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What is post-concussion syndrome?
A blow to the head from a car accident or while playing sports can cause a mild traumatic brain injury known as a concussion.
A concussion damages brain cells and affects how the brain functions, you’ll likely experience symptoms like headaches, confusion, and difficulty concentrating for a few days to two weeks (sometimes as long as a month).
Sometimes, symptoms are long term, lingering for several months or even years. This is known as post-concussion syndrome (PCS).
Concussions and PCS are “invisible” injuries. It can be difficult for patients to be taken seriously. Their symptoms are often minimized. This can be particularly concerning in athletes who are encouraged to return to play too soon. —Dr. Chandra Manuelpillai
What are the symptoms of post concussion syndrome?
The most common symptoms of PCS include:
- Decreased concentration
- Memory problems
- Sleep disturbances
- Vision problems like sensitivity to light and visual disturbances
A concussion damages your brain, affecting the brain’s chemistry. It can also lead to problems with blood flow in the brain. These imbalances ultimately lead to the symptoms of a concussion
Both children and adults can develop PCS, but it’s not clear why some people are more likely to develop it than others. Some research suggests you may be more likely to be diagnosed with PCS if:
- You are a child or teenager
- You had severe or many symptoms right after the injury (severe headaches, significant confusion)
- You had one or more previous concussions
- You have a history of depression or anxiety
- You are elderly (after a fall)
Post-concussion syndrome is not permanent. But it needs to be diagnosed early and monitored closely. With the appropriate treatment, symptoms should eventually go away. However, this may take time and a multidisciplinary approach including neurology, psychiatry, physical therapy, vestibular therapy, ocular therapy, etc. There is no single treatment that is effective in all cases. This is why concussion clinics are becoming more common. —Dr. Manuelpillai
Is post-concussion syndrome permanent?
Post-concussion syndrome can be treated with rest and a range of therapies. People typically recover from it within 3 to 6 months.
Though once you have had a concussion, you are at risk for more severe repeat concussions.
After being diagnosed with a concussion, you will need to rest until the symptoms subside. Your doctor will also advise you on the best PCS treatment plan depending on the extent of your injury.
If your symptoms persist for more than a month or so, your doctor may diagnose you with post-concussion syndrome. They will then recommend multiple approaches to treatment, including seeing a psychiatrist, physical therapist, and neurologist who has experience treating concussions.
What is the best treatment for post-concussion syndrome?
The amount of time it may take to get better can be frustrating. But it is important not to give up. Just as when you break a leg and you do not want to take a cast off too early, you do not want to go back to full physical or mental activities until you allow your brain to fully heal.—Dr. Manuelpillai
The goal of treatment is to let your brain rest and recuperate, as well as to reduce stressors.
Your doctor will monitor your recovery and adjust your treatments as you improve. They may repeat tests and adjust medication.
Treatment includes several approaches:
- Resting, which is very important for the brain to recuperate.
- Limiting screen time and reading to reduce strain on your brain. This will improve focus and attention.
- Light exercise may be OK, but you need to discuss with your doctor.
- Do not do any moderate to intense exercise until your symptoms are better and your doctor has said it was OK.
- Avoid playing any contact sports until you have your doctor’s OK.
- You may need to see a psychiatrist or therapist to help treat any anxiety and depression.
- You may need to see a neurologist to help treat headaches and monitor cognitive deficits.
- If you have a neck injury or other related injury, you may need to see a physical therapist for an exercise and rehabilitation program.
To prevent concussions, always use the proper protective gear when playing contact sports (helmets, padding, mouth gear). Always wear a seatbelt in the car, no matter where you sit.
If you do get a concussion, treat it right away and follow your doctor’s orders. Resting is crucial for healing quickly and minimizing the chances of developing post-concussion syndrome.
Dr. Gambrah-Lyles is a resident pediatrician at the Children's Hospital of Philadelphia. She is a graduate of the University of Pennsylvania Perelman School of Medicine (2019). She graduated cum laude and received her undergraduate degree in Biochemistry and Spanish from Washington University in St. Louis (2013). Her research explores the intersections between neurology, public health, and infectious disease. She has investigated nutrition and cerebral palsy in Botswana, and completed a year-long project in Brazil, researching growth and developmental outcomes of Zika virus infection in pediatric patients as a Doris Duke International Scholar. Dr. Gambrah-Lyles speaks four languages, loves staying active, and enjoys sharing her love for medicine through teaching and writing.