Concussion / Mild Traumatic Brain Injury

Understanding Concussion / Mild Traumatic Brain Injury

Also known as: mTBI, Car Accident Concussion, Brain Injury from Whiplash, Post-Traumatic Concussion Here is the single most important thing to know about concussion after a car accident: you do NOT need to hit your head to sustain a concussion. The rotational and coup-contrecoup forces of a whiplash-type MVA are sufficient on their own to produce neurometabolic disruption. Many post-MVA concussions are missed because patients assume "no head impact, no concussion" — but the brain moves inside the skull whether or not the skull was struck. The brain does not have pain receptors, so a concussion rarely announces itself with obvious brain-type symptoms.

Instead, you notice the downstream effects. Concussion symptoms cluster in four domains. Somatic: headache, nausea, dizziness, light sensitivity (photophobia), noise sensitivity (phonophobia), and balance trouble. Cognitive: brain fog, slowed thinking, trouble concentrating, memory lapses.

Emotional: irritability, anxiety, depression, emotional lability. Sleep: insomnia, hypersomnia, or fragmented sleep. Symptoms may begin immediately or emerge over 24-72 hours. Many patients describe feeling "not quite right" — subtly different in their thinking, mood, or tolerance for stimulation since the crash.

Modern concussion care is active, not rest-only. After a brief 24-48 hour relative rest period, we guide you through graded return-to-activity. Evidence — particularly the landmark Schneider 2014 BJSM study — supports cervicovestibular therapy for persistent post-concussive symptoms. We guide sub-symptom-threshold aerobic exercise using the Buffalo Concussion Treadmill Test protocol, target cervicogenic headache and vestibular/oculomotor dysfunction using VOMS-guided protocols, and document symptom burden with standardized tools (SCAT, PCSS) at every visit.

We coordinate with neurology, neuro-optometry, and primary care. About 80-90% of adults recover in 7-14 days with appropriate management. We may recommend: Activator, cervicovestibular therapy, VOMS-guided protocol, Buffalo Concussion Treadmill Test protocol, vestibular rehabilitation, low-level laser, corrective exercise Seek immediate care if: You experience worsening headache, repeated vomiting, seizure, one pupil larger than the other, slurred speech, extreme drowsiness, confusion, or weakness on one side — these may indicate intracranial bleeding requiring emergency imaging.