've seen with providing answers.

Lebber,

If when you wake, you remember a stressful dream, not necessarily a nightmare, it can indicate a breathing issue.

Have you done everything you can to be comfortable in bed ? The PCS brain is more sensitive to minor sensations. Have you tried sleeping with foam ear plugs? Many of us use them.

You should be trying to regulate your sleep patterns by getting up at the same time every day. Do not nap during the day. Shut down stimulation levels an hour or 2 before bed. Do not get in bed unless you are sleepy. You should fall asleep within 5 minutes. If you lie awake for 10 minutes, get up and do something mundane until you feel sleepy again. Do not fight to go to sleep.

Do not read anything that you cannot finish before going to sleep. Get all of your tasks done. If you have tasks to do in the morning, set them out or write notes about getting the task done. You do not want your brain thinking about "I need to put xyz in the car before going to work" or any other things you would normally remember over night. This routine of getting things ready for the morning can be part of your settling your brain down.

If, as you lie in bed, a morning task comes to mind, get up, write a note or put the item on the counter. For me, I might have a thought that my brain wants an answer to. I'll get up. Find that answer and write it down.

I sleep in all cotton. No synthetics, too much sensation to trigger my brain.

I used to have to be watching a movie that I had seen before to get my mind into the sleepy mode. I still do sometimes but not always. I would watch a simple music video or listen to the same singer. Foreign language singers worked well for me because i was able to not focus on the words, just the music and beautiful voice.

As you can see. Sleep is important and can take work to do well. Until I figured this out, I dreaded trying to go to sleep or stay asleep. Now, my systems make it easy.

Thank you for all the good tips Mark! I really appreciate that you take the time to adress my problem.

Lately I'm very serious about my sleep hygiene. I always kinda did, but now it is really necessary. I use my bedroom only for sleeping nothing else. Also limited furniture so there isn't to much stimulation. I always go to bed at the exact same hour. No screen time hours before sleep, only some radio for tinnitus. Unfortunatly i can't wear earplugs because of the tinnitus.

I guess i have to find a way to regulate my sleep pattern again. I think when i get over my fatigue, physical excersise will help a lot.
It will probably get better with time and finding what works best for me.

Best wishes