Concussion-Type Symptoms After Head Trauma in a Patient With No Apparent Neck Signs or Symptoms: A Case Report of...

In two head trauma events occurring 38 years apart, the same male patient presented to the same chiropractor with concussion-type symptoms, including headaches, dizziness, visual disturbances, and cognitive slowness (brain fog), but no neck pain and normal standard orthopedic neck test results. The chiropractor initially diagnosed the patient with concussion/mild traumatic brain injury (mTBI). A diagnosis of cervicogenic concussion (CGC) was made in both 1985 and 2023 after the patient reported the immediate and lasting resolution of all symptoms following what became a diagnostic-therapeutic trial (DTT) of cervical adjustments/manipulation. The DTT targeted cervical segmental joint dysfunction (CSD), also characterized as vertebral subluxation (VS) in the nature of hypomobility/fixations, identified by the chiropractor on further cervical motion palpation examination (CMPE). On both occasions, the chiropractor confirmed improvement in CSD/VS on post-DTT adjustment CMPE. Cervical pathology constituted by CSD/VS and/or cervical segmental degenerative joint disease was considered the probable cervicogenic etiology of the patient's concussion-type symptoms and CGC diagnosis rather than a brain etiology and concussion/mTBI. This case report illustrates how cervical dysfunction/pathology can mimic the symptoms of concussion/mTBI, highlighting the importance of recognizing CGC in the differential diagnosis of concussion/mTBI.