Post-concussion syndrome is a common development after a car crash or any accident which involves so-called closed head injury. It has been described as a psychophysiologic response to the fear of annihilation.

The symptoms are less esoteric than the description and can include fearfulness, tetchiness, anxiety and insomnia. These reactions can pass quickly or may last for years. It is thought that the syndrome can lead to neuroses after three to six months.

Orthodox medicine tends to treat the symptoms with drugs, usually using anxiolytics and antipsychotics (Valutazione Statistica dei Risultati. Minerva Chirurgica, October 31, 1990; 45 (20): 1309-14).

Osteopathy takes a very different view. It identifies other effects of the syndrome, including short-term memory impairment, loss of mental acuity and changes in sleep patterns. (Journal of the Am Ost Ass, April 1963; 62 (8): 739-50; Journal of the Am Ost Ass, January 1975; 74 (5): 400-10). Impaired cerebral blood flow is also mentioned, as are “whiplash” injuries where no actual head injury may have occurred. Some osteopaths correctly identified that even minor closed head injuries that have disturbed the cerebral circulation are responsible for a significant increase in symptoms.

One study found that 70 patients with post-concussion symptoms had reduced cerebral blood flow, compared to 70 with minor injuries other than to the head and neck. When they were tested during their recovery, a reduction in symptoms tended to coincide with increased cerebral circulation (The Lancet, 1966; ii: 178-80).

Similarly, other osteopaths who linked whiplash type injuries to the syndrome have also been proved right (Journal of the Am Ost Ass, February 1994; 94 (2): 145-48; European Neurology, 1980; 19: 91-102).

An osteopath will use several orthopedic tests to discover if the whiplash caused neurovascular or nerve root compression. Either cervical magnetic resonance imagery (MRI) or computed tomography (CT scan) imaging is usually recommended to guide the treatment. In one test, the Minnesota Personality Inventory (MMPI) was given to 73 patients with traumatic closed head brain injury to objectively evaluate emotional status. Profile analysis showed that many were suffering some emotional disturbance; remarkably, those with minor injuries had higher distress levels than those with severe injuries. (Brain Injury, April/June 1991; 5 (2): 199-205). In Sweden, it has been proposed that those with brain concussion should be followed-up after discharge to minimize losses in social well being (Scand Journal of Rehabilitation Medicine, 1991; 23 (4): 179-85).

Several studies have shown the beneficial effects of osteopathy. The cranio-sacral method has long been used with marked success (L W Morey, Ost Med, July 1978 Vol 3, (7) p43-52; and H I Magoun, Osteopathy in the Cranial Field 1966). Manipulation in the cervical region plays a significant part in re-establishing an adequate arterial blood flow to the head and neck (Ost Annals, February 1975; 3 (2): 42-3).

!AHarald Gaier

Harald Gaier is a registered naturopath, osteopath and homeopath.

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