a.  20 year old right handed female that sustained multiple concussions from soccer injuries during her college training.

b.  Brain MRI was unremarkable.

c.  Clinical problems have included the following;
    1. somatic; neck and head pain, fatigue
        and dizziness
    2. cognitive; decrease in mental stamina with
        studying, reading, etc.
    3. emotional; exacerbation of obsessive
         compulsive disorder and depression

d.  No litigation is involved.

e.  SPECT imaging was done at rest, with concentration and follow-up after treatment. A pattern of decreased perfusion in the Parietal region was seen in all studies.

1. The concentration study demonstrated a very significant decrease in the right dorsal Frontal and Parietal cortex extending across the midline, a decrease in the Basal Ganglia and Thalamus.

2. The resting study showed a focal decrease in the right Parietal region only and focal increase in the Thalamus. The follow-up study done at rest six months later revealed a similar pattern that extended to the inferior Frontal pole.

f. Treatment has included Osteopathic Cranial Sacral manipulation of the neck, prolotherapy of the cervical ligaments to reduce the head and neck pain, abstinence from competitive soccer with transitioning into Tennis. Medication treatment has included Fluoxitine, anxiolytic and antipsychotic class of medication. Individual psychotherapy has resulted in successful academic performance and elimination of all medication except Fluoxitine.