Concussion is the most common form of head injury. It has been defined by the American Academy of Neurology as a “trauma-induced alteration in mental status that may or may not involve loss of consciousness.” There are many symptoms of concussion including, though not restricted to;
- Mild cognitive (thinking) problems
- Dizziness and problems with balance
- Memory loss around the incident.
Many people think of concussion and its relationship to contact sports such as rugby league, union and AFL. However, concussion can be caused by hitting the head as a consequence of a fall in the elderly and neurological populations. It has been reported that up to 79% of people following a concussion report dizziness, and 56% report balance impairment. Given that the elderly and those with neurological disorders often experience problems with their balance, this can have quite some impact.
Physiotherapists, especially neurological and vestibular physiotherapists, are trained in the assessment and management of balance and related problems, including headache. A recent example of this was a 31 year old man who presented with dizziness and headache secondary to a fall and concussion on the background of cerebellar degeneration. He had had a quite severe fall resulting in loss of consciousness, constant headache, and feeling of loss of balance. He had been told that the headache could take months to resolve, and that he simply had to wait until this occurred.
Wanting to take a proactive approach he presented for physiotherapy. Following a comprehensive assessment it was decided that a balance and vestibular approach would be most suitable. He was given some simple vestibular gaze stability exercises to perform daily at home, as well as some balance and general fitness exercises. Three weeks after assessment and provision of the exercise program he was headache free, and starting to participate in usual social and sporting related activities. A recent follow-up phone call, now 8 months later, revealed that he continues to be headache free, and participating in all social, work and sporting related activities.
This case demonstrates the diversity of conditions managed by neurological physiotherapists. If you are experiencing balance problems, with or without associated headache, come and see a neurological physiotherapist for assessment.