Mild Concussion has completely destroyed me
May 20, 2008 10:22 PM   Subscribe

I experienced a minor concussion about 3 months ago when I fell off my longboard and hit my head on the concrete. I didn't lose consciousness or feel nauseous I just felt dazed immediately afterwards and into the night. I took it easy for two weeks and all of my symptoms went away and I felt completely normal. Then I made a terrible decision and decided to drink a bit.

After taking only a few sips of a mixed drink my head started pounding and all my symptoms came back. Since then I have completely deteriorated mentally. After that night I have only gotten worse everyday, losing my ability to compose music write screenplays hear music and basically everything else a person can do on a regular basis. My grades got worse and worse and I eventually had to drop out of school. I got an MRI, which was normal. I get these headaches that feel like they are dissolving my brain and they cause me to have involuntary movements where my arm will shoot upwards or my neck will twitch violently. When I wake up the next day I feel terribly hung over. With every headache I seemingly lose more and more intelligence. I have been to countless doctors and neurologists and none of them know what to do. Any ideas? Thanks.
posted by thewood12 to Health & Fitness (21 answers total) 6 users marked this as a favorite
 
Have you talked to a psychiatrist? The pain caused by many psychological problems cannot easily be distinguished from actual physical pain, no matter how improbable that sounds.
posted by [NOT HERMITOSIS-IST] at 10:30 PM on May 20, 2008 [3 favorites]


This is probably not it, but frequently people with an Arnold-Chiari Malformation experience an onset of symptoms after mild trauma. The symptoms are vast and can vary wildly from person to person. The only way to diagnose it is with an MRI, which you say you've already had. I assume it was of your head; did you get one of your neck (brain stem area/C1, C2) as well? Because that's where you would see the malformation. It's a long shot, but with your health deteriorating as it is, it's best to go into your doc with a full arsenal.

You might also want to get a CT scan.

I know what it's like to live with an undiagnosed health problem like this; if your doctor ever gets stubborn and refuses to do a test or investigate a symptom because he thinks it's "unlikely", seek a second (or third, or fourth) opinion.
posted by phunniemee at 10:32 PM on May 20, 2008


Also, if I may ask: Where did you hit your head (i.e. what part of your head)? Where does the pounding originate when you get your headaches? Is your vision affected?

You might also want to go to someone who specializes in epilepsy. I've read cases of seizures much like what you describe.
posted by phunniemee at 10:35 PM on May 20, 2008


Are you drinking diet soda? Aspartame can do this to you. It fucked me up incredibly badly, with symptoms much like yours, and I never fully recovered; my intelligence has never been what it once was.

For awhile, the docs thought I might have MS. The symptoms were that bad. I was weak and trembly; I couldn't walk heel and toe; my eyes didn't track together. Heavy testing showed no tumors and no MS, and at that point I got to thinking again about food allergies.... and stopped drinking diet soda, my one remaining vice. (I'd removed everything else already.).

Stopping diet soda gave me an unbelievable headache for about a week, the worst I've ever had. Caffeine headaches have nothing on an aspartame headache. But after a few days, I started feeling better, and after 2 weeks I felt so much better I couldn't believe it. Worth a try, if you drink any diet soda at all.

Note also that cross-sensitivity with MSG is very common. MSG is in nearly everything, and learning to avoid it takes real focus. If you switch back to absolute staple foods with nothing else added for a week or two (especially avoid "natural flavors"!), and things improve, that's something you'll want to experiment further with.

MSG is hidden in normal food in many many many ways. If you do google searches, you'll get lists of things to avoid. Basically, any -lyzed protein, any time they say things like 'pea protein' instead of just 'peas', and "natural flavors" are the most common methods of hiding it.

From your symptoms, I have a strong hunch that aspartame/MSG might be involved. If, however, you don't drink the stuff, it might be a more ordinary food allergy, or any number of other causes.
posted by Malor at 10:37 PM on May 20, 2008 [1 favorite]


Psychosomatic?

Do you have the coverage/cash to get a BOLD fMRI done to see if there was actual damage to the blood supply?
posted by porpoise at 11:10 PM on May 20, 2008


I'd find a therapist who does Myofascial Release or a massage therapist who has extensive experience working with headaches.
posted by goshling at 12:18 AM on May 21, 2008


I will never drink diet soda after reading your response Malor that is absolutely ridiculous. I posted on here because I believe doctors are often too caught up in their own instincts and egotistical by the book perceptions of the symptoms you describe to them. In this case they are completely wrong to assume that because I am very complicated. When I was 15 I was diagnosed with Postural Orthosta Techardia syndrome. I know that is playing into this as I have several allergies from it and low blood pressure. But there is definitely another component because I have always been able to subdue this illness. I am definitely going to get an FMRI done thanks for that suggestion. I have been to a psychiatrist and he is convinced I am psychosomatic but that's only because he has seen so many cases like me. I feel like maybe I am straining my brain from thinking too hard. The other night I focused on one of these mind eating headaches too much and it just got worse and worse. When I woke up in the morning my brain felt "messed up" like it had holes in it where the headaches were even though they were gone. These have been happening on the right back side of my head for about two months now even though the injury was to the left occipital region. They started when I tried to force music to play louder in my head and my brain recoiled in pain right in the upper right corner. Every since then I have been spiraling downward. I am a music producer and composer. Yesterday I woke up in a daze and tried to play the piano. I couldn't play it. I felt like all my rhythm had been lost and I was just hitting random keys. This is incredibly terrifying to me because I feel like my reason for living is gone. Thanks for trying to help, any other information you could give me would be awesome. I am lost right now.
posted by thewood12 at 12:42 AM on May 21, 2008


Sorry, I misspelled Orthostatic and forgot to answer some questions. The night I strained the right side of my brain I immediately felt worse and woke up several hours later suddenly. I opened my eyes and my right eye was completely covered by a black dot. I couldn't see out of it at all. Other than that, I have had blurred vision periodically and tunnel vision a few times. I also have persistent ringing of the ears that is getting a little better each day. It seems like my nervous system is to blame for some of these problems. POTS syndrome is an autonomic nervous system dysfunction and the headaches only come on strong when my nervous system is out of control. But could that really cause physical damage to the brain? Let me know what you guys think it's a freakin puzzle with too many pieces. Thanks.
posted by thewood12 at 12:53 AM on May 21, 2008


perhaps this is relevant, from the 2008 CMTD:

Posttraumatic Headache
A variety of nonspecific symptoms may follow closed head injury, regardless of whether consciousness is lost. Headache is often a conspicuous feature. Some authorities believe that psychological factors may be important because there is no correlation of severity of the injury with neurologic signs.

The headache itself usually appears within a day or so following injury, may worsen over the ensuing weeks, and then gradually subsides. It is usually a constant dull ache, with superimposed throbbing that may be localized, lateralized, or generalized. It is sometimes accompanied by nausea, vomiting, or scintillating scotomas.

Disequilibrium, sometimes with a rotatory component, may also occur and is often enhanced by postural change or head movement. Impaired memory, poor concentration, emotional instability, and increased irritability are other common complaints and occasionally are the sole manifestations of the syndrome. The duration of symptoms relates in part to the severity of the original injury, but even trivial injuries are sometimes followed by symptoms that persist for months.

Special investigations are usually not helpful. The electroencephalogram may show minor nonspecific changes, while the electronystagmogram sometimes suggests either peripheral or central vestibulopathy. CT scans or MRI of the head usually show no abnormal findings.

Treatment is difficult, but optimistic encouragement and graduated rehabilitation, depending on the occupational circumstances, are advised. Headaches often respond to simple analgesics.
posted by sero_venientibus_ossa at 4:51 AM on May 21, 2008


I have a feeling this thread might do more harm than good. AskMe is not good at diagnosing neurological conditions; it's good at gathering together 20 different diagnoses, at least 19 of which will be misdiagnoses. Please consult a psychiatrist!
posted by East Manitoba Regional Junior Kabaddi Champion '94 at 6:00 AM on May 21, 2008 [3 favorites]


I think malor may be on to something. I'm not a doctor, of course, so I could be completely wrong, but it seems worth at least mentioning at your next appointment. But, do not be the patient that is convinced you have some condition cause you read it on teh internets.

Excitotoxicity
:

Excitotoxicity can occur from substances produced within the body (endogenous excitotoxins). Glutamate is a prime example of an excitotoxin in the brain, and it is paradoxically also the major excitatory neurotransmitter in the mammalian CNS.[7] During normal conditions, glutamate concentration can be increased up to 1mM in the synaptic cleft, which is rapidly decreased in the lapse of milliseconds. When the glutamate concentration around the synaptic cleft cannot be decreased or reaches higher levels, the neuron kills itself by a process called apoptosis.

This pathologic phenomenon can also occur after brain injury. Brain trauma or stroke can cause ischemia, in which blood flow is reduced to inadequate levels. Ischemia is followed by accumulation of glutamate and aspartate in the extracellular fluid, causing cell death, which is aggravated by lack of oxygen and glucose. The biochemical cascade resulting from ischemia and involving excitotoxicity is called the ischemic cascade. Because of the events resulting from ischemia and glutamate receptor activation, a deep chemical coma may be induced in patients with brain injury to reduce the metabolic rate of the brain (its need of oxygen and glucose) and save energy to be used to remove glutamate actively. (It must be noted that the main aim in induced comas is to reduce the intracranial pressure, not brain metabolism).
posted by gauchodaspampas at 6:18 AM on May 21, 2008




I can't offer any help about your specific problem, but you might want to read Oliver Sacks' Musicophilia: Tales of Music and the Brain, which talks about the connection between music and neurological disorders (some very hopeful and miraculous, others quite sad). He has a bunch of case studies of musicians, a couple of which sound similar to your situation (not being able to play) -- I don't think the cases line up exactly to yours, IIRC, but maybe it could be helpful?
posted by pised at 7:21 AM on May 21, 2008


Oops. Related.
posted by gauchodaspampas at 7:29 AM on May 21, 2008


There are a lot of scary possibilities out there, I hope it turns out good for you.

Things that pop to mind-
-Did your MRI look for or eliminate the possibility you had a minor stroke?
-Can you set up with your doctor a "floating" appointment so that you can get an MRI or CAT scan while you are suffering from a headache? Perhaps there's an anyurism that's only visible when you are having the attack.
-Maybe the injury "knocked something loose" (sorry) and exposed a previously underlying tendency toward migraine?

Because you only noticed symptoms after an injury, I'd exhaust ALL physical causes before I consider the psychosomatic possibility.

I also recommend a psychiatrist- they just MDs for the brain. Not just for mental disorders.
posted by gjc at 7:46 AM on May 21, 2008


I am very sorry to hear about your problems. I do not know much about many of the problems or diagnostic tests except for fMRI and other types of MR imaging. I do not think that there is any test that could be done with BOLD-contrast fMRI that would be helpful. There are good reasons that fMRI is incredibly popular in research, but hardly ever used in clinical settings.

For clinical purposes, a standard imaging protocol is high-res T1, T2 and proton density imaging. One slightly less common option that might be useful is MR flow angiography, and ADC mapping (sometimes referred to as diffusion-weighted imaging.)

Flow angiography will illuminate all of the blood vessels in the head, and ADC can show tissue damage and swelling that is not visible in other types of imaging. Finally, some type of quantitative perfusion-imaging (like ASL) would be able to show what I think porpoise imagines fMRI to measure, but I am not sure how often this is practiced clinically. All of these have interesting pictures on Google image search, if you are interested in what things look like.
posted by Maxwell_Smart at 9:14 AM on May 21, 2008


In my experience these kinds of symptoms are not terribly uncommon following a head injury. Seconding the recommendation for more physical exams to pin point the exact nature of the phsyical injury but be aware that you might not be able to, at least not to your satisfaction.

3 months is not a terribly long time to recover from head trauma, give yourself time to heal.
posted by fshgrl at 6:08 PM on May 21, 2008


Thanks guys I hope it's not exictotoxicity taht sounds insane. I'm feeling a little better today and I can play the piano again. I think I just need to take it easy I've been way to streesed out. I'm getting an MRA though just in case there are some problems with blood vessels.
posted by thewood12 at 8:58 PM on May 21, 2008


Oh, I should add... the panic makes it worse. I was impaired, but panicky BECAUSE I was impaired, and I'm absolutely certain it made the symptoms worse. It's very possible to think yourself sicker than you actually are.

In other words, you may have a real (likely temporary) impairment... but you can talk yourself into having a much worse one. That's also likely temporary, but basically you can make things far more difficult on yourself than they otherwise would be. This is also tough on doctors, because if you've added on a bunch of psychosomatic symptoms to go with the actual ones underneath, that makes diagnosis harder... and they may think it's ALL psychosomatic.

It's not uncommon for it to take quite some time to recover from these things. If you actually have killed off some brain cells or damaged the connections, it can take quite awhile to generate new ones to get everything fully reconnected again. Keep practicing at whatever it is you like to do. That's one of the best ways to regain your skills.

The brain is highly redundant and highly plastic, so chances are pretty low that you did yourself any permanent long-term damage. It's possible, but betting strongly against it would be the smart money.
posted by Malor at 5:32 AM on May 22, 2008


Since you have been to doctors and neurologists, I'm assuming a subdural hematoma has been ruled out; otherwise that could explain most of your symptoms. I'm also assuming you don't have fluid leaking from your nose or ears.

A good friend of mine has Postural Orthostatic Tachycardia Syndrome (POTS), as well. He's fairly tall and slender and is so flexible his doctor thought he had Marfan's, but he was ultimately diagnosed with generalized connective tissue disorder, which often involves very stretchy collagen, too.

There is a problem which often results in headaches like yours, and other symptoms that sound a lot like yours to me, and two thirds of the people who develop this problem also have POTS: spontaneous spinal cerebrospinal fluid (CSF) leaks. It "is known for causing orthostatic headaches. It is an important cause of new headaches in young and middle-aged individuals, but initial misdiagnosis is common." Orthostatic headaches occur or get worse when you stand or sit up.

The headaches and other problems are caused by a fall in CSF pressure due to a fluid leak somewhere in the spine. The drop in CSF pressure causes the brain to sag downward in the skull and can result in all kinds of things ranging from headache to episodes of blindness and blurring of vision; numbness, pain and weakness in the arms and legs; tinnitus and echo effects in hearing; balance problems and difficulty walking; stiffness in the neck; and etc.

Since you had a concussion 3 months ago, you would not meet the "spontaneous" criterion, but "The precise cause of spontaneous spinal CSF leaks remains largely unknown, but an underlying structural weakness of the spinal meninges generally is suspected. A history of a more or less trivial traumatic event preceding the onset of symptoms can be elicited in about one third of patients, suggesting a role for mechanical factors as well.", and you conform to that except for the "trivial" part.

If I had to construct a cause and effect narrative to fit your case to a CSF leak in the spine, it would go something like this: you have a congenital connective tissue problem which results in POTS and a weakness in the membranes of your brain and your spine. When you had your concussion, a CSF leak popped open in your spine, but sealed up again when you took it easy after the accident. But when you took that drink, the vasodilation that alcohol produces caused a wave of pressure in your CSF that popped the leak open again, and it has been leaking ever since, giving rise to all these symptoms.

Good luck!
posted by jamjam at 3:37 PM on May 22, 2008


Thanks for the help guys CSF sounds interesting but that wouldn't explain why I feel like I lose more and more intelligence everyday, or at least every-time I have one of those mind eating headaches. Is it possible I could be damaging nerve cells in the brain or would I not be able to feel that? I'm curious because every-time I have a headache it is tingling, burning or searing and the next day my brain feels burnt, which suggests nerve damage. I've actually experienced these types of headaches about three months before the first injury and I always felt like my autonomic nervous system and my obsessions with them played into it. Sometimes I would wake up and my brain would feel burnt but I never really noticed a lack in mental function and they only lasted for a few weeks. The head injury just brought them back again. let me know what you guys think.
posted by thewood12 at 7:49 PM on May 24, 2008


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