Autonomic Dysregulation After a Concussion or Brain Injury

How Brain Injuries Impact Cerebral Blood Flow, Oxygen, the Nervous System, and Long-Term Recovery

When someone suffers a concussion or traumatic brain injury (TBI), the damage isn’t always visible on a scan. But under the surface, complex changes begin to unfold. These changes—often involving the autonomic nervous system, blood flow, oxygen levels, and cellular inflammation—can disrupt normal brain function and lead to lingering symptoms that don’t go away with rest.

At our Kansas City clinic, we specialize in modern, active concussion care that targets these hidden dysfunctions and supports real healing.

The Neurometabolic Cascade: What Happens Immediately After a Concussion

Right after a concussion, the brain undergoes what's known as a neurometabolic cascade—a chain reaction of chemical and cellular events triggered by the injury. This includes:

• A surge in glutamate and calcium levels

• Rapid drops in ATP (brain energy)

• Disrupted ion balance across brain cells

• Increased demand for glucose despite reduced cerebral blood flow

• Release of inflammatory cytokines

This chaotic energy crisis stresses brain cells and impairs their ability to function. Even though the injury might be mild, the cellular disruption is not—and it can take weeks or even months for the brain to rebalance itself.

Leakiness of the Blood-Brain Barrier (BBB)

Another major issue is damage to the blood-brain barrier, the protective lining that controls what enters and exits brain tissue. After a concussion:

• The BBB can become leaky, allowing toxins, immune cells, and inflammatory proteins to enter the brain

• This can trigger a chronic inflammatory state

• It may also sensitize the brain to light, sound, motion, and stress

• And it often worsens autonomic dysregulation, oxygen imbalance, and blood flow instability

A compromised BBB is one of the main drivers of persistent post-concussion symptoms, even when imaging looks normal.

Autonomic Dysregulation and Sympathetic Dominance

When the autonomic nervous system is disrupted, patients can experience:

• Racing heart or lightheadedness

• Shallow, irregular breathing

• Sleep disturbances

• Hormone imbalances

• Chronic fatigue or “brain fog”

• Anxiety, panic-like symptoms, or sensory overload

This is often a result of sympathetic dominance, where the body remains stuck in a chronic stress response.

Why Rest Alone Can Make Things Worse

While rest is important in the first 24–48 hours after injury, extended rest beyond that can delay recovery. Prolonged inactivity reduces blood flow, oxygen delivery, and brain stimulation—all of which are critical for healing.

Modern research now supports active recovery using:

• Light cardiovascular exercise

• Breathing retraining

• Vagus nerve stimulation

• Gradual return to physical and cognitive activity

How EWOT Supports Concussion Recovery

We use Exercise With Oxygen Therapy (EWOT) to safely reintroduce controlled movement while boosting oxygen delivery and flushing out CO₂. EWOT helps:

• Normalize cerebral blood flow

• Restore oxygen balance in healing tissue

• Support autonomic and neurovascular regulation

• Improve HRV, energy, and mood

• Help patients tolerate standing, movement, and light without symptoms

It’s one of the fastest ways to interrupt the stress cycle and help the brain get back on track.

The Power of Breathing Retraining

After a concussion, most people unconsciously begin breathing faster and shallower, especially when feeling anxious or dizzy. This worsens CO₂ retention and activates the stress response.

We teach simple paced breathing exercises (typically 4–6 breaths per minute) that:

• Lower heart rate and blood pressure

• Improve vagal tone and HRV

• Calm the fight-or-flight system

• Enhance cerebral oxygenation

• Support better sleep and emotional regulation

This technique is safe, simple, and one of the most effective tools for healing from the inside out.

Symptoms of Ongoing Dysregulation After Concussion

If you're still struggling with symptoms weeks or months after a concussion, you’re not alone—and there is a reason for it. Common symptoms include:

• Dizziness or lightheadedness

• Headaches or pressure in the head

• Fatigue or feeling “off”

• Sensitivity to light, sound, or motion

• Anxiety or mood swings

• Brain fog or trouble focusing

• Racing heart or chest tightness

These are signs of unresolved neurometabolic, autonomic, and inflammatory dysfunction—not just a minor bump on the head.

Why Choose Dr. Lance Stevenson for Concussion Recovery?

Dr. Lance Stevenson is Kansas City’s trusted expert in concussion care and post-traumatic brain dysfunction. With a focus on restoring brain-body regulation, our clinic provides:

• Comprehensive neuro-autonomic evaluations

• Guided treatment including EWOT, breathing therapy, and HRV-based interventions

• Legal and billing support for personal injury cases

• No out-of-pocket cost if you're under a medical lien

We don’t wait for symptoms to go away. We help your brain recover—step by step.