Objective/Clinical Features: A 14-year-old female was struck in the frontal bone (glabella) by a volleyball with significant impact on March 2012 from an inferior to superior direction, while she was twisting her body towards the left. She was seen by both a pediatrician and neuro-pediatrician and was told to take Tylenol, and rest (watch and wait). She presented to this office on July 2012, approximately 4-months post-trauma, with no memory of the volleyball game, decreased visual fields, dizziness, nausea, extreme fatigue, and headaches since impact along with focal in occipital and glabella regions. Due to her symptomatology she had been unable to attend school since the March 2012 accident.
Intervention/Outcomes: The patient was treated with chiropractic sacro occipital technique (SOT) category two supine block (two wedges) placement for pelvic torsion and associated sacroiliac joint hypermobility syndrome, cervical stairstep adjustments (non high velocity low amplitude) without only slow gentle small arc twisting or rotation, and parietal sagittal suture cranial release techniques. The day following the first treatment she was able to return to school for the first time since the injury and she reported that the pain in her occipital region had subsided. She was seen for three more visits with the focus on cranial adjusting of the craniofacial region and by August 2012, one month later, she was symptom free. Until she was treated at this office her symptoms had remained stable without any improvement. Following the first treatment there was consistent improvement noted which continued after each subsequent office visit
Discussion: The temporal nature of her symptoms, from the time of the trauma, are consistent with her having suffered a post-concussion syndrome with associated brain trauma. Of significance is that her symptoms had not changed for four months until receiving her first chiropractic treatment, which suggests a possible correlation between the care rendered and the patient’s presentation post-treatment. While regression to the mean, placebo or ideomotor effects, or coincidence might be a consideration, her lasting effects since the injury and immediate response to treatment is compelling. With any single subject case report it is always difficult to generalize the findings to the population at large, however there may be a subset of patients that are unresponsive to medication and watching and waiting that might find conservative SOT chiropractic care a viable option.
Conclusion: Based on the finding of this case report SOT and cranial treatment for the care of post-concussion syndromes in athletes warrants further study. Ideally interdisciplinary conservative care facilities would be optimal to treat patients with these methods, particularly when they are unresponsive to medication and more aggressive options are not a reasonable option.
Author keywords: Chiropractic —TMJ — dental — Sacro-occipital technique.
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