A complete guide to post concussive syndrome.

A Complete Guide To Post Concussive Syndrome

Sierra Care | January 28, 2023


A Complete Guide On Post-Concussive Syndrome

Post-concussive syndrome is a set of symptoms that are common in patients who have suffered from a concussion. No two people will have the exact same symptoms and the severity of symptoms does not always depend on the severity of the concussion. This variability makes post-concussive syndrome hard to define and even harder to diagnose. This article will explain post-concussive symptoms causes, signs, symptoms, treatments, and recovery.

What is Post-Concussive Syndrome?

Post-concussive syndrome may occur after a head impact that leads to an injury to the neurons that make up the brain. Neurons are incredibly complex, they share information using mechanical connections, electrical signals, and chemical release. A head impact can disrupt any one of these mechanisms and alter the function of the neurons. The damage from most mild to moderate head injuries can be repaired by the brain over days to weeks. Both the head injury and the process of healing can lead to the symptoms of post-concussive syndrome.

What is a concussion?

The definition of a concussion has changed over time as research has shown just how little trauma to the head needs to occur to lead to changes in neuron function. Currently, a concussion can be defined as a head injury that leads to:

  • Loss of consciousness
  • Loss of memory
  • Difficulty keeping the eyes open during a conversation
  • Inappropriate responses to questions
  • Uncoordinated movements
  • Severe headache

This definition is extremely broad and can cover everything from severe head impacts that lead to several minutes of loss of consciousness to a mild impact that causes little more than a headache. Many of the symptoms of concussion are also present with severe forms of traumatic brain injury that result from bleeding in the brain, severe skull fractures, and extreme trauma. This has led to the term “mild traumatic brain injury” being used as an alternative name for concussion. Click on this link for more information on the signs, symptoms, and treatments of an acute concussion.

How do I know if I have a concussion?

There is no one test that can diagnose a concussion. If you are experiencing one of the symptoms listed above it is possible that you had a concussion and may experience post-concussive syndrome. The presence of post-concussive syndrome hours to days after a head impact is the best way to diagnose a recent concussion. Most people who suffer from a concussion experience some period of post-concussive syndrome.

If you have sustained a head injury and have any new symptoms, you should be evaluated by a healthcare professional. Even mild head trauma can lead to life-threatening medical conditions. This is especially true for infants, toddlers, the elderly, and patients on certain blood-thinning medications.

What are the Symptoms of Post-Concussive Syndrome?

Post-concussive syndrome has multiple signs and symptoms. Some of these symptoms may be felt throughout your everyday life and others may only be noticed by a healthcare professional. These symptoms can last anywhere from hours to weeks. More severe head impacts generally lead to more severe symptoms that last for a longer period of time, but this is not always the case.

Symptoms of post-concussive syndrome

Some of the most common symptoms of post-concussive syndrome are:

  • Headache
  • Light or sound sensitivity
  • A sensation that the room is spinning (vertigo)
  • General dizziness or lightheadedness
  • Excessive sleep
  • Difficulty getting to sleep or staying asleep
  • Daytime tiredness, regardless of sleep duration
  • Irritability
  • Anxiety
  • Depression

No two people with post-concussive syndrome will experience the same symptoms. These symptoms may also change over time but generally improve in the days following the concussion. New or worsening symptoms days after a concussion are a reason to follow up with your doctor for a repeat examination or additional testing.

Signs of post-concussive syndrome

Concussions generally do not present with many signs (changes that can be seen on a physical examination). A physical examination will usually be normal in a patient with post-concussive syndrome. There are some signs of a concussion, but these generally disappear minutes to hours after the concussion. The most common signs of a concussion are:

  • Sudden loss of consciousness for a short period of time
  • Asking repetitive questions
  • Uncertainty of what happened
  • Difficulty staying awake
  • Nausea and vomiting

If someone is injured and presenting with these signs they should be evaluated by a healthcare professional as soon as possible.

What tests should be done on a patient with post-concussive syndrome?

If a doctor suspects you are suffering from post-concussive syndrome they generally will not order any tests. Post-concussive syndrome is a clinical diagnosis, this means that it can be diagnosed based on the history of your symptoms and physical examination alone. However, this does not mean that testing will never be done. There are some symptoms that may lead a doctor to perform testing such as a brain MRI or CT scan.

  • Worsening symptoms days after the injury
  • New symptoms days after the injury
  • Symptoms that do not improve over time
  • Symptoms severe enough to result in disability

If a patient is presenting within hours of a head impact that has led to concussion symptoms there are several signs that doctors will look for when deciding to obtain a CT scan or MRI of the brain. The findings that most commonly lead to one of these tests are:

  • Bruising around the eyes
  • Drug or alcohol use at the time of injury
  • An area concerning for a skull fracture
  • Vomiting
  • Confusion for more than 2 hours after the injury
  • New weakness or numbness in a leg or arm

Recovering from Post-Concussive Syndrome

Recovery from post-concussive syndrome is unique to each patient. Most patients experience rapid recovery with an improvement of symptoms in days and full recovery in weeks. Some patients have a much longer course of recovery, with weeks to months of debilitating and disabling symptoms. Several steps can be taken to help control symptoms, speed recovery, and reduce the risk of developing a life-long disability.

Managing the symptoms of post-concussive syndrome

Headaches are the most common symptom of post-concussive syndrome. Many patients are able to manage headaches with over-the-counter medications such as Tylenol and ibuprofen. However, there are more effective treatments that are overlooked by most patients and healthcare providers.

Headaches, lightheadedness, dizziness, and nausea can all be caused by tight muscles and strained ligaments in the neck and upper back following an impact to the head. Manipulating, stretching, and helping to restore the balance in these muscles after an injury can improve symptoms and speed recovery. Sierra Care is a rehabilitation center with physical therapists who are trained to treat patients with brain injuries of any severity.

Symptoms such as light sensitivity, insomnia, anxiety, depression, nausea, and difficulty with concentration often do not improve with over-the-counter medication and therapy alone. Discuss these symptoms and possible treatment options with your doctor if they do not improve shortly after an injury.

Speeding recovery from post-concussive syndrome

As discussed above, physical therapists can help the body recover from post-concussive syndrome. Equally important is recovery of the brain. Any brain injury, from a mild concussion to the most devastating traumatic brain injury, disrupts the connections between the neurons that make up the brain. Through special exercises, practicing difficult skills, and training focused on hand-eye-coordination, the occupational and physical therapists at Sierra Care help to engage both the mind and the body, a critical combination in recovery from post-concussive syndrome.

Even a mild case of post-concussive syndrome can be devastating to a patient’s overall health. The debilitating symptoms that follow a concussion lead to reduced activity. This activity reduction can lead to weakness, poor balance, and overall physical decline that will not improve unless specifically treated by physical and occupational therapists. By starting therapy early, the risk of developing these long-term secondary symptoms can be nearly eliminated. For patients who have already experiences a loss in strength, balance, and endurance as a result of a previous concussion, these can be restored by working with a dedicated team of therapists!

Repeated injuries to the brain in a short period of time dramatically slow recovery. Sustaining another head injury while suffering from post-concussive syndrome can lead to dramatically worsening symptoms and in rare cases, permanent brain damage. Always wait for a complete resolution of post-concussive symptoms before resuming high-intensity exercise, contact sports, or other strenuous physical activity.

Working with post-concussive syndrome

Post-concussive syndrome often leads patients to miss several days of work due to headaches, nausea, and increased sleepiness. Patients with more severe and longer-lasting symptoms may miss weeks or months and require short-term disability. Many concussions in adults are sustained at work. If you are injured at work be sure to seek out assistance with worker’s compensation paperwork and attend all scheduled follow-up appointments. For more information on workplace injuries and the services that Sierra Care provides to patients with severe injuries requiring worker’s compensation see our guide on catastrophic injuries and worker’s compensation in the state of California.

Managing long-term complications of post-concussive syndrome

Most people suffering from post-concussive syndrome have a significant improvement in their symptoms within 7–10 days. A small number of patients can experience symptoms for months to years. While chronic post-concussive syndrome is rare, it can lead to significant lifelong disability.

Living with chronic post-concussive syndrome can be made easier with treatment by experienced therapists specialized in the treatment of traumatic brain injury. Sierra Care provides therapy services to survivors of traumatic brain injury in California and has numerous therapists, nurses, and doctors specialized in the care of these patients. Visit our page on traumatic brain injury rehabilitation for more information on the therapies and services that Sierra Care provides to its patients.