Concussion

Recognizing concussion after a car wreck

After a car wreck, neck pain may be the first thing you notice. Trouble concentrating, unusual fatigue, dizziness, or changes in sleep may be less obvious. These symptoms deserve attention, especially when they affect your work, driving, or everyday activities.

A concussion is a traumatic brain injury (TBI). It can result from a blow to the head or a force to the body that rapidly moves the head and brain. You do not have to hit your head or lose consciousness to have a concussion.

At Elite Family Chiropractic, Dr. Gorski considers both possible brain injury and injuries to the neck when evaluating patients after a car wreck. The goal is to recognize concerning findings, understand what may be contributing to your symptoms, and help you reach the appropriate care.

Concussion symptoms to watch for

Symptoms may appear right away or become noticeable over the following hours or days. Common changes include:

• Headache or pressure in the head

• Dizziness, balance difficulties, or nausea

• Sensitivity to light or noise and changes in vision

• Feeling mentally foggy or slower than usual

• Trouble remembering information or concentrating

• Irritability, anxiety, or other mood changes

• Fatigue or sleeping more or less than usual

These symptoms are not unique to concussion. Neck injuries, migraine, inner-ear problems, and other conditions can cause similar difficulties. A clinical assessment helps determine what needs attention.

Understanding how concussion can evolve over time

A concussion can begin with a single injury, but the biological response and recovery can continue afterward. Research has identified changes in brain function and structure that may extend beyond the initial event and, in some cases, beyond obvious symptoms.

Most people improve with appropriate guidance and time. However, recovery varies, and persistent or changing symptoms deserve reassessment. Feeling better and biological recovery do not always follow identical timelines, which is one reason return to activities with a risk of another head injury requires clinical guidance.

National expert recommendations call for moving beyond broad labels such as “mild,” “moderate,” and “severe” toward a fuller picture of each person’s brain injury. Your symptoms, examination, recovery, and personal circumstances help guide care, with imaging or blood tests used when clinically appropriate. A label alone should not determine the care you receive. This does not mean that every concussion causes progressive damage or requires advanced testing.

What an evaluation may include

Dr. Gorski reviews how the injury happened, when symptoms began, and how they have changed. Previous concussions, headaches, medications, sleep, and emergency department records can all affect the assessment.

Depending on your presentation, evaluation may include a neurological screening, a neck examination, and assessment of balance, coordination, or eye movements. Findings that need a more detailed neurological, vestibular, or cognitive assessment can prompt referral to the appropriate clinician.

An important part of the visit is determining whether you need urgent medical evaluation, additional testing, follow-up, or care involving more than one provider. Concussion assessment relies on the clinical picture; a scan or laboratory result alone cannot answer every question.

Concussion and whiplash can occur together

The same forces involved in a car wreck can injure the brain and the connective tissues of the neck. A ligament sprain or muscle or tendon strain may contribute to pain and restricted movement. Neck-related headaches and dizziness can also overlap with concussion symptoms.

Identifying these contributors matters because each may require a different approach. Care for a neck injury may improve neck-related symptoms while concussion recovery requires its own monitoring and activity guidance. Improvement in neck pain alone does not establish that a brain injury has resolved.

Learn more about our approach to whiplash evaluation and care.

The role of CT and MRI

Concussion is primarily a clinical diagnosis. A normal CT or routine MRI does not rule it out.

A head CT is often used when clinicians need to evaluate possible bleeding or another urgent structural injury. MRI may be appropriate when symptoms or neurological findings persist or remain unexplained, depending on the clinical situation.

Certain MRI sequences can provide additional information. Susceptibility-weighted imaging, or SWI, can help reveal small areas of bleeding. Diffusion tensor imaging, or DTI, examines patterns of water movement in brain tissue and is an important research tool. DTI is not an established routine test for confirming concussion in an individual patient.

The useful question is which test, if any, could answer a specific concern and change your care. Imaging decisions should follow your history, examination, and the judgment of the clinician managing that part of your evaluation.

Read more about concussion symptoms despite a normal MRI.

What blood biomarkers can tell us

GFAP and UCH-L1 are proteins associated with cells in the brain. Their levels in the blood can rise after a traumatic brain injury.

Some FDA-cleared tests measure these proteins to help clinicians decide whether a head CT is needed in selected adults evaluated soon after a suspected brain injury. Each test has specific eligibility criteria and a limited testing window; examples include within 12 or 24 hours.

These tests are used alongside a clinical assessment. They do not independently confirm or exclude every concussion, measure its severity, or establish that the brain has healed. Results obtained weeks or months later cannot simply be interpreted using an acute test’s cutoffs.

Research into biomarkers across different stages of recovery continues. Whether testing would be useful depends on the timing, the specific assay, and the clinical question. Dr. Gorski can help identify when further medical evaluation is appropriate.

Dr Gorski’s postgraduate concussion education

Dr. Brad Gorski’s postgraduate education includes concussion and head-trauma coursework listed in his curriculum vitae through Cleveland University–Kansas City and the Academy of Chiropractic, Post-Doctoral Division. Relevant courses include:

• Traumatic Brain Injury and Concussion Overview

• Head Trauma and Traumatic Brain Injury Part 1

• Head Trauma and Traumatic Brain Injury Part 2

• Concussion and Electroencephalogram Testing

• Concussion and Electroencephalogram Testing Pathological Results

This education informs his attention to symptom recognition, clinical findings, triage, and coordination with other healthcare professionals. When your findings call for care beyond a chiropractic evaluation, appropriate referral is part of the plan.

A plan based on your findings

Your care may involve your primary care clinician, a concussion clinic, a neurologist, or rehabilitation professionals with relevant training. The right team depends on your symptoms and examination.

Early recovery commonly involves a brief period of relative rest followed by a gradual return to safe activity, adjusted to symptoms and clinical guidance. Driving, work, exercise, and activities that carry a risk of another head injury may need specific restrictions.

At Elite Family Chiropractic, care may also address an associated neck injury when appropriate. Follow-up considers daily function and symptom changes as well as pain. Persistent dizziness, cognitive difficulties, headaches, or exercise intolerance may call for additional evaluation or targeted rehabilitation.

Read more about concussion symptoms after a car wreck.

When to seek emergency care

After a head or body injury, seek emergency medical care for a worsening headache, repeated vomiting, a seizure, increasing confusion, slurred speech, new weakness or numbness, unequal pupils, or difficulty waking. These signs need urgent assessment rather than a routine office appointment.

Schedule a concussion evaluation in Charleston

If headaches, dizziness, brain fog, or other symptoms began after a car wreck, an evaluation can help clarify the next step.

Call 843-892-5671 or request an appointment with Elite Family Chiropractic.

1662 Savannah Highway, Suite 115, Charleston, SC 29407. Serving James Island, Johns Island West Ashley, and the Charleston area.