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Tipping the scale: Enhancing Neurological Recovery in TBI through Osteopathic Principles

Journal: The AAO Journal Date: 2025/09, 35(3):Pages: 6. doi: Subito , type of study: case report

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/3/article-p6.xml)

Keywords:

alcohol use disorder [1]
case report [725]
drugs [33]
geriatrics [128]
male [830]
OMT [3795]
osteopathic manipulative treatment [3816]
schizophrenia [4]
TBI [5]
traumatic brain injury [20]

Abstract:

Background: Traumatic brain injury (TBI) is a leading cause of disability and death, with outcomes worsened by comorbidities like alcohol use disorder and schizophrenia. These conditions increase cerebrovascular fragility, elevating the risk for intracranial hemorrhage (ICH). Osteopathic Manipulative Treatment (OMT) has shown promise in safely enhancing recovery by addressing structural dysfunction and supporting physiological processes [5]. This case explores integrating OMT in managing a critically ill TBI patient with multiple risk factors. Case: A 65-year-old male with alcohol use disorder and schizophrenia sustained left-sided subarachnoid and subdural hemorrhages following an assault. He developed a midbrain hemorrhage during hospitalization, requiring intubation and surgical intensive care unit (SICU) admission. The patient presented with somatic dysfunctions, including left temporal strain, a posterior sacral base, and thoracic outlet congestion. Five OMT sessions, incorporating cranial osteopathy and balanced ligamentous tension, were performed to support physiological recovery. Results: Following OMT, the patient demonstrated significant neurological improvement, progressing from an ICH score of 4 (97% mortality risk) to successful downgrading from the SICU with a GCS of 15. Improvements in venous and lymphatic drainage, autonomic regulation, and respiratory mechanics were noted, aligning with osteopathic principles. Discussion: This case highlights OMT’s role as a safe adjunctive therapy in acute TBI management. Techniques targeting cranial and sacral dysfunctions supported recovery by optimizing venous outflow, reducing intracranial pressure, and balancing autonomic tone. Further research is needed to validate these findings in larger cohorts.


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