The asymmetry could be in reaction time, sensitivity to movement or to brightness, postural adaptations, etc. I found an article regarding 30 days post injury, but am interested in scientific documentation of years after injury. .
I do not know of articles but we see quite a few of these clinically.
It seems to turn out that many post concussive signs and symptoms are actually cervical syndrome or cervical biomechanical problems that induce stretching of the brain stem and brain.
I say this because I have not seen one of these, acute or chronic (years later as in your question) that did not show objectively and report subjectively the alleviation of these signs and symptoms with effective manipulative treatment that reduces brain stem axial stretch.
The acutes vary a bit in their response depending upon the extent and magnitude of swelling but the chronic almost all respond quickly and similarly with variations depending more on the presenting signs and symptoms.
I have not thought to document these findings until now.
The pertinent web site is MeningealRelease.com
I see many of them clinically too, but one is involved in a lawsuit. He was struck by a car, and the opposing lawyers claim that he is making everything up because it is a few years post injury. I'm looking for a valid reference to dispute what I know is true.
The best area to look would be in football, or perhaps rugby (US football?), where 'post concussive signs and symptoms are actually cervical syndrome or cervical biomechanical problems that induce stretching of the brain stem and brain' could be expected to occur and where almost every spectator will have seen how a player would not react so well after such an injury or impact.........but whether this has been studies or reported is another issue. I could imagine that no-one would want to report such issues because of the potential impact upon their particular sport.
You may find these interesting:
Cereb Cortex. 2013 May;23(5):1159-66. doi: 10.1093/cercor/bhs102. Epub 2012 May 10.
Sports concussions and aging: a neuroimaging investigation.
Tremblay S1, De Beaumont L, Henry LC, Boulanger Y, Evans AC, Bourgouin P, Poirier J, Théoret H, Lassonde M.
Brain. 2009 Mar;132(Pt 3):695-708. doi: 10.1093/brain/awn347. Epub 2009 Jan 28.
Brain function decline in healthy retired athletes who sustained their last sports concussion in early adulthood.
De Beaumont L1, Théoret H, Mongeon D, Messier J, Leclerc S, Tremblay S, Ellemberg D, Lassonde M.
Neurosurgery. 2007 Aug;61(2):329-36; discussion 336-7.
Long-term and cumulative effects of sports concussion on motor cortex inhibition.
De Beaumont L1, Lassonde M, Leclerc S, Théoret H.
Hi,
besides the many sports related works in this field, you may find this useful:
Front Hum Neurosci. 2012 Jun 19;6:160. doi: 10.3389/fnhum.2012.00160. eCollection 2012.Longitudinal diffusion tensor imaging and neuropsychological correlates in traumatic brain injury patients.
Farbota KD1, Bendlin BB, Alexander AL, Rowley HA, Dempsey RJ, Johnson SC.
There are some considerations on visuomotor speed and diffusivity in visual processing related white matter tracts.
There has been quite a bit of research done on concussion, expected symptom remission, and factors that may contribute to the prolongation of reported symptoms. External factors like psychiatric causes/mood change and/or secondary gain factors need to be addressed, as those are two of the larger elephants in the room in these scenarios.
How have the pt's / claiment's reports been verified?
Was a neuropsychological assessment done? Were validity measures used and passed? What were the findings?
Was there a 3rd party evaluation from the appropriate physician specialist(s) done? Were the results supportive?
Why pursue this now? Did symptoms previously remit and come back?
Is it common to have such a delay/prolonged presentation of symptoms?
As an outside observer, those are the types of questions I'd wonder about…as would an informed trier of fact.
Thank you for taking your time to answer this. I would have to check on the neuropsych evaluation. I evaluated him for visual processing -- he shows a clear asymmetry in spatial processing. It is being pursued now, because his court case is coming up in 3 months and the lawyer is preparing her case. (He was a pedestrian, hit by a car. The driver is claiming that all of his symptoms are either made up or from his daily life stress, and that the car accident had nothing to do with it.) Symptoms have been continuous since date of impact.
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