No two people recover from a concussion or traumatic brain injury in exactly the same way.
The severity of the impact matters, but so does the person’s health before the injury. Conditions such as anxiety, depression, diabetes, high blood pressure, epilepsy, or a previous stroke may influence symptoms, treatment decisions, and the length of recovery.
During this episode of Mind Matters: Navigating Head Injuries and Concussions, legal nurse consultant Kiley Como spoke with Dr. Eric Reese of the Neural Connection about pre-existing conditions, coordinated care, and the difference between dizziness and vertigo after a head injury.
Why Medical History Matters
A detailed medical history is one of the most important parts of evaluating a brain injury.
A patient’s health before the accident may affect how the body and brain respond afterward. Someone with an existing neurological, cardiovascular, metabolic, or mental health condition may experience a more complicated recovery.
Dr. Reese explained that anxiety and depression may become more severe following a concussion. Conditions such as hypertension and diabetes may also influence inflammation, circulation, and the brain’s available resources for healing.
Patients should tell their providers about all existing diagnoses, medications, previous injuries, and ongoing symptoms.
Providers cannot consider information they do not have, so patients may need to raise these issues even when they are not asked directly.
Existing Inflammation May Complicate Healing
A concussion can produce a significant inflammatory response in the brain and body.
If a patient already has inflammation related to diabetes, hypertension, an autoimmune condition, or another chronic illness, the new injury may add to an existing problem.
Dr. Reese compared this to adding gasoline to a fire.
This does not mean that someone with a chronic condition cannot recover. It means the care team may need to modify treatment, monitor the patient more closely, or involve additional specialists.
A chiropractor or neurological rehabilitation provider may need to communicate with the patient’s primary care doctor, cardiologist, neurologist, or mental health professional.
Mental Health Can Affect Treatment Participation
Pre-existing anxiety or depression may influence more than the symptoms a patient experiences.
These conditions may also make it harder to schedule appointments, make decisions, complete exercises, communicate with providers, or remain consistent with treatment.
Someone who already becomes overwhelmed by choices may feel paralyzed when suddenly managing medical visits, insurance questions, legal concerns, transportation problems, and physical symptoms.
Missed appointments can then delay recovery and create even more stress.
Dr. Reese described the value of serving as a healthcare “co-pilot,” helping patients connect with specialists, understand the next step, and avoid falling through the cracks.
Recovery Should Not Follow a Cookie-Cutter Plan
Pre-existing conditions may create limitations, but they do not automatically determine the final outcome.
The type of brain injury, severity of symptoms, available support, and quality of care also matter.
Dr. Reese emphasized setting honest expectations while recognizing that every patient is different.
An effective provider should also understand the limits of their own specialty. Some of the best outcomes occur when one provider recognizes that the patient needs help from several other professionals.
Referring a patient to the correct specialist is not a failure to provide care. It is often an essential part of providing responsible care.
Trust and Communication Improve Treatment
Brain injury recovery can involve several professionals, including physicians, neurologists, therapists, chiropractors, mental health providers, and rehabilitation specialists.
Those providers need to communicate.
When patients trust their care team, they may be more willing to report difficult symptoms, follow recommendations, and participate actively in treatment.
The provider also gains a better understanding of the patient’s concerns, motivations, and barriers.
Dr. Reese believes technology may eventually improve this coordination. Remote monitoring, telehealth, wearable devices, and health applications may allow providers to review information such as blood pressure, activity, or sleep before the patient arrives for an appointment.
The information still requires thoughtful interpretation, but better access to data may help providers recognize changes sooner.
Dizziness and Vertigo Are Not the Same
Dizziness and vertigo are often used as if they mean the same thing, but they describe different experiences.
Vertigo usually involves a sensation that the person, the room, or the surrounding world is spinning.
Patients may describe it as feeling like they are on a roller coaster or that their environment is moving uncontrollably.
Dizziness is a broader category. It may include:
- Lightheadedness
- Disorientation
- Motion sensitivity
- Feeling unsteady
- Feeling faint when standing
- Difficulty processing busy environments
- A sense that the world is moving too quickly
Clarifying the exact sensation helps the provider determine which systems may be involved.
When Inner-Ear Crystals Cause Vertigo
One common cause of vertigo is benign paroxysmal positional vertigo, or BPPV.
BPPV may occur when tiny crystals in the inner ear become displaced. Certain head movements then send incorrect information to the brain, causing brief but intense spinning sensations.
Providers may use positional testing to identify the affected inner-ear canal and a repositioning maneuver to move the crystals.
However, not every case of vertigo comes from displaced crystals. Some symptoms may be related to the brain, visual system, neck, or central vestibular pathways.
That is why a complete evaluation is important.
How Eye-Movement Testing Provides Answers
The Neural Connection uses video nystagmography, also called video oculography, to evaluate dizziness and vertigo.
During the test, the patient wears specialized goggles while completing a series of eye-movement tasks.
The provider may examine whether the eyes drift in darkness, move smoothly, remain fixed on a target, or show abnormal patterns of involuntary movement called nystagmus.
These findings may provide information about:
- Inner-ear disorders
- Visual processing
- Central neurological problems
- Post-concussion dysfunction
- The patient’s ability to stabilize their vision
A person may not realize how difficult it has become to keep their eyes focused on a stationary object.
That difficulty can make computer work, shopping in a large store, walking through a crowd, or driving beside moving traffic feel exhausting and disorienting.
Objective Testing Can Document Progress
Many concussion symptoms do not appear on routine CT scans or MRIs.
Objective eye-movement testing can help quantify abnormalities that may otherwise be described only through the patient’s symptoms.
The provider can compare results before and after treatment to determine whether function has improved.
This information may help guide rehabilitation while also creating documentation of how the injury affected the patient.
Dr. Reese explained that showing patients the actual eye movements can also make the diagnosis easier to understand. Instead of hearing unfamiliar medical terms, the patient can see what the provider observed and how it connects to their symptoms.
Look at the Whole Patient
Concussion recovery does not begin with the injury alone.
It begins with the person who experienced it, including their medical history, mental health, medications, support system, and ability to participate in care.
Pre-existing conditions may complicate recovery, but recognizing those conditions allows the care team to make better decisions and establish realistic expectations.
Dizziness, vertigo, anxiety, sleep problems, and cognitive changes should also be described clearly rather than treated as vague or unrelated complaints.
The more complete the information, the better chance providers have of identifying what is wrong, coordinating the right care, and helping the patient return to daily life.
More Podcasts – https://www.shanesmithlaw.com/podcast/
In Pain? Call Shane!
(980) 999-9999
Do you need an attorney? https://hubs.li/Q04fHBBj0
Been in a Charlotte Car Accident? https://hubs.li/Q04hFzPw0
For more information order our free book!
Related Post:
Why Dizziness After a Concussion May Not Come From the Brain Alone
