Definition

A concussion is an injury to the brain. It causes problems with how it works. It can make memory, balance, thinking, and coordination hard. Post-concussion syndrome (PCS) is when it lasts longer than six months.

The Brain
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Causes

The cause of PCS is not known. A brain injury may cause a brief change in how brain cells work. This change can get in the way of using the mind and body to do tasks.

Risk Factors

PCS is more common in women. It is also more common in older adults.

Other things that may raise the risk are:

  • A prior concussion
  • Abusing drugs or alcohol
  • Prior anxiety or physical problems
  • Loss of consciousness during the event
  • Loss of memory of the event

Anxiety, trouble with thinking, and noise sensitivity that lasts a few days after the injury may also raise the risk.

Symptoms

Not everyone with PCS feels the same. A person may have:

  • Lightheadedness
  • Lack of energy
  • Headache
  • Sleeping problems
  • Lack of interest in activities that were once enjoyed
  • Feelings of despair
  • Irritability
  • Personality changes
  • A sensitivity to noise and light
  • Problems with focus

PCS may affect daily tasks, social life, and work.

Diagnosis

The doctor will ask about your symptoms, health history, and activity levels. You will also be asked about your health before you got hurt. Questionnaires and neurological and mental tests may be done. This is often enough to make the diagnosis.

Treatment

The goal of treatment is to manage symptoms until they pass. Options are:

  • Waiting to resume normal activities by resting the body and mind
  • Avoiding things that may jostle the brain, such as sports and roller coasters
  • Medicines, such as:
    • Over the counter or prescription pain relievers
    • Antidepressants to ease depression, anxiety, sleep problems, mood changes, or lack of energy
    • Sleep medicine
  • Counseling to help manage emotions
  • Rehabilitation to help learn new ways to do tasks

Prevention

PCS cannot be prevented.

RESOURCES:

Brain Injury Association of America
http://www.biausa.org

Centers for Disease Control and Prevention
http://www.cdc.gov

CANADIAN RESOURCES:

Canadian Psychiatric Association
http://www.cpa-apc.org

Ontario Brain Injury Association
http://www.obia.ca

REFERENCES:

Broshek DK, De Marco AP, et al. A review of post-concussion syndrome and psychological factors associated with concussion. Brain Inj. 2015;29(2):228-237.

Concussion and mild traumatic brain injury. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/concussion-and-mild-traumatic-brain-injury. Accessed October 7, 2020.

Ellenborgen RG, Batjer H, et al. National Football League Head, Neck and Spine Committee’s Concussion Diagnosis and Management Protocol: 2017-2018 season. Br J Sport Med. 2018; pii: bjsports-2018-099203.

Management of Concussion/Mild Traumatic Brain Injury Working Group. Veterans Affairs/Department of Defense clinical practice guideline for management of concussion/mild traumatic brain injury. VA/DoD 2016 PDF.

Rose SC, Fischer AN, et al. How long it too long? The lack of consensus regarding the post-concussion syndrome diagnosis. Brain Inj. 2015;29(7-8):798-803.

TBI: Get the facts. Centers for Disease Control website. Available at: http://www.cdc.gov/traumaticbraininjury/get_the_facts.html. Accessed October 7, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 10/7/2020