48 y.o. female suffered a blow to the L crown of her head by a falling object estimated to be 40 lbs approximately 8 weeks earlier. Immediate LOC and awoke to a pool of blood on the concrete. Doesn’t know how long LOC lasted. Transported by ambulance to ER. CT and X-rays were negative. I saw her yesterday after a referral by a physician.
The patient relayed current symptoms while in tears. Symptoms included:
The patient had been unable to work since the injury.
Findings: no upper cervical compactions present (surprised me); C1 R lateral shear and palpation of R trans process caused nausea; alar and transverse ligaments intact; frontals rotated clockwise on ant-post axis; sphenobasilar L SB-Rot and R torsion; L temporal pseudo-sheared inferiorly on lateral aspect but it was essentially rotating around an axis at the petrous apex; L parietal compressed inferiorly; L coronal and temporoparietal suture tender and compacted. TM joints were clear.
Treatment to the SpB SB-Rot, L temporal, C1, L parietal, and frontals decreased headache from 8/10 to 1/10. Cervical ROM was improved. The patient was very pleased with the response to the first treatment.
Take Aways: A blow to L top of the head most likely resulted in her head being forcibly side-bent to the L, and the C1 “squirted” (laterally sheared) to the R.
In trauma, all bets are off on how things move. Anything goes. Trauma can result in structures moving off-axis or around an axis that shouldn’t be there…see frontals and L temporal descriptions above. This was a good response to her first treatment, but she had severe head trauma and will need more treatment. She will most likely need to see a behavioral optometrist for her visual processing disorder.
I hope this case study helps illustrate the effect we can make in people’s lives with this work! Have fun.
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