S6E16 - Is Your Neck the Missing Link to Brain Fog and Headaches?

What if those lingering headaches, brain fog, or “post-concussion” symptoms weren’t coming from your brain at all—but from your neck? In this episode, Dr. Blaskovich (“Dr. B”), a board-certified chiropractor specializing in head and neck injuries, shares how overlooked upper cervical ligament damage can mimic brain injuries and cause long-term symptoms. From sports concussions to car accidents, whiplash to chronic pain, Dr. B explains why so many people struggle without answers—and what treatment options really exist.

If you’ve ever wondered whether your symptoms might be rooted in something doctors missed, this episode is a must-listen.

Listen now, hit follow, and share this episode with someone who needs to hear it!

Guest Social Media info -
https://www.instagram.com/dr.blaskovich/
https://www.youtube.com/@dr.bsinjuryresources
linkedin.com/in/sasha-blaskovich-18790220

Transcript

Co-Hosts: 0:10

Hi, I am Carrie, a stroke survivor, and a member of BIND. Hi. And I'm Brittany. I'm a brain injury survivor and a member of BIND Today. Our guest today is Dr Sasha Blaskovich or Dr B as many patients like to say. Um, is a board certified chiropractic doctor who specializes in assessing and treating head and neck injuries. After playing football for over a decade and working with injured patients for over 20 years, Dr. Blaskovich has devoted his career to helping people going through similar problems as he has gone through with his head and neck and has focused his continued education and injuries for more than 20 years.

Bernard: 0:55

Opinions shared by the guests of the show are their own and do not necessarily represent the views of the hosts bindwaves or the Brain Injury Network. This podcast is for informational purposes only, and it's not a substitute for professional medical advice, the diagnosis or treatment. Always seek the advice of a healthcare provider with any questions you may have regarding a medical condition.

Speaker 2: 1:19

Thank you.

Co-Hosts: 1:22

So to get us started, tell us a little bit about yourself and how you became interested in being a chiropractor and what inspired you to join this field?

Dr. B: 1:32

Well, initially the reason I wanted to become a chiropractor was because of a hip issue I was having as a 12-year-old or 9-year-old playing soccer for several years. Where my leg would go numb when I would, um, run around. But other than that, I was the strongest, tallest kid on the team. But it was just that pounding that would just shut something down where my leg would go numb. And so it was a chiropractor back at that time that my dad was seeing for a herniated disc, um, who. Offered to have a look at me,'cause my dad was telling him about me. And uh, he basically said, uh, you know, you've got a 19 millimeter leg length difference. Your spine is out and I need to do a few adjustments, give you a heel lift. And at that point in time I was going to. From doctor to doctor for about two years, all telling my parents that I wasn't strong enough and my body just wasn't able to handle sports and I should stop playing sports. And then this chiropractor literally fixed me in a span of six weeks with a heel lift and a few adjustments. And I was sold. I wanted to do what he did. Um, he was excited about what he did. He loved talking about his patient success stories. Um, it was just, it was super exciting. And then I had decided at the age of 12 I wanted to be a chiropractor, not knowing that the reason I would be, or the, the way I would be practicing chiropractic would've nothing to do with, you know, hips and leg length differences, but with, excuse me, misdiagnosed concussions. Um, or, or misdiagnosed, uh, upper cervical ligament injuries masquerading as concussion diagnoses. And so that's what brings us to today is basically, you know, I devoted my career. After finally figuring out what was wrong with me after a football injury in university, which I never would've been playing. Um, had my parents listen to these doctors telling them that I shouldn't play sports anymore. So maybe they should have listened. But, um, anyways, the chiropractor did, um, fix me from that and, and, and got me in direction where I wanted to do what he did. Um, only lo and behold to, you know, finish chiropractic school, um, several years after this injury and, and have the, the knowledge the. The basis and the ability to go and learn, um, things about this problem that I have, that the average person in the public wouldn't know where to start. Uh, and the average doctor in society doesn't, can't be bothered trying to learn about it because they're busy enough and focused enough on what they're doing. Uh, assuming that this is such a rare and obscure thing that I had. Uh, well, it turns out that it's actually extremely common to some varying degree of severity, uh, where the person has injuries or an injury that. Results in damaged ligaments in the upper cervical spine or upper neck, rendering that region to mobile, whether it's hypermobile or unstable, both are different variations of too much mobility. And that excessive mobility then puts pressure repeatedly on the brainstem causing someone like myself or other people. And again, it's very, very common to have some level of concussive like symptoms persistently for either many years or the rest of their life. That go undiagnosed and, and sometimes it's progressive. And oftentimes these patients, uh, find me either by word of mouth or online support groups or what have you. Um, and lo and behold, they have very similar injuries to what I had or what I still have. Uh, that we're undiagnosed and, and the diagnosis helps them gain direction and gain a sort of a, a, a sense of purpose and path to, to getting some benefit or some improvement to this, uh, you know, so-called lifelong sentence.

Co-Hosts: 5:12

Okay, so now I'm gonna ask you a que, this isn't exactly the question I had. We're gonna, I'm gonna come back to that one. But, I mean, we're brain injured. I mean, I was a stroke survivor, so obviously I didn't have. Anything to do with that kinda stuff. I see a chiropractor for other issues. Um, but yeah, but so you're not saying that necessarily, like the issues that you're talking about, like you had, that wasn't caused from a brain injury or was it caused from concussions that were just undiagnosed? I guess that's what I'm trying to understand

Dr. B: 5:44

That's a, yeah, that's a very deep question because ultimately, and, and the, the, you know, I've, I've talked about this on many podcasts, how the upper cervical instability, which then results in, you know, repeated malpositioning of the bones. Um, and, and it's, and it's, um, persistent. Causing basically in a really simplified fashion, the drainage tube that's inside the spinal cord and brainstem to be slightly kinked. And when that brainstem drainage portion gets slightly kinked, the amount of fluid that the brain is making, which has to equal the amount that is draining through that upper neck, is no longer equal. So there's less draining at, at a, in a, in a tiny fraction then that's being produced. So every time that there's a, a, a drainage. Moment, there's a little bit that back pools. And so that little bit, that back pools then stays stuck inside the brain and inside the skull eventually causing a mild expansion, if you will, of that fluid cavern where it's being produced. And then that does compress brain tissue resulting in brain related symptoms. But the true origin of that expanding pressure, and it's not always, it's not a constant thing. It flues with relation to the. Unstable positioning of that upper neck, then the per person gets diagnosed with a brain related, um, problem. But the actual origin of that distension or that pressure increase isn't actually coming from the brain. It's coming because of the upper neck, having that glitch, reducing the amount of drainage. That then causes back pooling, and then you get brain compression, mild compression, and it can cause, you know, tons of things like visual changes, uh, cognition, uh, memory loss, brain fog, and just a constant pressure inside the brain, just like feeling like you're constantly having a mild flu. And those are sort of the simplest, uh, symptoms that people generally will portray having that, and unfortunately when you, when the the MRI is done over their brain, there isn't a massive or a gross amount of fluid accumulation that is perceived by the radiologist. So it gets d uh, reported on as normal or unremarkable. But when you've seen thousands of these scans, you can see what a person's scan looks like of the brain where they don't have that accumulation. And then you can also see the subtle difference with somebody who does have that mild accumulation, which likely has bearing on their symptoms. But you know, when I discuss that with radiologists or neurologists or neurosurgeons, in their opinion, these are normal variants and, and non-entities for that person. But I humbly disagree with that.

Co-Hosts: 8:22

Sure. Yeah, that kind of makes sense. So, yeah. Um. Happened to me. So, yeah, because my, my brain injury was from a car accident and so I broke, like my airbags didn't employed, and then I broke my seat with my head and I blacked out. So it was like a really hard, and then I went to my neurologist and he's like, okay, go home, turn off the lights. So I did, I went back to school, which was two hour drive. So, um, but at the hospital after accident they're like, oh, you have her 80 this and your C four C five. And so. Then later it was like post concussion. So mine was a cat and mouse game, but I still have problems like my hands go numb each time, and then I get cricks in my neck all the time. But yeah.

Dr. B: 9:05

Yeah. So, and then, so the mid neck is always the whiplash component that is recognized, I guess. Whereas when you get to the upper neck, the, the momentum of the 12 pound head, you know, being decelerating or accelerated, having, having to be somehow decelerating or slowed down by something. And when the, you know, event happens that a person, for example, isn't braced for. Then this 12 pound head has so much momentum that can only be slowed down because there's no bracing or no guarding, muscular guarding by ligaments. And those ligaments will fail to some degree, whether they fully tear or they just stretch a bunch of fibers. No matter how you dice it or slice it, you end up with too much mobility after that. And that too much mobility isn't actually a good thing. So this whole notion that a, a person has a great range of motion, uh, that might sometimes be pathologic.

Co-Hosts: 9:57

Interesting. So, um, other than like automobiles, else caused whiplash?

Dr. B: 10:08

Sorry, say that.

Co-Hosts: 10:10

Um, so what, uh, what other causes of whiplash instead of automobiles, like is there any other causes that

Dr. B: 10:16

Oh, absolutely. Yeah. Bar fights, slip and falls skiing, horseback riding, um, soccer, uh, any kind of contact sport. So football is probably one of the most common ones. And then, you know, soccer probably follows that in hockey, ice hockey. So there's no shortage of, um, you know, examples I guess in the, in the professional leagues of, uh, people getting quote unquote concussed. But when you look at the game footage or the film footage of that, you know, moment where they got. So-called, you know, their head bashed. There's a lot of cases where there isn't a massive head impact, but there is impact that causes a, a forceful rotation of the neck. And so that, you know, rotation component is what damages these upper neck ligaments.'cause the main rot amount of rotation in the head or the neck, sorry, comes between C one and C two, the top two bones. And so when you have a forceful rotation of that area, you will have a predisposition to damaging ligaments. Which then puts you into the same cascade, like I explained, uh, of re repeated and persistent misalignment causing sort of the drainage channel to be reduced, somewhat, causing the back backflow into the brain, causing then the brain-like symptoms, which, you know, we get labeled with, you know, post-concussive syndrome.

Co-Hosts: 11:30

Sure. So when you just said that in my brain, I'm a, I'm a hockey fan, so, um, in my brain I'm thinking in hockey fights or like boxing. That moment you see the, you see the lights go out in that person. And you're like, oh, he was knocked out. You like, you know, he's knocked out. That's that moment of whiplash. I mean, maybe, maybe, can you, we all think we know what Whiplash is. Maybe give us the textbook definition of whiplash

Dr. B: 11:58

Well, whiplash. Whiplash. Yeah. So whiplash is a mechanism of motion. It's not an actual injury. So to diagnose somebody with a whiplash injury, it, it's technically incorrect. So whiplash is an acceleration, deceleration phenomenon that, um, is, is the motions that the head and neck go through. So that's, that's what whiplash actually is. And then the true diagnosis, if you were to really dissect it. Uh, medically and scientifically would be, you know, the person sustained a whiplash event and they sustained then, uh, either grade one, grade two, grade three sprains of whatever ligament you can. Uh. Properly name or whatever ligaments you can properly name. And in order to name those ligaments, you have to do motion x-ray or video fluoroscopy, x-ray of the person's neck in motion so that you can see which segments, for example, you know, are sliding in inappropriately or gapping inappropriately compared to their neighbors. And then by measuring those amounts, you can determine then that. You know, the degree of severity of the, of the damage to the ligament, but more importantly that the ligament is compromised because it's supposed to restrict that motion. And if you see an excess motion, then you can say this person had a whiplash and they sustained a C four five anterior longitudinal ligament spraying grade two. And so what that means is that person is gonna have too much movement at C four five in the backwards plane. They might have it in the forwards with the posterior longitudinal ligament as well, in which case you can almost guarantee, or you can guarantee that within 7, 10, 12, 15 years, that person will have degenerative arthritis at C four five and so C four five, C five six probably in the reverse order. So five, six, and then four five are by and far the most common areas in the cervical spine where you see degenerative changes in the average person. In addition to the fact that their normal curvature, which is supposed to be concave in the back, is either straightened or reversed. And then that causes a abnormal mechanics in that region of the spine. Plus to add fuel to the fire, you have excessive motion, excessive friction, and excessive wearing down or breaking down of the disc or the cartilage in between. And then, like I said, 7, 10, 12 years later, you do an x-ray and you're like, oh, this the person has degenerative arthritis. Well, I've even seen that degenerative arthritis in somebody who's 23 years old who sustained one of these injuries when they were 12.

Co-Hosts: 14:29

Sure.

Dr. B: 14:29

A 23-year-old shouldn't have degenerative arthritis at C five six. That's something you technically expect to see in somebody who's 55, 65, 70 years old due to normal wear and tear, which I don't believe exists. But seeing it in somebody young and then listening to their history or or dissecting their history, there is an event that led to that. Like I said, it takes, you know, 7, 10, 12, 15 years to finally develop into degenerative arthritis, which is visible in an x-ray, but it absolutely is linked to that event.

Co-Hosts: 15:00

Okay. And, um, that all makes sense. So, but just because you have one of these cervical spine injuries or, or even a whiplash. Event we'll just say, um, doesn't necessarily, I mean, I am, you know, I'm not a doctor. I just pretend to know what I'm saying.

Dr. B: 15:19

Uh.

Co-Hosts: 15:20

I know. No, no, you haven't. It, it's good. That's the whole point. We do This is so that we can better understand, but you can have this cervical damage that doesn't necessarily mean you ended up with a brain injury. I mean, now we know, we do know concussion equals brain injury or some, most likely, some level

Dr. B: 15:38

It, it influences the brain. Yeah, so I think a, a, a strong delineation between a true brain injury, which you can actually then see on scans, and there are scans that can highlight or, or make hotspots on, on the brain tissue to say that there's a metabolic change and therefore the brain was injured. But when that's all done and you don't see anything, then the influence that is being perceived as brain-like related. Has to be coming from somewhere else. And so this subtle accumulation of increased fluid causing increased intracranial pressure, um, resulting in compressive forces on brain tissue and neurons, which will then start either glitching or hyper firing or doing something that they're not supposed to is happening. So it's not directly a brain injury, but it's an injury to that region that has an influence or an impact on the brain Mechanically.

Co-Hosts: 16:27

Okay, and

Dr. B: 16:28

And I do believe long term with people that are like that or that have that scenario, and again, depending on the severity of that scenario, likely leads to some form of chronic prog, chronic degenerative disorder that we've given names to, such as dementia, Alzheimer's, A LS, ms, Parkinson's. I believe those are all somehow directly linked to this phenomenon long term. So if someone's had this for decades and it's been undiagnosed. And potentially they've been doing all the wrong treatments for it, sort of perpetuating the instability, if you will. Um, they're predisposed to, uh, acquiring one of those conditions later on.

Co-Hosts: 17:07

Okay. All right.

Brittany: 17:09

So we also talked about like the conditions and your brain being heard also cause brain fog. So how does the cervical spine play a role the occurrence of brain fog? like headaches and dizziness, and what exactly is brain fog?

Dr. B: 17:25

I think brain fog is just a term that people have given to just not feeling clear in their decision making, in their perceiving, in their vision, in their hearing, uh, just in how they feel balance and coordination wise. That there's just something that's sluggish and not sort of clear and, and firing on all cylinders, uh, as, as they perceive that it should or as they recall that it used to before they had these injuries. Where they could just, you know, without any effort, have things fall into place and be able to multitask and be able to concentrate on a task and be able to, you know, be distracted from that task and then quickly get back to it and not, you know, lose their train of thought. Um, those are basically sort of the phenomena that would be diagnosed or defined by people as brain fog, um, and the cervical spine. So that back pooling literally. I tie back to that would be probably the main caus ator. And then when you talk about headaches, that increased pressure is a version or a a, a means by which the increased pressure can be perceived as pain by somebody. So AKA headache, but more importantly, the little intrinsic muscles or the deepest muscles in the upper neck. That would be trying to then stabilize the unstable upper spine when the ligaments have been damaged. So they all have an intricate connection to the brainstem and brain coverings. The spinal cord coverings called the dura matter, so that's the outermost covering of the spinal cord, brainstem and brain. And these muscles actually have myo dural bridges, which are basically muscle to dura connections that are intended to actually be there to make sure that the dura never folds back in against the brainstem or spinal cord. But it's always kept. It's clear of contacting the brainstem and spinal cord, excuse me. But when these muscles get really, really tight while they're trying to fight and hold, uh, this instability together, those, uh, myo dural bridges get more tension put on them. So you'll get a dural headache. Because of the Myo Duro bridge being hypertense. And then by releasing the muscles with just acupressure, you can release the tension on the muscle. Release the tension on the Myo Duro bridge. Release the tension on the dura, and reduce the headache. And the key feature or factor there is when you're pressing on those muscles, they should trigger a referral into the headache spot. Like say a person's feeling, a forehead, headache, or headache behind their eyes, or a temple headache. When you press on these muscles up here, there will likely be a trigger point referral, either going to the forehead, going in the behind the eyes, or to the temple actually making that headache that they're already perceiving feel worse. And when you then release that muscle. That trigger point and it eases off. Then the actual background headache is less so they will actually have a reduction in the headache. But initially to treat it, you find the trigger point in the neck that refers to their headache spot and you pulverize it basically causing during the treatment sort of an accentuation of the headache. But then after you're done, the baseline headache will drop.

Co-Hosts: 20:31

Okay.

Dr. B: 20:31

probably the most common, whether we call that a muscle tension headache or a cervicogenic headache or a, or a dural headache. Um, they all are basically one in the same and they all also resemble migraines with, you know, flashes before your eyes, dark spots. So people often get diagnosed with migraines and all sorts of migraine type protocols are, you know, initiated sometimes with success. But I would say more often than not, with no success. And that's because they're treating they're, it's not a vascular headache. It's an actual mechanical muscle and MyoD dural bridge and dural headache.

Carrie: 21:04

Okay, so what, what would you say maybe are like some more common symptoms for someone to look at? Because like we know if you get a splitting headache like you've never gotten before, that about to come to end. That it could very well be an aneurysm about to burst and it's get to the hospital, you know, oh, I just have, I have constant headaches or. maybe is that one symptom that you would say, okay, this is where you need to say, I need to maybe take a different look and see if it's something with my alignment as opposed to. You know, I've been there, I've gotten an MR. I am not, I don't have an aneurysm, I don't have this, but in migraines, you know, it's not really a migraine, but it's definitely kind of concerning. I keep having a headache.

Dr. B: 21:49

Yep.

Co-Hosts: 21:50

kind of symptoms would you look for or say, or you would know to go, okay, maybe I should go ask a chiropractor about this?

Dr. B: 21:57

Yeah, and I would say not every chiropractor is proficient in this. Um, I would seek out a upper cervical chiropractor personally, uh, who focuses on the Atlas region, um, but just headaches alone. Are rare in this patient demographic. So maybe with a, a brain injury, it is just a headache. But the patients that I see in myself included the, the flux of symptoms usually includes either blurry vision, double vision, ringing in the ears, fullness in the ears, uh, like a constant sinus pressure or postnasal drip, sorry, hoarseness of the voice. Um, heart palpitations, like the, basically the heart racing, breathing difficulties, urinary urgency, constipation, diarrhea, uh, balancing, coordination issues, fine motor, like they feel like they're kind of vibrating a little bit. So those are all brainstem related components that if a person is experiencing those. Not just a headache but a headache as well potentially. Then the likelihood that the upper neck is involved in everything that they're experiencing is really high. Really, really high. And then, like I said, seeking out an upper cervical chiropractor who can possibly triangulate by x-ray to say, okay, you're C1 one is malpositioned in so many degrees tilt and so many degrees rotation, and we're gonna make an attempt at aligning that, um, is absolutely, you know A very critical thing to try. And in the cases where a patient has done that and repeatedly that is done and potentially gives them some short-lived benefit, but very quickly recurs, in which case, you know, the chiropractor would say this, you know, your adjustments are not holding. Then my suspicion would strongly rise to say, okay, there's possibly ligament damage up there, which would be a, a logical reason as to why it's not holding, and that, that that person should then logically undergo a motion x-ray to see if they indeed do have an unstable upper cervical spine, which will then explain everything. And there are very few motion x-rays out there to diagnose this, but it is the gold standard for diagnosing excess motion in the cervical spine

Brittany: 24:15

Okay. So what form of treatment, um, have you pursued?

Dr. B: 24:20

Myself?

Brittany: 24:22

Um, just in general for the symptoms that you see in patients

Dr. B: 24:26

like for the, for the upper cervical instability?

Co-Hosts: 24:29

Yes. Mm-hmm.

Dr. B: 24:30

Yeah, so there are are three basic sort of categories, least invasive to most invasive. So the least invasive would be basically the, the ischemic compression or the acupressure or the sustained pressure on the selective muscles in the upper cervical spine, and sometimes the jaw or the, the chewing muscles or the, the, the clenching muscles. And then if, and that's basically gonna give a temporary reset to those muscles and make them functional for a period of time, they will tighten up again because the actual, they're not the problem, they're responding to the problem.'cause the problem is damaged ligaments resulting in excessive movement of the bones, which those muscles then try to mitigate. So releasing those muscles repeatedly, which is basically what I've been doing for the last 24 years, is very effective. But the, the repeated repetitive nature of having to do that is not something that everybody is willing to grasp or accept. And so the next step beyond that would be some kind of a regenerative therapy, which would be interventional medicine. So either platelet rich plasma or stem cell injections, which then always require the motion X-ray as evidentiary diagnostic modality to show where there is excessive motion so that the doctors that inject the platelet rich plasma or the stem cells know exactly where to go, so they're not blindly just doing it everywhere and hoping for the best. And then if that is not successful enough for the individual who's dealing with these problems, then the last ditch effort is basically fusion surgery. Where the C one and C two are basically, excuse me, fused together surgically, in which case the instability becomes completely immobile, which means there's no longer any brain stem irritation by C one and C two. And I guess there is a fourth option is just to, you know. Learn to live with it and, and, and accept the fact that you're gonna repeatedly have that, which is unfortunately what most people, uh, are in, who eventually discover then this, this acupressure or the stem cells and PRP or the surgical options. But sometimes they're searching for, you know, decades before they get to that point. And thankfully with the internet, people are in chat groups and support groups where they're exposed to these, these concepts. And I think that expedites their, you know, getting to that point much faster than hoping that their medical doctors. Or neurologists or whatever doctor they're seeing is gonna guide them in that direction'cause they won't.

Carrie: 26:51

No, I think that's great. I'm so glad that we had you on today, Dr. B, because this, I mean, again, like you said, this is not the normal information that people seek out when they go to a chiropractor, but it definitely makes lot of sense to me what you're saying. And so I'm glad that we had you on we appreciate you taking the time out and hope you have a safe drive the rest of the way to Seattle today. Thanks for coming on. Appreciate it.

Brittany: 27:15

Until next time. Until next time.

Rick: 27:19

We hope you've enjoyed listening to bindwaves and continue to support Brain Injury Network in our nonprofit mission, we support brain injury survivors as they reconnect into life, the community, and the workplace. And we couldn't do that without great listeners like you. We appreciate each and every one of you. Please remember to click the like button, the share button, and the subscribe button on YouTube. And follow us on Instagram@bindwaves and Brain Injury Network on Facebook. You can email us at bindwaves@thebind.org or go to our website bindwaves.org or call us at(972) 769-2463. Please continue watching. Until next time.