Concussions or TBIs (traumatic brain injuries) either happen accidentally, following a fall or other accident, in contact sports (activities such as boxing or football are especially high risk), or in cases where the patient has been the victim of violent assault.
In many cases, people who have experienced concussion recover quickly, but in some cases, symptoms typically associated with concussion (such as headaches, fatigue and dizziness) may continue well after the expected recovery time. This is referred to as post concussion syndrome, or PCS.
Diagnosing Post Concussion Syndrome
While it remains unclear as to why some people experience this more than others, the risk may be higher in young people, those with a history of headaches, women and people aged over 40. Some experts also believe pre-existing psychiatric conditions may also be also a risk factor.
Symptoms can start to appear within days of the initial injury, although it can sometimes take weeks before they begin, and PCS may be worse in those who experience headaches or mental changes such as mental fogginess, memory loss or fatigue soon after the injury.
There’s no specific way to diagnose PCS, and symptoms can vary depending on the person. Several symptoms of PCS also look similar to conditions such as anxiety, depression or PTSD, so it’s important to have a clear diagnosis. As part of this process, a doctor typically looks for symptoms such as:
- Increased sensitivity to light or noise
- Mood or personality changes
- Changes to smell or taste
- Disordered sleep or insomnia
- Vertigo or dizziness
- Problems with concentration
- Slow reaction times
- Reduced libido
- Hearing loss or tinnitus
- Difficulties with memory
- Difficulties learning new information
In addition to an assessment, a doctor may also ask for a CT (computerized tomography) or MRI (magnetic resonance imaging) scan to check for any structural abnormalities in the brain. If dizziness is one of the symptoms, they may also refer the patient to an ear, nose and throat specialist.
Recovery and Treatment
It is possible to recover from PCS, although timeframes for recovery vary. Typically the condition subsides within around three months, although in some cases it has been known to linger for a year or more. This is known as “persistent post concussive syndrome”.
While there is no one definitive treatment for PCS, anti-anxiety or antidepressant medication may be prescribed to help with any mood changes, ideally in conjunction with a form of therapy such as counseling.
Pain relief medication can also be used to help with headaches or migraines, although it should be noted that extensive use of over-the-counter and prescription pain relief medication may worsen PCS symptoms.
It’s generally advised to rest following a head injury, but (as advised by a trained clinician) to try and resume normal activities as soon as it’s safe to do so. Rushing into physical activity too soon may increase the risk of another head injury: this is known as SIS, or second impact syndrome.
In addition to engaging in basic self care (good quality sleep, stress reduction and avoiding alcohol or recreational drugs), reassurance from a healthcare professional is also beneficial, as learning more about the condition and developing strategies to aid recovery can help to alleviate any concerns or or doubts surrounding their long term recovery.