Post-concussion Headaches and Migraines

Headaches and Migraines are common symptoms that individuals experience after a trauma to the head. Concussions are a substantially threatening injury to the brain, as they create inflammation and swelling that can have long term changes, affecting concentration, mood and alertness for up to five years. 

When an individual hits their head, they often injure an area known as the suboccipital region. This is a very delicate area, as it is not only responsible for proprioceptive feedback to the vestibular and cerebellar regions of the brain (7x more so than any other area), but it also encapsulates important blood vessels and nerves that are supplying the scalp-giving us normal function of sinuses, eyes, muscles, skin and sensation.  

What is proprioception and how will it affect my headaches? Proprioception is better understood as sensory feedback from our body or environment to our brain. When we alter the feedback mechanisms of the suboccipital region (where the back of your head meets your spine), we alter how the brain perceives our head in space. Essentially, if the communication between our neck and brain is disrupted, then normal function of our muscles, joints and nerves is altered. In these cases we often see a patient with a propensity towards:

1)       Chronic head tilt to one side

2)      Chronic head rotation

3)      Deviation of normal eye movement

4)      Dizziness/Vertigo symptoms

5)      Tension and misalignments of cervical and suboccipital regions

6)      Loss of normal posture (head begins to move forward)

7)      Falling to one side/imbalance

What’s causing the headache/migraine pressure? Believe it or not, what’s causing your headache usually stemming from an external source (*However, there can be bleeding that occurs, so it is recommended that you immediately seek medical treatment following a substantial injury).   Due to the mechanism of the head trauma, and the list of potential symptoms listed above, a patient is usually suffering from compression at the base of the skull. This compression is restricting blood vessels and nerves that are exiting the suboccipital region and traversing the scalp, anteriorly.   The nerves become irritated and cause abnormal muscular and vascular responses, eliciting headaches. The blood vessels become constricted at the base of the skull and expand in the areas of the scalp around the eye, temples and forehead region, causing headaches or migraine pain during vasodilation as they are activating the nociception (pain) receptors that are in the periphery of our blood vessels. 

Common Headaches/Migraine symptoms:

1)      Pain at the base of the skull

2)      Pain behind or around the eyes

3)      Pain in the forehead/sinus regions

4)      Pain in the temples

5)      Pain/stiffness in the neck

6)      Stiffness in upper back/shoulders

7)      Reduced rib expansion/breathing difficulty

8)      Nausea/vomiting

9)      Sensitivity to smell, light, sound, foods
 

Brain Rehab is vitally important and begins with looking for functional deficits in cortical activity after a concussion, as the frontal and parietal lobes often have reductions in function.  Frontal lobe deficit is often evident when mood or personality changes after an injury, difficulty with focus or concentration, executive planning or difficulty with problem solving and complex tasks.  Parietal lobe issues are accompanied by balance/coordination issues and uncertainty of spatial awareness.  Vertigo/dizziness issues are often associated with concussion, and are mainly a result of vestibular and cerebellum dysfunction, which are the parts of the brain that control balance/coordination, spatial awareness and eye movements.  Individuals often get dizzy when they move their head too quickly or have many objects to focus on (see vertigo page under 'our care').  Once these regions of insufficiency are determined, we then create a functional neurological treatment plan that coincides with the structural and physical portion in an attempt to fire up the brain and allow it to heal at a much faster and more efficient rate.  These treatments often incorporate complex and specific eye movements, brain exercises and balance/coordination training.  

Chiropractic Neurology (functional neurology) allows us to diagnose the cause(s) of the problem and treat accordingly. We incorporate structural, neurological and physical rehab to gain long-lasting, healthy results.