Postconcussion Syndrome
(PCS; Persistent PCS)
Definition
Postconcussion syndrome (PCS) refers to continued symptoms of mild traumatic brain injury. Most often it resolves within a month but sometimes the symptoms persist for much longer.
Getting treated early for PCS may help you get better faster. If you think you have PCS, contact your doctor right away.
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Causes
The exact cause of PCS is unknown. Several factors contribute to PCS, including:
- Microscopic brain damage from a mild brain injury
- Psychological or emotional stress that results from a mild brain injury
Risk Factors
These factors increase your chance of developing PCS. Tell your doctor if you have any of these risk factors:
- A mild concussion or brain injury caused by a car accident or assault
- Feeling depressed or being diagnosed with depression after a mild brain injury
- Low social support, including not having a lot of close friends or people to confide in after a mild brain injury
Symptoms
PCS symptoms vary from person-to-person. If you experience any of these symptoms do not assume it is due to PCS. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your doctor. Symptoms include:
- Headache
- Dizziness
- Balance problems
- Nausea
- Vision problems
- Being very sensitive to noise and/or light
- Depression
- Mood swings—a quick change in mood (eg, being happy to becoming very sad)
- Anxiety
- Becoming easily irritated or annoyed for little or no reason
- Trouble remembering things
- Trouble concentrating or paying attention
- Trouble sleeping
- Feeling tired all the time
Diagnosis
PCS is hard to diagnose. The brain damage caused by a mild brain injury is so slight that many tests cannot detect it. It is important to see a doctor with special training in brain injury. These doctors are called neurologists, neuropsychologists, and neurosurgeons. To find one of these doctors, call a local head injury foundation for a referral.
Your doctor will ask questions about:
- Your personal and family medical history
- Your head injury
- Sleep habits
- Recent missed work or school
- Recent memory or relationship problems
- Recent emotional problems, such as irritability, anxiety, and depression
Tests may include:
- Memory and attention tests—to assess your memory and attention abilities
- CT scan —a type of x-ray that uses a computer to make pictures of structures inside the head; to look for signs of persistent injury and/or to see if surgery may improve the symptoms
- MRI scan —a test that uses magnetic waves to make pictures of structures inside the head; to look for signs of persistent injury and/or to see if surgery may improve the symptoms
- Electroencephalogram (EEG)—A test which evaluates the electrical activity of the brain.
Treatment
PCS treatment depends on your symptoms. Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Medications
- Over-the-counter medications to reduce the severity of headaches
- Antidepressants to help reduce depression and anxiety
- Nerve blocks to relieve severe, nerve-injury induced pain/headaches
Psychological Treatment
- Talking with a mental health professional about the problems you are having related to PCS
- Learning how to cope with those problems in your life
Vocational Therapy
- Learning skills and training to start or resume a career
Neurotherapy
Neurotherapy (also called biofeedback) is a painless treatment using computers to help you learn how to modify your brainwaves to improve attention and memory.
Surgery
In some cases, a collection of blood in an area of bruising on the brain may require surgery, which may help resolve or improve symptoms.
Prevention
There are no guidelines for preventing PCS because the cause is not known. To help reduce your chances of getting PCS, take the following steps:
- Prevent brain injury by following the recommendations of the Centers for Disease Control and the Brain Injury Association of America.
- See a doctor who specializes in brain injury as soon as you think you may have PCS.
RESOURCES:
Brain Injury Association of America
National Help Line: 800-444-6443
http://www.biausa.org/
US Centers for Disease Control
http://www.cdc.gov/index.htm/
CANADIAN RESOURCES:
Canadian Psychiatric Association
http://www.cpa-apc.org/
Ontario Brain Injury Association
http://www.obia.on.ca/
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Last reviewed September 2012 by Rimas Lukas, MD
Last Updated: 09/26/2012