Cervicogenic Tension Headache:

Headaches resulting from a concussion can be caused by several things. Among them are tension headaches resulting from impaired central awareness of movements with the neck and jaw joints, impaired fine motor control and coordination of purposeful and reflexive eye movements, disturbed processing of movement signals from the balance organ in the inner ear, or a combination of all of these disorders. These functional disorders cause impaired control over the stabilizing muscles in the neck and increased muscle tension in the neck and jaw muscles. The composition and complexity of these functional disorders is the reason why headaches resulting from post-concussion syndrome respond poorly to standard physical treatment.

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Migraine Headache:

It is also common to develop migraine headaches as a stress reaction and sequelae of post-concussion syndrome. Post-concussion syndrome causes a number of functional disorders in the brain and nervous system. Including disrupted regulation of the autonomic nervous system. It is believed that the combination of challenges in coordinating and processing different sensory inputs and disrupted regulation of the autonomic nervous system can cause so much stress on the system that migraines develop.

Cervicogenic Vertigo:

Dizziness resulting from post-concussion syndrome can be caused by very complex dysfunctions in the central nervous system. Complex does not mean that it is dangerous, but that it can be challenging to treat. In the same way that concussion causes impaired central awareness of movements of the neck and jaw that trigger tension headaches. Impaired central awareness of movements of the neck and jaw can cause difficulty in orienting and trigger dizziness. This form of dizziness is called cervicogenic vertigo.  

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Visual Compensatory Vertigo:

Another cause of dizziness due to concussion and post-concussion syndrome is impaired fine motor control and coordination of purposeful and reflexive eye movements. This leads to difficulties in placing the gaze in a coordinated and precise manner on the object to be viewed, and there is a lot of distracting eye movements that make the visual movement perceived as larger and disproportionate to the physical movement. This makes it challenging for the sensory system to coordinate, process and filter the different movement signals that can trigger dizziness.  

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Motion illusion:

Another cause of dizziness due to impaired fine motor control and coordination over purposeful and reflexive eye movements. Is that the parts of the brain involved in distinguishing between visual movement and physical movement are unable to distinguish each other. This triggers a false sensation of movement, motion illusion (induced motion), as a result of visual-vestibular conflict. It is the same as what happens when you are sitting on a train that is at rest and the neighboring train starts to move. You feel the G-forces and feel the train moving forward. This type of dizziness, motion illusion, is triggered every time you move your gaze or something moves in your field of vision.  

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Canal Dehiscence & BPPV:

Head trauma and concussion can also cause physical damage to the balance organ in the inner ear in the form of a fracture in the bone structure itself, canal dehiscence or perilymphatic fistula, or particles inside the balance organ become loose as a result of the head trauma and lead to BPPV.  

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Persistent Postural-Perceptual Dizziness (PPPD) & Mal de debarqument syndrome (MdDS):

In many cases of post-concussion syndrome, a combination of the above-mentioned dysfunctions can be seen, causing great difficulties in filtering, interpreting, coordinating and processing different sensory impressions. This combination of complex dysfunctions can cause dizziness syndromes called Persistent Postural-Perceptual Dizziness (PPPD) & Mal de debarqument syndrome (MdDS).

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Vestibular migraine:

Just as one can develop migraine headaches as a stress reaction as a result of post-concussion syndrome, concussion and post-concussion syndrome can trigger dizziness caused by migraine, vestibular migraine. In many cases, the patient may have been suffering from migraine headaches before the concussion, and the functional disorders triggered by the concussion and post-concussion syndrome cause the migraine to develop into vestibular migraine.    

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Postural Orthostatic Tachycardia Syndrome (POTS):

The complex functional disorders that a concussion and post-concussion syndrome cause in the brain and nervous system can also involve the autonomic nervous system and trigger a condition called dysautonomia. POTS is a form of dysautonomia in which the autonomic nervous system has difficulty regulating the heart rate in an upright position. This causes an abnormally high pulse during non-exertional activity, and dizziness in the form of lightheadedness and the feeling of fainting (near syncope).  

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All of the above-mentioned diagnoses can also trigger other symptoms that are identical to symptoms triggered by post-concussion syndrome alone. Including headaches, brain fog, visual disturbances, tremors, difficulty concentrating and fatigue. So, to put it mildly, it can be said that the different functional disorders negatively affect each other and further accentuate symptoms.  

The ability to maintain balance and perform smooth, controlled and coordinated movements is not controlled by a single center in the brain, but a complex and interdependent interaction between several parts of the brain that receive different types of sensory input and movement information from different sensory organs simultaneously. This includes the ability to filter, interpret, coordinate and process different sensory inputs simultaneously, as well as activating command centers that control muscle movements and responsiveness, and coordinating the movements activated by the command centers.  

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Including among others:

• Movement signals from muscles and joints in the arms and legs that tell where the body parts are in relation to the rest of the body.

• Movement signals from muscles and joints in the pelvis, back and neck that tell where the body parts are in relation to the arms and legs, and the head.

• Movement signals from the balance organ in the inner ear that tell you whether you are moving or standing still, whether you are standing straight or upside down, and whether you are in rotational or translational motion.

• Calibration of visual vs. physical movement so that one can distinguish between one's own movement and the movement of the environment.  

• Visual orientation using fine motor control and coordination over purposeful and reflexive eye movements.

• The cerebellum's ability to analyze and correct ongoing movements so that movements with the eyes, arms and legs, and back and neck become smooth and coordinated.          
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Concussion and post-concussion syndrome cause an impaired ability to filter, interpret, coordinate, and process different sensory inputs. This results in a negative domino effect that makes it more challenging for the command centers to send the right message, and the cerebellum has challenges calibrating movements smoothly. This results in both impaired balance, coordination, and responsiveness.  

The head trauma that causes a concussion also causes trauma to the neck and vice versa. That is why most people suffer the combination of a concussion and a whiplash. It is rare to see structural damage to muscles, tendons and joints in a whiplash injury. Only in the most serious accidents, which account for about a third of cases. However, more than 50% of those who sustain a whiplash injury are plagued by chronic symptoms for several years. The reason for this is most likely that the patients also suffer a concussion, which, among other things, causes the brain's awareness of movement with the back, neck and jaw joint to deteriorate. And thus also has poorer control over muscle tone and activation of stabilizing muscles. The functional disorders in the brain and nervous system are also probably the reason why people with stiffness and pain in the back, neck and jaw joint as a result of post-concussion syndrome and chronic whiplash syndrome respond poorly to traditional physical treatment and exercise.

Visual disturbances are a very common symptom after a concussion and are expressed in different ways depending on which parts of the brain and nervous system have suffered functional disturbances.  

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Blurred vision and difficulty focusing the eyes can be caused by:

• Impaired fine motor control and coordination of eye movements.

• Impaired coordination.  

• Impaired control over pupillary reflex.

• Impaired vision.  

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Double vision can be caused by:

• Impaired coordination.

• Weakness in one or more muscles of the eye.

• Dysfunction in visual centers.

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Blurry vision can be caused by:

• Impaired fine motor control and coordination of eye movements.

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Visual illusion can be caused by:

• Dysfunction between several parts of the brain that are involved in distinguishing between visual movement and physical movement, distinguishing between surroundings and objects that are in motion or one's own movement. One can feel the surroundings moving even if one is sitting still and the surroundings are not moving.

Brain fog describes the experience of not being fully present and the experience that the head is lagging behind with the accompanying slow thought process and impaired concentration. Brain fog resulting from concussion and post-concussion syndrome is due to a complex dysfunction in several parts of the brain. Including dysfunction in areas that are involved in processing, coordinating and processing different sensory impressions that make it more challenging for the brain to create easily understandable experiences of what is happening in the environment and thus more challenging to process the sensory impressions together and to transfer the experiences and information to short-term and long-term memory. This can also include impaired fine motor control and coordination of purposeful and reflexive eye movements that make it more challenging to collect visual information, and thus challenging to process and process events in the environment.

Hypersensitivity to sensory input is very common in post-concussion syndrome, and is due to both an impaired ability to filter or attenuate sensory input, and an impaired ability to process and coordinate light, sound, and movement. This dysfunction means that when exposed to ordinary sensory input, the brain becomes overworked and the environment is experienced as overwhelming and unpleasant. For example, in hypersensitivity to sound, there is a lack of function of the nerve cell "brakes" in the auditory centers, which means that the auditory centers are overactive and hypersensitive at all times, and it takes minimal sound stimuli to trigger discomfort. The same principles apply to hypersensitivity to light and visual input, smell, pain, and movement.

Concussion and post-concussion syndrome cause functional disorders in several parts of the brain that are important for cognitive and executive functions such as concentration and memory. You can have functional disorders in specific centers of the brain that are involved in cognition and execution, and you can have a complex functional disorder that involves several parts of the brain that are important for the collection, processing and coordination of different sensory impressions that are necessary for good and effortless cognition and execution. This can lead to difficulties with concentration, memory, difficulty finding words, multitasking and problem solving. Even though the centers in the brain that are specifically involved in cognition and execution function normally.

Fatigue and chronic exhaustion are very common in post-concussion syndrome. The reason for this chronic fatigue is due to the complex and extensive functional disorders in the brain after a concussion. Including challenges with filtering, coordinating and processing different sensory impressions at the same time; some parts of the brain work too much while other parts of the brain work too little, and parts of the brain that are not normally activated by certain actions are activated as a result of a number of miscompensations that the brain has made in an attempt to compensate for the functional disorders caused by the concussion and post-concussion syndrome. This requires a lot of energy, and is the reason that the patient can tolerate little activity and sensory impressions before symptoms are triggered or worsened. This is further exacerbated by high sensitivity to sensory impressions, which leads to further overexertion and discomfort.

• Irritability

• Mood swings

• Anxiety  

• Depression  

• Decreased motivation and interest

• The feeling of physical uneasiness and restlessness

• The feeling of not being yourself

• Tinnitus

• Nausea

• Sleep disorder