Dr Hammesfahr

From: William Hammesfahr, MD, hnihelp@yahoo.com
Date: 11/13/01
Time: 4:44:06 PM
Remote Name: 24.94.129.17
Comments

Posted 5/16/01 In brain injury, concussion, and post-concussion syndrome, the concept is that the brain is injured. This is certainly true in many cases, but in almost all cases, a second injury, little recognized, also occurs. This injury is to the mechanism that controls blood flow to the brain. This injury can be in one of two places. The first is in the brain. What happens is that the brain, as it bounces about in the skull, injures blood vessels on the surface of the brain. This injury results in narrowing of the blood vessels, which causes a partial lack of blood flow to the brain. This compounds the original injury, and it causes symptoms. The second type of injury to the control mechanism is due to a joint injury in the neck. In a simplified description, the joints of the neck are connected to blood vessels in the brain. When the neck joints become irritated, as after a whiplash, the nerves become excited, and tells the blood vessels to narrow. This narrowing decreases the blood flow to the brain, and causes neurological symptoms. Of course, a patient may also have a superimposed brain injury, called a coup and contra-coup injury, in addition to vascular injury. If the symptoms of a brain injury are the same as the symptoms of the vascular injury, it is not until the vascular injury resolves, that one can determine how much "permanent" brain injury exists. In our experience, however, as long as the blood vessels stay functioning normally, there is always ongoing improvement in the underlying brain injury. The fluctuating level of functioning in patients with concussions is generally due to the blood vessels becoming more or less irritated as time goes on. As the blood vessel becomes more irritated, dizziness, confusion, memory loss, personality changes, depression, anger, headache and other symptoms (all or part) may occur. As the blood vessel changes in diameter, the symptoms change. This accounts for many patients' experiences, that when the neck becomes irritated, they notice "spacey-ness," distractibility, cognitive changes, etc.