Concussion treatment in New York

A concussion occurs when a blow to the head is so forceful that it temporarily disturbs the functioning of the brain. Because of this, it’s imperative that a person who believes that he or she has suffered a concussion seek medical care. The doctors at New York Dynamic Neuromuscular Rehabilitation are highly skilled at brain concussion treatment and concussion symptoms treatment. Even if a person has no symptoms, even slight concussion treatment is better than no treatment at all. Slight concussion treatment can be the difference between a return to a normal life or disability or even death. It’s up to a physician to judge the severity of a patient’s concussion or whether he or she is suffering from one. The physician is also the one to tell the patient when he or she can resume normal activities, including sports.

The skull that encases the brain both protects it and can make injuries worse when they do occur. When it’s concussed, the brain bangs up against the hard bone of the skull. Unlike other organs, a brain that’s injured and reacts by swelling as it would in post concussion trauma has nowhere to expand. This is what makes untreated concussions so very dangerous. The risk of this is increased if the victim receives another blow to the head before the first incident can be treated or recovered from.

People who play violent contact sports like football are at risk for concussion, as are people who experience combat. Concussions are also a risk for people who ride bicycles or motorcycles without a helmet. Most concussions are seen in people who are the victims of motor vehicle accidents.

The symptoms of a concussion depend on the severity of the injury. Sometimes there are no symptoms at first, but warning signs concussion can be confusion or drowsiness, nausea and vomiting, blurry vision, pupils of different sizes, either brief or long term unconsciousness, memory problems, personality changes, headache and bleeding in the scalp. Clear fluid leaking from the nose or the ears are sure warning signs concussion. This is an indication that not only has the brain functioning been disturbed but that the skull has been fractured.

If the person is unconscious, a first aider should give them an AVPU evaluation while an ambulance is called. The AVPU checks the person’s level of response. It stands for:

An alert victim will have his or her eyes open and will be able to respond to questions.

Can the victim respond to the first aider’s voice and follow directions?

Does the victim respond to pain?

Is the victim responsive or unresponsive to stimulus?

The first aider should let the medical team know of any change in the victim’s AVPU. The victim shouldn’t be given any drugs until his or her condition is diagnosed.

When the victim reaches the hospital, his or her head will be X-rayed or CT scans will be taken of the head for a diagnosis. There might also be studies of the victim’s blood and cerebrospinal fluid. The patient will need to be put to bed and watched for signs of post concussion trauma like bleeding into the brain. This is called a hematoma. This is when blood starts to flow between the brain and the meninges, a tissue that protects the brain. The outer layer of the meninges is a tough layer that’s called the dura mater. What’s called a subdural hematoma is bleeding between this layer and the brain. Another type of hematoma is an epidural hematoma. This is when the brain bleeds between the meninges and the skull. This is considered a real emergency. It most often occurs after severe blows to the temples. The patient will be unconscious for a while, then wake up only to lapse into unconsciousness again. With an intracerebral hematoma, the blood pools inside the brain and squeezes brain matter against the skull. This can cause a stroke.

The frightening thing about a hematoma is that it can continue to grow even when the bleeding stops because it absorbs bodily fluids. Again, because there’s nowhere for the fluids to go in a closed head injury, they put pressure on the brain. This could lead to the destruction of vital areas of the brain. Another thing about this kind of pressure is that it can develop rapidly or slowly.

The patient needs to be watched in the hospital or at home by the medical staff or a caregiver. Concussion and sleep are connected, and one of the signs that the doctor needs to be alerted right away is if the patient falls asleep and can’t be woken up. Other signs that the patient might be experiencing post traumatic concussion are:

• Vomiting
• Paralysis
• Temperature above 100 degrees F.
• Convulsions
• Stiff Neck
• Very severe headache

Fortunately, many patients who have suffered a brain injury never suffer from post traumatic concussion, or the condition resolves itself.

Here at New York Dynamic Neuromuscular Rehabilitation, we have developed an interesting kind of brain concussion treatment called virtual reality treatment, or VR. This is a type of rehabilitation where the patient’s concussion symptoms treatment is helped in a immersive environment that feels real to the patient.

One type of virtual reality treatment that’s proven to be very effective is called the Computer Assisted Rehabilitation Environment, or C.A.R.E.N. The patient is placed in a room where his movements are evaluated through force plate motion capture technology. In this setting, the patient will feel like he or she is performing certain tasks. Combining different sensory information to produce better motor output the processing routs are reestablished once again and the brain heals by rewiring. Physicians and physical therapists can use the C.A.R.E.N system to evaluate the extent of any physical or cognitive deficits the patient has and design the best program to treat him or her. They can even monitor the patient’s concussion and sleep patterns.

Though New York Dynamic Neuromuscular Rehabilitation is the only private clinic in the country to have this type of technology, it’s been used in military hospitals to treat soldiers suffering from traumatic brain injury. Give us a call today to set up your consultation.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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