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The Atlas Vertebra Key To Maintaining Head Balance And Alignment

The Atlas Vertebra Key To Maintaining Head Balance And Alignment

The Atlas vertebra is named for the mythological figure who held the world on their back/neck. The vertebrae are located at the top of the spine, where the cranium and spine connect. More than just a foundation for support, the vertebrae could be the most important vertebrae of the body. It consists of a complex bundle of nerves, vertebral arteries, and is the point where the entire weight of the cranium makes contact.  
 
The myth requires Atlas to be careful while holding the world carefully and confidently at all times, otherwise it will come crashing down. The key is being able to balance it perfectly. The vertebra has the same job to hold the head up properly and maintain posture. If not problems with balance and alignment will begin to develop, and affect the entire spine.  
11860 Vista Del Sol, Ste. 128 The Atlas Vertebra Key To Maintaining Head Balance And Alignment
 

The Atlas Vertebra

 

Balance

The Atlas vertebrae’s role in maintaining balance is based on its ability to adjust to the weight of the head. The actual vertebra is wider than the other cervical vertebrae. This creates a center of gravity that is reinforced through proper posture. It distributes the weight of the head (10-12lb) evenly to centralize the weight and is supported by the natural curvature of the spine. If the center of gravity shifts, the Atlas vertebra will tilt in that direction as well. This creates instability in the cervical spine and can increase the amount of weight the spine is taking and trying to redistribute. This creates spinal issues and leads to everything from poor posture, overcompensation that leads to injury.  

Shifting Causes

Disruption to the vertebra and its ability to balance can come from a variety of causes and can occur as a result of chronic and acute conditions. Some include:
  • Auto accidents, sports, work injuries can cause cervical soft tissue damage
  • Dislocation of cervical vertebrae below the Atlas results in instability
  • Poor posture/s make individuals overcompensate to one side of the body straining muscles, ligaments, tendons causing pain and other issues
  • Herniated, bulging, and slipped discs
11860 Vista Del Sol, Ste. 128 The Atlas Vertebra Key To Maintaining Head Balance And Alignment
 

Unbalanced effects

Spinal issues range from simple neck pain and soreness to full-on chronic pain. Because the Atlas can alter the balance of the entire spine, combined with cranium support, issues can be localized and referred creating further complications. Addressing the root problems requires a comprehensive chiropractic approach. Chiropractic will assess the position of the spine and determine the degree to which Atlas has shifted out of place. An adjustment treatment plan makes it possible to undo the widespread damage.

Body Composition


 

Muscle Loss

Individuals do not realize that muscle loss occurs throughout their lifetime. This is because muscles, like other tissues in the body, must go through cell turnover and protein synthesis. This means that the body is constantly breaking down protein in the muscles and rebuilding them. Skeletal muscle can be developed with proper nutrition and includes consuming a proper amount of protein to provide the necessary amino acids and from physical activity. The reverse is also true, if an individual becomes less physically active and/or their diet no longer supports the development of increased muscle tissue, the body enters a catabolic/tissue-reducing state known as muscle atrophy.

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Woodfield, H Charles 3rd et al. �Craniocervical chiropractic procedures – a pr�cis of upper cervical chiropractic.��The Journal of the Canadian Chiropractic Association�vol. 59,2 (2015): 173-92.
Osteonecrosis of Femoral Head Misdiagnosed As Sciatica

Osteonecrosis of Femoral Head Misdiagnosed As Sciatica

Osteonecrosis is a condition that causes the death of bone tissue from temporary or permanent loss of blood supply to the affected area. It is commonly known as Avascular necrosis and can lead to miniature/tiny breaks in the bone and the bone/s eventually collapsing. Specifically, it affects the upper part of the femur or femoral head and surrounding joints.  
11860 Vista Del Sol, Ste. 128 Sciatica or Osteonecrosis of Femoral Head? A Common Misdiagnosis
 
It can occur in any bone however, osteonecrosis typically affects the hip/s. Pain associated with osteonecrosis of the hip can be localized to the center of the groin, thigh, or buttock. Because of the hip joint’s close proximity to the sciatic nerve, misdiagnosis for sciatica is common.  
 

Mimicking Sciatica Symptoms

Unfortunately, many health care providers can misdiagnose osteonecrosis hip pain as sciatica. Whatever the cause of the hip injury, most individuals with hip pathology report pain in the groin, upper thigh, and buttocks. That is why a trained medical professional that knows the differences in the symptoms of each condition can make all the difference in making a proper diagnosis. And a proper diagnosis leads to proper and complete treatment of whichever condition it may be. With osteonecrosis, misdiagnosis often delays the proper treatment and continues to progress. Common symptoms of sciatica:
  • Leg pain is the primary symptom can be mild to severe
  • Low back pain is secondary can be mild to severe
  • Nerve-related symptoms
  • Numbness
  • Tingling
  • Shooting pain
  • Pins-and-needles sensation
  • Muscle weakness
  • Hip pain especially flexion and internal rotation of the hip.
  • Leg or foot weakness
11860 Vista Del Sol, Ste. 128 Osteonecrosis of Femoral Head Misdiagnosed As Sciatica
 

Osteonecrosis Symptoms and Similarities

For many, there are no symptoms in the early stages of osteonecrosis. As the condition worsens, the affected joint could present pain symptoms only when weight is placed on it. Eventually, individuals begin to feel the pain even when lying down. Pain can be mild to severe with a gradual development. Other symptoms that mimick sciatica:

Walking Inability

Walking gait is complicated with both conditions which is a major cause behind the misdiagnosis.

Limping

Individuals often limp with osteonecrosis of the hip and spinal disc problems. This is another reason that the condition is misdiagnosed as a spinal disc problem or nerve root compression of the sciatic nerve.

Hip Pain

The tributaries/veins of the sciatic nerve also supply the hip area and often cause confusion between the two conditions.  
 

Differences

Despite all of the similarities. There are differences in both conditions.

Nature of The Pain

  • With sciatica, the pain is related to the nervous system. Movement can complicate the pain. While rest helps to reduce the pain.
  • With Osteonecrosis the pain is geared toward the muscular. Rest does not help reduce the pain. In fact, the pain increases at night.

Location

  • Sciatica pain can radiate through the whole leg from the low back to the toe.
  • Osteonecrosis pain is confined to the hip joint, groin, and radiates to the knee joint only. Osteonecrosis pain does not radiate below the knee joint.

Restricted Movement

  • Osteonecrosis of the hip joint, means the movements involving the hip joint are restricted. Individuals cannot rotate the leg to the right and left. Individuals cannot bend or fold from the hip.
  • With sciatica, the rotation of the leg is not affected. Movements involving stretching the sciatic nerve can cause relief or pain.

Walking Gait Differences

Gait is the way an individual stands and walks.
  • Osteonecrosis of the hip joint causes individuals to not be able to open the hip joint properly or to step properly.
  • With sciatica, an individual tends to lean on their side to relax the compression on the nerve.

Risk Factors

More than 20,000 people enter hospitals for the treatment of osteonecrosis of the hip yearly. Other than the hip, areas of the body likely to be affected are the shoulder, knee, hand, and foot. The condition can occur for a variety of reasons. A few of these include:
  • Fracture – a broken bone can interrupt the blood flow to other sections of the bone.
  • Dislocation of bone or joint/s
  • Alcoholism
  • Trauma
  • Radiation damage
  • Steroid use
Some individuals can have more than one condition or injury that contributes to hip flexor pain. An example is that it is possible to have both hip osteoarthritis and hip impingement. Without proper treatment, the condition can worsen, causing joint or hip pain from the degradation of the bone.  
11860 Vista Del Sol, Ste. 128 Osteonecrosis of Femoral Head Misdiagnosed As Sciatica
 
Anyone can be affected, but osteonecrosis is most common in individuals aged 30 to 50. Treatment options include a total replacement of the hip known as arthroplasty. And if it is sciatica then chiropractic treatment is a first-line treatment protocol. However, a chiropractor can make the distinction between the two and treat sciatica or refer the patient to the proper specialist.
 

Lower Back Pain Relief


 

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Li, Wen-Long et al. �Exploring the Risk Factors for the Misdiagnosis of Osteonecrosis of Femoral Head: A Case-Control Study.��Orthopaedic surgery, 10.1111/os.12821. 16 Oct. 2020, doi:10.1111/os.12821
Head Down, Shoulders Hunched Forward = Phone Neck Pain

Head Down, Shoulders Hunched Forward = Phone Neck Pain

Being attached to a smartphone and looking down for a long can cause phone neck pain. We are all constantly connected to our family, friends, work, etc. When we keep our head down, shoulders hunched forward, neck straining from the uncomfortable angle for a long time a neck injury can develop. This has to do with knowing how to maintain proper posture while using a smartphone.

Most of us know this syndrome as tech neck, text neck, and is caused by straining the neck too far down and forward while talking/texting, etc. Holding this position for too long will cause neck muscle strain and pain. This also occurs with handheld devices with users hunching their shoulders forward. The awkward neck angel and rounded shoulders strain the entire upper body.

 

11860 Vista Del Sol, Ste. 128 Head Down, Shoulders Hunched Forward = Phone Neck Pain

Phone Neck Pain Stretches/Tips

Here are a few tips along with some light stretches/exercises to keep the neck muscles flexible and loose.

  • Try to bring the phone to eye level.
  • Check around and look up from the screen every few minutes so as not to remain in a downward position.
  • Incorporate light and easy neck stretches and exercises.

Chin Tuck

Move the chin towards the chest, and hold for 5 seconds as there will be a comfortable stretch from the neck to the base of the skull to the mid-back. Try doing a few up to 10 times until you feel thoroughly stretched.

Side Bend

Tilt the head to the right, bringing the ear close to the shoulder. Use your hand to pull your head farther into the stretch if possible. Hold for 20 seconds. Bring the head back to the center, and tilt to the left, and hold for 20 seconds. Repeat this motion 3-5 times on each side.

Head Rotation

Rotate the chin towards the right shoulder and hold for 20 seconds. Use your hand to push your head farther into the stretch if possible. Bring the head back to the center, and rotate to the left, and hold for 20 seconds. Repeat this motion 3-5 times on each side.

Neck pain can turn into a full injury or condition if an individual continues with this form of very poor posture. Taking care of our bodies needs to be a priority. Make proper posture a habit and it will help prevent neck and back pain from developing. This along with related posture and biomechanical issues. Proper posture means the head is upright, the ears are in line with the shoulders, and the shoulder blades are down.

Neck Pain Chiropractic Care

 

Dr. Alex Jimenez�s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

Neck Stiffness, Crick in the Neck and Chiropractic

Neck Stiffness, Crick in the Neck and Chiropractic

We are familiar with neck stiffness or a crick. This can prevent us from comfortably moving the head all around. A crick can cause the spine, and shoulders to feel rigid and stressed from not being able to turn around and could cause an upper or low-back strain from having to turn the whole body to look back or even just to the side. Chiropractic treatment is available and will help, along with some self-care therapies that can be done at home.

 

11860 Vista Del Sol, Ste. 128 Neck Stiffness, A Crick in the Neck and Chiropractic Relief El Paso, Texas

Crick in the Neck vs. Neck Stiffness

A crick in the neck is the same as a stiff neck. It develops when the neck muscles, tendons, and ligaments become strained/sprained. Most strains and sprains are minor but do cause inflammation/swelling of the neck�s soft tissues, which results in stiffness and, at times muscle spasms.

 

The symptoms

Cricks in the neck are uncomfortable, but not necessarily painful. If there is a pre-existing neck condition or injuries like whiplash the crick and stiffness could increase the uncomfortableness and generate pain.

The most common symptoms include:

  • Neck stiffness
  • Muscle stiffness
  • Reduced mobility affecting the neck�s range of motion
  • A popping sensation when trying to turn or tilt the head

 

Neck Pain Herniated Discs

Causes of a stiff neck or crick

There are different causes of neck stiffness. It can be a combination of things you can control and some you can�t.

Possible causes that you can control:

  • Poor posture working either sitting or standing for several hours without breaks or stretching.
  • Sleeping in a position that puts the neck in an awkward position or using a pillow that does not support the neck when sleeping.
  • Constantly looking down at a cell phone or tablet.
  • Stress and emotional tension can cause involuntarily tightening of the neck muscles and shoulders.
  • Heavy labor along with incorrect lifting techniques.
  • Reaching or having to look up/overhead for several hours like when painting a ceiling.

Possible causes that are out of your control:

  • Whiplash injury
  • Sports-injuries like a football stinger
  • Aging muscles and bones

Around 13% of cases the stiffness, and pain are caused by separate cervical spinal conditions, like:

  • Cervical herniated disc
  • Cervical spinal stenosis
  • Spinal fracture
  • Spondylosis (spinal osteoarthritis)

At-home therapy

Usually, a crick in the neck will go away within a few days without the need to visit a doctor or chiropractor. There are home remedies that can help alleviate neck stiffness.

 

Why Chiropractic Works In Relieving Joint Pain El Paso, Texas

Cold and heat therapy

Cold therapy reduces the swelling of soft tissues, like muscles and ligaments, while heat soothes the tightness by boosting blood circulation to the affected area. There are different products available that can deliver cold or heat to the neck and upper back.

  • Apply ice for 15 minutes each hour.
  • Apply heat therapy like a heating pad for 15 minutes every 2 or 3 hours.

 

Over-the-counter anti-inflammation medicines

Non-steroidal anti-inflammatory medications like ibuprofen and naproxen can help relieve inflammation and pain.

Gentle neck stretches and exercises

Cervical stretches and exercises can:

  • Ease muscular tension
  • Muscle spasms
  • Strengthen muscles
  • Improve neck flexibility
  • Improve range of motion

Prevention

Because neck stiffness can be linked to lifestyle choices, individuals may find that they occur repeatedly. Simple neck stretches, chiropractic treatment, using a supportive pillow, and taking frequent breaks at your job can help prevent neck stiffness and keep you moving. These professionals have undergone extensive training in their field and are capable of treating neck pain effectively. So if you or a loved one are experiencing neck pain, give us a call. We�re ready to help!


 

Neck Pain Chiropractic

 


 

NCBI Resources

 

Phone Related Neck and Head Injuries El Paso, Texas

Phone Related Neck and Head Injuries El Paso, Texas

Head and neck injuries related to phone use are on the rise. Since the first iPhone was released, according to a study in JAMA Otolaryngology-Head & Neck Surgery.

Doctors are warning cell phone users to be especially careful when:

  • Walking around and texting

It is a distraction and one of the leading causes of head and neck injuries.

 

11860 Vista Del Sol, Ste. 126 Phone-Related Neck and Head Injuries El Paso, TX.

 

2,501 reported cases of phone-related head and neck injuries that lead to emergency room visits between January 1998 and December 2017 found in a nationwide database. Injuries in teens and young adults aged 13 to 29 years old were about 40%, in women (55%) and men (45%).

 

Common Phone Injuries

Common injuries include:

  • Cuts
  • Bruises
  • Abrasions
  • Internal injuries usually happen around the eyes and nose
  • Possible trauma to the brain

Over 41% of these injuries happened at home and were minor with little or no treatment needed. Around 50% of injuries were a result of distracted driving and 30% from distracted walking.

 

 

Any type of phone distraction in and out of the home puts you and others at risk for:

  • Falls
  • Slips
  • Trips

All of which can lead to injuries and other possible consequences (e.g. a busted phone).

More individuals are getting injured because of phone use while moving around and not paying attention to what’s around them.

Children

 

11860 Vista Del Sol, Ste. 126 Phone-Related Neck and Head Injuries El Paso, TX.

 

Children under the age of 13 were at higher risk to suffer a mechanical injury like parents accidentally dropping the phone on their child or children hitting themselves in the face. For example, ninety cases of injuries occurred while playing Pokemon Go.

Spending as little as two to four hours a day hunched over a smartphone is enough to make a serious impact on the body over time. And though two to four hours may not seem like a long time, it isn�t hard to arrive at two hours by adding several 15-minute or half-hour segments together.

For teenagers, specifically, two to four hours on a smartphone has changed as of now teenagers spend around seven to eight hours on their phones. Spending twice as much time on afternoons or the space between classes or lunch. Think about the impact of 1500 plus hours of bad posture throughout the year. There is no surprise that teenagers are at risk.

The lasting impact of text neck and distracted phone use on today�s young people will be costly. Therefore, the public needs to be educated about the risks of distracted phone use and reducing this distracted behavior.


 

*Neck* Pain Chiropractic Care El Paso, Texas

 


 

NCBI Resources

If you begin noticing pain, spasms, or irritation around the neck, shoulders, or back make an appointment with a professional chiropractor. Explain when the pain occurred, the severity, and the activity that started it. A simple adjustment may be all that is needed to get re-aligned and gain relief from pain caused by overuse. A chiropractor can also help decrease the chances of the injury worsening over time.

 

Head Trauma And Other Intra-Cranial Pathology Imaging Approaches

Head Trauma And Other Intra-Cranial Pathology Imaging Approaches

Head Trauma: Skull Fractures

head trauma imaging el paso tx.
  • SKULL FX: COMMON IN THE SETTINGS OF HEAD INJURIES. SKULL FX OFTEN POINT TO OTHER COMPLICATING FACTORS: INTRA-CRANIALHEMORRHAGING, CLOSED TRAUMATIC BRAIN INJURY AND OTHER SERIOUS COMPLICATIONS
  • SKULL X-RAYS ARE VIRTUALLY OBSOLETE IN EVALUATING HEAD INJURY. CT SCANNING W/O CONTRAST IS THE MOST IMPORTANT INITIAL STEP IN EVALUATION OF ACUTE HEAD TRAUMA. MRI HASA POOR ABILITY TO REVEAL SKULL FRACTURES, AND NOT TYPICALLY USED FOR AN INITIAL DX OF ACUTE HEAD TRAUMA.
  • SKULL FX ARE IDENTIFIED AS FXS OF SKULL VAULT, SKULL BASE AND FACIAL SKELETON EACH ASSOCIATED WITH SPECIFIC FEATURES AND HELP TO PREDICT COMPLICATIONS.
  • LINEAR SKULL FX: SKULL VAULT. M/C FX. CT SCANNING IS THE KEY TO EVALUATE ARTERIALEXTRADURAL HEMORRHAGING
  • X-RAY DDX: SUTURES VS. LINEAR SKULL FX. FX IS THINNER, �BLACKER� I.E. MORE LUCENT, CROSSESSUTURES,�AND VASCULAR GROOVES, LACKSSERRATIONS
  • RX: IF NO INTRACRANIAL BLEEDS THAT NO TREATMENT. NEUROSURGICAL CARE IF BLEEDSDETECTED BY CT SCANNING
head trauma imaging el paso tx.
  • DEPRESSED SKULL FX: 75% IN THE VAULT. CAN BE DEADLY. CONSIDERED AN OPEN FX. MOST CASES NEED NEUROSURGICALEXPLORATION ESPECIALLY IFFRAGMENTS DEPRESSED >1-CM.COMPLICATIONS: VASCULAR INJURY/HEMATOMAS, PNEUMOCEPHALUS, MENINGITIS, TBI, CSF LEAK, BRAIN HERNIATION ETC.
  • IMAGING: CT SCANNING W/O CONTRAST
head trauma imaging el paso tx.
  • BASILAR SKULL FX: CAN BE DEADLY. OFTEN ALONG OTHER MAJOR HEAD TRAUMA OF THE VAULT AND FACIALSKELETON, OFTEN WITH TBI AND MAJORINTRACRANIAL HEMORRHAGING. OFTEN OCCUR AS �HEADBAND� EFFECT OF IMPACT AND MECHANICAL TENSION THROUGH THE OCCIPUT AND TEMPORAL BONES THROUGH SPHENOID AND OTHER BASE OF SKULL BONES. CLINICALLY: RACCOON EYES, BATTEL SIGN, CSFRHINO/OTORRHEA.

Facial Fractures

head trauma imaging el paso tx.
  • NASAL BONES FX: 45% OF ALLFACEFXM/C IMPACT IS LATERAL(FIST BLOW ETC.) IF UNDISPLACEDNO TREATMENT, IF DISPLACED MAY COMPLICATE AIR FLOW AND RESPIRATORY PASSAGE, MAY BE ASSOCIATED WITH OTHER FACIAL/SKULL INJURY. X-RAYS 80%SENSITIVE, FOLLOWED BY CT INCOMPLEX INJURIES.
  • ORBITAL BLOW OUT FX: COMMONORBITAL INJURY D/T IMPACT ON THE GLOBE AND/OR ORBITAL BONE. FX OF ORBITAL FLOOR INTOMAXILLARY SINUS VS. MEDIAL WALL INTO ETHMOID SINUS. COMPLICATIONS: ENTRAPPEDINFERIOR RECTUS M, PROLAPSEORBITAL FAT,�AND SOFT TISSUES, HEMORRHAGING AND OPTIC NERVE DAMAGE. RX: CONCERNS OF GLOBE INJURY ARE IMPORTANT, GENERALLY TREATEDCONSERVATIVELY IF NO COMPLICATIONS PRESENT
head trauma imaging el paso tx.
  • TRIPOD FX: 2ND M/C FACIAL FX#AFTER NASAL (40% OF MIDFACEFX) 3-POINT FX-ZYGOMATICARCH, ORBITAL PROCESS OF ZYGOMATIC BONE & SIDE OF MAXILLARY SINUS WALL, MAXILLARY PROCESS OF ZYGOMATIC BONE.COMPLICATED BY NERVE INJURY, TEMPORALIS M DAMAGE ETC. CT SCANNING IS MORE INFORMATIVE THAT X-RAYS (WATER�S VIEW).
  • LEFORT FX: SERIOUS FX ALWAYS INVOLVES PTERYGOID PLATES, POTENTIALLY SEPARATINGMIDFACE AND ALVEOLAR PROCESS WITH TEETH FROM THE SKULL. CONCERNS: AIRWAYS, HEMOSTASIS, NERVE INJURIES. CT SCANNING IS REQUIRED. POTENTIAL RISK OF BASILAR SKULL FX
head trauma imaging el paso tx.
  • PING-PONG FX:�EXCLUSIVELY IN INFANTS. AN INCOMPLETE FX D/T FOCALDEPRESSION: FORCEPS DELIVERY, DIFFICULT LABOUR ETC. FOCALTRABECULAR MICROFRACTURIINGLEAVING DEPRESSION RESEMBLING APING-PONG. DX IS MAINLY CLINICALSEEN AS FOCAL DEFECT �DEPRESSION� IN THE SKULL. TYPICALLYNEUROLOGICALLY INTACT. CT MAY HELP IF BRAIN INJURY IS SUSPECTED. RX: OBSERVATIONAL VS. SURGICAL IN COMPLICATED INJURIES. SPONTANEOUSREMODELING HAS BEEN REPORTED
head trauma imaging el paso tx.
  • LEPTOMENINGEAL CYST (GROWING SKULL FX)- ARE AN ENLARGING SKULL FRACTURE THAT DEVELOPS ADJACENT TO POSTTRAUMATIC ENCEPHALOMALACIA
  • IT IS NOT A CYST, BUT AN EXTENSION OF THEENCEPHALOMALACIA THAT SEEN A FEW MONTHS POST-TRAUMA WITH PREVIOUS SKULL FX FOLLOWEDBY HERNIATION OF THE MENINGES AND ADJACENTBRAIN WITH PULSATIONS OF THE CSF. CT IS BEST ATDX THIS PATHOLOGY. INDICATES: GROWING FX AND ADJACENT ENCEPHALOMALACIA AS FOCALHYPOATTENUATING LESION.
  • CLINICALLY: PALPABLE CALVARIAL ENLARGEMENT, PAIN, NEUROLOGICAL SIGNS/SEIZURES. RX: NEUROSURGICAL CONSULT IS REQUIRED
  • DDX: INFILTRATING CELLS/METS/OTHER NEOPLASMSINTO SUTURES, EG, INFECTION ETC.
head trauma imaging el paso tx.
  • MANDIBULAR FXS: COMMON. POTENTIALLYCONSIDERED AN OPEN FX D/T INTRA-ORALEXTENSION. 40% FOCAL BREAK DESPITEMANDIBLE BEING A RING. DIRECT IMPACT(ASSAULT) M/C MECHANISM
  • PATHOLOGICAL FX D/T BONE NEOPLASMS, INFECTION ETC. IATROGENIC DURING ORAL SURGERY (TOOTH EXTRACTION)
  • IMAGING: MANDIBLE X-RAYS, PANOREX, CT SCANNING ESP. IN CASES OF ASSOCIATEDFACE/HEAD TRAUMA
  • COMPLICATIONS: AIRWAY OBSTRUCTION, HEMOSTASIS IS A MAJOR CONSIDERATION, DAMAGE TO MANDIBULAR N, OSTEOMYELITIS/CELLULITIS AND POTENTIAL SPREAD THROUGH FLOOR OF THE MOUTH (LUDWIGANGINA) AND NECK FASCIAL SOFT TISSUES INTOMEDIASTINUM. CANNOT BE NEGLECTED D/T HIGH MORTALITY RATES.
  • RX: CONSERVATIVE VS. OPERATIVE

Acute Intracranial Hemorrhage

head trauma imaging el paso tx.
  • EPI AKA EXTRADURAL: (EDH) TRAUMATIC RAPTURE OF MENINGEAL ARTERIES (MMA CLASSIC) WITH RAPIDLY FORMING HEMATOMA BETWEEN THE INNER SKULL AND OUTER DURA. CT SCANNING IS THE KEY TO DX: PRESENTS AS �LENTIFORM� I.E. BICONVEX COLLECTION OF ACUTE (HYPERDENSE) BLOOD THAT DOES NOT CROSSSUTURES AND HELPS WITH DDX OF A SUBDURAL HEMATOMA. CLINICALLY: HA, LUCID EPISODE INITIALLY AND DETERIORATING IN A FEW HOURS.COMPLICATIONS: BRAIN HERNIATION, CN PALSY. O/A GOOD PROGNOSIS IF QUICKLY EVACUATED.
  • SUBDURAL HEMATOMA (SDH): RAPTURE OF BRIDGINGVEINS BETWEEN INNER DURA AND THE ARACHNOID.SLOW BUT PROGRESSIVE BLEED. MAY PARTICULARLYAFFECT THE VERY YOUNG AND ELDERLY AND IN ALL AGES (MVA, FALLS ETC.) MAY DEVELOP IN �SHAKEN BABY SYNDROME�. DX MAY BE DELAYED AND WORSEN THE PROGNOSIS WITH HIGH FATALITIES. IN ELDERLY HEAD TRAUMA MAY BE MINOR OR NOT RECALLED. EARLYIMAGING WITH CT IS CRUCIAL. PRESENTS AS CRESCENTSHAPEDCOLLECTION THAT CAN CROSS SUTURES BUT STOPPED AT DURAL REFLECTIONS. DIFFERENTATTENUATION ON CT D/T DIFFERENT STAGES OF BLOODDECOMPOSITION: ACUTE, SUBACUTE,�AND CHRONIC.MAY FORM A CHRONIC COLLECTION-CYSTICHYGROMA. CLINICALLY: VARIABLE PRESENTATION, 45-60% PRESENT WITH SEVERELY DEPRESSED CNS STATUS, PUPILLARY INEQUALITY. OFTEN WITH INITIAL BRAIN CONTUSION, THEN A LUCID EPISODE BEFORE SEVERELYDETERIORATING. IN 30% CASES OF FATAL BRAIN INJURY PATIENTS HAD SDH. RX: URGENT NEUROSURGICAL.
head trauma imaging el paso tx.
  • SUBARACHNOID HEMORRHAGE (SAH): BLOOD IN THE SUB-ARACHNOID SPACE AS THE RESULT OF TRAUMATIC OR NON-TRAUMATIC ETIOLOGY: BERRY ANEURYSMS AROUND CIRCLE OF WILLIS.SAH 3% OF STROKES, 5% OF FETAL STROKES.CLINICALLY: PRESENTS AS A �THUNDERCLAP HEADACHE� DESCRIBED AS A �WORST HA INLIFE�. PT COLLAPSES MAY OR MAY NOT REGAIN CONSCIOUSNESS. PATHOGY: DIFFUSE BLOOD INSA SPACE 1)SUPRASELLAR CISTERN WITH DIFFUSE PERIPHERAL EXTENSION, 2)�PERIMESENCEPHALIC, 3) BASAL CISTERNS. BLOOD LEAKED INTO SA SPACE UNDERARTERIAL PRESSURE INDUCES GLOBAL INCREASE IN INTRACRANIAL PRESSURE, ACUTE GLOBAL ISCHEMIA WORSENED BY VASOSPASM AND OTHER CHANGES.
  • DX: IMAGING: URGENT CT SCANNING W/O CONTRAST, CT ANGIOGRAPHY MAY HELP TO RULE OUT 99% OF SAH. LUMBAR PUNCTUREMAY HELP IN DELAYED PRESENTATION. AFTER INITIAL DX: MR ANGIOGRAPHY HELPS TO FIND THE CAUSE AND OTHER IMPORTANT FEATURES
  • IMAGING FEATURES: ACUTE BLOOD IS HYPERDENSE ON CT. FOUND IN DIFFERENTCYSTERNS: PERIMESENCEPHALIC, SUPRASELLA, BASAL, VENTRICLES,
  • RX: INTRAVENOUS ANTIHYPERTENSIVE MEDS, OSMOTIC AGENTS (MANNITOL) TO DECREASEICP. NEUROSURGICAL CLIPPING AND OTHER APPROACHES.

CNS Neoplasms: Benign vs. Malignant

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  • BRAIN TUMORS REPRESENT 2% OF ALL CANCERS. ONE THIRD ARE MALIGNANT, OF WHICH METASTATIC BRAIN LESIONS ARE THE MOST COMMON
  • CLINICALLY PRESENT WITH LOCAL CNS ABNORMALITIES, INCREASED ICP, INTRACEREBRAL BLEEDING ETC. FAMILIALSYNDROMES: VON-HIPPEL-LANDAU, TUBEROUS SCLEROSIS, TURCOT SYNDROME, NF1 & NF2 INCREASE THE RISK. IN CHILDREN: M/C ASTROCYTOMAS, EPENDYMOMAS, PNETNEOPLASMS (E.G. MEDULLOBLASTOMA) ETC. DX: BASED ON WHO CLASSIFICATION.
  • ADULTS: M/C BENIGN NEOPLASM: MENINGIOMA. M/C PRIMARY: GLIOBLASTOMA MULTIFORME (GBM)METSESPECIALLY FROM LUNG, MELANOMA,�AND BREAST.OTHERS: CNS LYMPHOMA
  • IMAGING IS CRUCIAL: INITIAL SYMPTOMS MAY PRESENT AS SEIZURE, ICP SIGNS HA. EVALUATED BY CT AND MRI WITH IV GADOLINIUM.
  • IMAGING DETERMINES: INTRA-AXIAL VS. EXTRA-AXIALNEOPLASMS. METS FROM PRIMARY BRAIN NEOPLASMS MAYO CCUR VIA CSF AND LOCAL VESSELS INVASION
  • NOTE AXIAL CT SLICE OF MENINGIOMA WITH AVIDCONTRAST ENHANCEMENT.
  • AXIAL MRI ON FLAIR PULSE SEQUENCE REVEALED EXTENSIVE NEOPLASM AND MARKED CYTOTOXIC EDEMA OF THE BRAIN PARENCHYMA CHARACTERISTIC OF GRADE IV GLIOMA (GBM) WITH VERY POOR PROGNOSIS. ABOVE FAR RIGHT IMAGE: AXIAL MRI FLAIR: BRAIN METASTASIS FROM BREAST CANCER. MELANOMA IS COMMONLY METASTASIZESTO THE BRAIN (SEE PATH SPECIMEN) MRI CAN BE DIAGNOSTIC D/T HIGH SIGNAL ON T1 AND CONTRAST ENHANCEMENT.
  • RX: NEUROSURGICAL, RADIATION, CHEMOTHERAPY,�IMMUNOTHERAPY TECHNIQUES ARE EMERGING

Inflammatory CNS Pathology

head trauma imaging el paso tx.

CNS Infections

  • BACTERIAL
  • MYCOBACTERIAL
  • FUNGAL
  • VIRAL
  • PARASITIC
Concussions & Post-Concussion Syndrome

Concussions & Post-Concussion Syndrome

Concussions are traumatic brain injuries that affect brain function. Effects from these injuries are often temporary but can include headaches, problems with concentration, memory, balance and coordination. Concussions are usually caused by a blow to the head or violent shaking of the head and upper body. Some concussions cause loss of consciousness, but most do not. And it is possible to have a concussion and not realize it. Concussions are common in contact sports, such as football. However, most people gain a full recovery after a concussion.

Concussions

Traumatic Brain Injuries (TBI)

  • Most often the result of head trauma
  • Can also happen due to excessive shaking of the head or acceleration/deceleration
  • Mild injuries (mTBI/concussions) are the most common type of brain injury

Glasgow Coma Scale

concussions el paso tx.

Common Causes Of Concussion

  • Motor vehicle collisions
  • Falls
  • Sports injuries
  • Assault
  • Accidental or intentional discharge of weapons
  • Impact with objects

Blog Image Concussion Demonstration e

Prevention

Prevention of concussive injuries can be paramount

Encourage Patients To Wear Helmets
  • Competitive sports, especially boxing, hokey, football and baseball
  • Horseback riding
  • Riding bicycles, motorcycles, ATVs, etc.
  • High elevation activates such as rock climbing, zip lining
  • Skiing, snowboarding
Encourage Patients To Wear Seatbelts
  • Discuss the importance of wearing seatbelts at all times in vehicles with all of your patients
  • Also encourage use of appropriate booster or car seats for children to ensure adequate fit and function of seat belts.
Driving Safely
  • Patients should never drive while under the influence of drugs, including certain medications or alcohol
  • Never text and drive
concussions el paso tx.
Make Spaces Safer For Children
  • Install baby gates and window latches in the home
  • May in areas with shock-absorbing material, such as hardwood mulch or sand
  • Supervise children carefully, especially when they�re near water
Prevent Falls
  • Clearing tripping hazards such as loose rugs, uneven flooring or walkway clutter
  • Using nonslip mats in the bathtub and on shower floors, and installing grab bars next to the toilet, tub and shower
  • Ensure appropriate footwear
  • Installing handrails on both sides of stairways
  • Improving lighting throughout the home
  • Balance training exercises

Balance Training

  • Single leg balance
  • Bosu ball training
  • Core strengthening
  • Brain balancing exercises

Concussion Verbiage

Concussion vs. mTBI (mild traumatic brain injury)

  • mTBI is the term being used more commonly in medical settings, but concussion is a more largely recognized term in the community by sports coaches, etc.
  • The two terms describe the same basic thing, mTBI is a better term to use in your charting

Evaluating Concussion

  • Remember that there does not always have to be loss of consciousness for there to be a concussion
  • Post-Concussion Syndrome can occur without LOC as well
  • Symptoms of concussion may not be immediate and could take days to develop
  • Monitor for 48 post head injury watching for red flags
  • Use Acute concussion evaluation (ACE) form to gather information
  • Order imaging (CT/MRI) as needed if concussion red flags are present

Red Flags

Requires imaging (CT/MRI)

  • Headaches worsening
  • Patient appears drowsy or can�t be awakened
  • Has difficulty recognizing people or places
  • Neck pain
  • Seizure activity
  • Repeated vomiting
  • Increasing confusion or irritability
  • Unusual behavioral change
  • Focal neurologic signs
  • Slurred speech
  • Weakness or numbness in extremities
  • Change in state of consciousness

Common Symptoms Of Concussion

  • Headache or a sensation of pressure in the head
  • Loss of or alteration of consciousness
  • Blurred eyesight or other vision problems, such as dilated or uneven pupils
  • Confusion
  • Dizziness
  • Ringing in the ears
  • Nausea or vomiting
  • Slurred speech
  • Delayed response to questions
  • Memory loss
  • Fatigue
  • Trouble concentrating
  • Continued or persistent memory loss
  • Irritability and other personality changes
  • Sensitivity to light and noise
  • Sleep problems
  • Mood swings, stress, anxiety or depression
  • Disorders of taste and smell
Concussions el paso tx.

Mental/Behavioral Changes

  • Verbal outbursts
  • Physical outbursts
  • Poor judgment
  • Impulsive behavior
  • Negativity
  • Intolerance
  • Apathy
  • Egocentricity
  • Rigidity and inflexibility
  • Risky behavior
  • Lack of empathy
  • Lack of motivation or initiative
  • Depression or anxiety

Symptoms In Children

  • Concussions can present differently in children
  • Excessive crying
  • Loss of appetite
  • Loss of interest in favorite toys or activities
  • Sleep issues
  • Vomiting
  • Irritability
  • Unsteadiness while standing

Amnesia

Memory loss and failure to form new memories

Retrograde Amnesia
  • Inability to remember things that happened before the injury
  • Due to failure in recall
Anterograde Amnesia
  • Inability to remember things that happened after the injury
  • Due to failure to formulate new memories
Even short memory losses can be predictive of outcome
  • Amnesia may be up to 4-10 times more predictive of symptoms and cognitive deficits following concussion than is LOC (less than 1 minute)

Return To Play Progression

WhyMeniscalTearsOccur ElPasoChiropractor
Baseline: No Symptoms
  • As the baseline step of the Return to Play Progression, the athlete needs to have completed physical and cognitive rest and not be experiencing concussion symptoms for a minimum of 48 hours. Keep in mind, the younger the athlete, the more conservative the treatment.
Step 1: Light Aerobic Activity
  • The Goal: Only to increase an athlete�s heart rate.
  • The Time: 5 to 10 minutes.
  • The Activities: Exercise bike, walking, or light jogging.
  • Absolutely no weight lifting, jumping or hard running.
Step 2: Moderate activity
  • The Goal: Limited body and head movement.
  • The Time: Reduced from typical routine.
  • The Activities: Moderate jogging, brief running, moderate-intensity stationary biking, and moderate-intensity weightlifting
Step 3: Heavy, non-contact activity
  • The Goal: More intense but non-contact
  • The Time: Close to typical routine
  • The Activities: Running, high-intensity stationary biking, the player�s regular weightlifting routine, and non- contact sport-specific drills. This stage may add some cognitive component to practice in addition to the aerobic and movement components introduced in Steps 1 and 2.
Step 4: Practice & full contact
  • The Goal: Reintegrate in full contact practice.
Step 5: Competition
  • The Goal: Return to competition.

Microglial Priming

After head trauma microglial cells are primed and can become over active

  • To combat this, you must mediate the inflammation cascade
Prevent repeated head trauma
  • Due to priming of the foam cells, response to follow-up trauma may be far more severe and damaging

What Is Post-Concussion Syndrome (PCS)?

  • Symptoms following head trauma or mild traumatic brain injury, that can last weeks, months or years after injury
  • Symptoms persist longer than expected after initial concussion
  • More common in women and persons of advanced age who suffer head trauma
  • Severity of PCS often does not correlate to severity of head injury

PCS Symptoms

  • Headaches
  • Dizziness
  • Fatigue
  • Irritability
  • Anxiety
  • Insomnia
  • Loss of concentration and memory
  • Ringing in the ears
  • Blurry vision
  • Noise and light sensitivity
  • Rarely, decreases in taste and smell

Concussion Associated Risk Factors

  • Early symptoms of headache after injury
  • Mental changes such as amnesia or fogginess
  • Fatigue
  • Prior history of headaches

Evaluation Of PCS

PCS is a diagnosis of exclusion

  • If patient presents with symptoms after head injury, and other possible causes have been ruled out => PCS
  • Use appropriate testing and imaging studies to rule out other causes of symptoms

Headaches In PCS

Often �tension� type headache

Treat as you would for tension headache
  • Reduce stress
  • Improve stress coping skills
  • MSK treatment of the cervical and thoracic regions
  • Constitutional hydrotherapy
  • Adrenal supportive/adaptogenic herbs
Can be migraine, especially in people who had pre-existing migraine conditions prior to injury
  • Reduce inflammatory load
  • Consider management with supplements and or medications
  • Reduce light and sound exposure if there is sensitivity

Dizziness In PCS

  • After head trauma, always assess for BPPV, as this is the most common type of vertigo after trauma
  • Dix-Hallpike maneuver to diagnose
  • Epley�s maneuver for treatment

Light & Sound Sensitivity

Hypersensitivity to light and sound is common in PCS and typically exacerbates other symptoms such as headache and anxiety
Management of excess mesencephalon stimulation is crucial in such cases
  • Sunglasses
  • Other light blocking glasses
  • Earplugs
  • Cotton in ears

Treatment Of PCS

Manage each symptom individually as you otherwise would

Manage CNS inflammation
  • Curcumin
  • Boswelia
  • Fish oil/Omega-3s � (***after r/o bleed)
Cognitive behavioral therapy
  • Mindfulness & relaxation training
  • Acupuncture
  • Brain balancing physical therapy exercises
  • Refer for psychological evaluation/treatment
  • Refer to mTBI specialist

mTBI Specialists

  • mTBI is difficult to treat and is an entire specialty both in the allopathic and complementary medicine
  • Primary objective is to recognize and refer for appropriate care
  • Pursue training in mTBI or plan to refer to TBI specialists

Sources

  1. �A Head for the Future.� DVBIC, 4 Apr. 2017, dvbic.dcoe.mil/aheadforthefuture.
  2. Alexander G. Reeves, A. & Swenson, R. Disorders of the Nervous System. Dartmouth, 2004.
  3. �Heads Up to Health Care Providers.� Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Feb. 2015, www.cdc.gov/headsup/providers/.
  4. �Post-Concussion Syndrome.� Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 July 2017, www.mayoclinic.org/diseases-conditions/post- concussion-syndrome/symptoms-causes/syc-20353352.
Expectant Mothers Benefit From Chiropractic Care

Expectant Mothers Benefit From Chiropractic Care

Expectant Mothers: Pregnancy is an exciting, precious time in a woman’s life, full of new experiences. Unfortunately, the baby’s development brings about bodily changes that often wreak havoc on the back and joints, and end up causing pain. These issues also frequently cause issues during delivery, and increase the time it takes for the body to recover post-pregnancy.

Expectant moms benefit from chiropractic care in a number of ways. Here are five key ways chiropractic care helps alleviate the toll pregnancy takes on a woman’s body.

#1: Expectant Mothers: Chiropractic Keeps The Spine In Alignment.

Pregnancy adds significant additional weight to a woman’s body in a short amount of time. This change bears on the spine, frequently pulling it out of alignment.

When this happens, the pain can be quite severe. Chiropractic care during pregnancy works to keep the spine in alignment and all supporting tendons working optimally, to be better prepared and able to adequately support the extra weight.

#2: Chiropractic Reduces Need For Pain Relievers.

Most times, individuals experiencing moderate pain pop a couple of over the counter pain relievers and think nothing of it. However, pregnant women strive to avoid medications when possible.

Chiropractic adjustments decrease the underlying issues that cause pain, so the patient relies less on medications. Experiencing less pain as well as eliminating the need for pain killers is a win-win situation for expectant mothers.

expectant#3: Chiropractic Strengthens And Repairs Joints.

Pregnancy really beats up an expectant mothers joints. Chiropractic care for expectant mothers is a productive way to minimize the effect the large, protruding abdomen has on her hips, legs, and ankles.

Treating the body as a whole, chiropractic treatment works to strengthen the body and promotes healing of injured or strained areas.

#4: Chiropractic Helps Achieve Pelvic Alignment.

An aligned pelvis is critical to the birthing process, and increases the chances of being able to give birth naturally. According to the American Pregnancy Association,

“When the pelvis is misaligned it may reduce the amount of room available for the developing baby. This restriction is called intrauterine constraint. A misaligned pelvis may also make it difficult for the baby to get into the best possible position for delivery. This can affect the mother�s ability to have a natural, non-invasive birth.”

An experienced chiropractor can effectively align the pelvis before delivery, so the mother is able to deliver with little incident.

#5: Chiropractic Increases The Body’s Ability To Bounce Back.

Let’s face it, every pregnant woman thinks “will I ever fit in the clingy red dress again?” The healthier and stronger a woman’s body is before and during pregnancy, the easier it is to get back into shape once the baby is born. Eating right and safely exercising are effective ways to accomplish this.

Chiropractic care is also a valuable component to fitness. Expectant mothers who choose chiropractic enjoy better posture, less pain, and increased mobility, especially late in the third trimester.

This allows them to maintain exercise routines and be active longer than those suffering from back pain and achy joints. After the delivery, it’s easier to get back into a fitness routine, and into that red dress, if the new mother’s joints, back, and hips are aligned and functioning properly.

Chiropractic care can serve to reduce pain and increase the overall heath of expectant mothers, letting her relax and focus on the more pleasant aspects of pregnancy. Expecting women who commit to chiropractic care can look forward to a stronger body, the chances of a smoother delivery, and an easier recovery after the baby comes.

Pregnancy & Chiropractic Care

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