Concussions are the most common type of traumatic head injury (TBI) and they possess varying degrees of severity and side-effects. Concussions result from a non-penetrating blow or impact to the skull. The brain can collide with the inside surface of the skull. Concussions may be mild, moderate, or severe, generally depending on the symptoms.
What is Post-Concussive Syndrome?
Post-concussive syndrome (PCS) is a disorder in which a combination of varying symptoms (such as dizziness or headaches) persists for days or even months beyond the initial injury. The terms post-concussive and post-concussion are technically the same and are used interchangeably.
Simply put, PCS is generally the designation medical professionals give to post concussion symptoms that last beyond the initial week following injury. Not all people who experience a concussion will suffer from post-concussion syndrome.
Recognizing Post-Concussive Syndrome
PCS is a generalized condition and is experienced differently from patient to patient. Studies have revealed that patients who have a previous history of head trauma, young patients (children), or those with a known history of headaches/migraines are more susceptible to PCS. Symptoms are sometimes recognized lasting for at least 3 months’ duration, with the onset typically appearing within the first week. In comparison, persistent post-concussive syndrome (PPCS) is generally associated with symptoms lasting beyond 6 months, though some researchers define PPCS with symptoms exceeding 3 months.
In most patients who do exhibit PCS symptoms, effects begin within the first seven to 10 days and fade away within six to nine weeks, though there have been cases of symptoms persisting for three to six months. In a few rare instances, PCS symptoms did not dissipate until 11 to 12 months had elapsed.
No universally accepted definition of post-concussive syndrome exists, but most medical professionals define the syndrome as the development of three or more of the following symptoms:
- Headache
- Dizziness
- Fatigue
- Irritability
- Impaired memory
- Concentration
- Insomnia
- Lowered tolerance to noise and light
Diagnosing post-concussion syndrome is difficult, as there is no definitive test for the condition. Diagnosis is based on the patient’s history of previous head injuries along with persistent symptoms lasting longer than 2 weeks. A doctor will typically conduct a physical exam and a neurological exam, and may also order an imaging test such as a CT scan or MRI to rule out other causes of symptoms such as infection, poisoning, or bleeding in the brain.
Treating Post-Concussive Syndrome
PCS symptoms are often severe enough to interfere with work, especially in jobs requiring hours of computer screen time or jobs in loud environments with heavy machinery.
A treating physician or neurologist may also prescribe migraine or pain medications, as well as treating psychological symptoms using a combination of antidepressants and psychotherapy. Symptoms do usually fade with time, but the patient must take steps to aid his/her own recovery by actively reducing the stress and noise from his/her daily environment. Time must be dedicated to resting, sleeping, and avoiding “busy” settings. Patients should also avoid extensive screen time with computers or watching TV until their symptoms subside. Patients with a history of traumatic brain injury are more susceptible to PCS, so even a recurrence of a mild concussion could trigger a period of stronger, persistent symptoms.
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