Understanding Post-Concussion Syndrome

by Steve Holder on June 25, 2008

In today’s world of miracle science, concussion is a type of mild brain injury still being widely debated in medical circles. What causes a concussion is clear. It results when the brain impacts the interior of the skull because of a blow to the head, fall, or violent head movement. But what actually happens inside the brain as a result of a concussion is still being researched.

Despite the debate over the cellular processes involved, the symptoms of a concussion are well recognized and may include any combination of the following:

  • Headache
  • Dizziness, lack of coordination, loss of balance
  • Nausea or vomiting
  • Blurred vision, double vision, or sensitivity to light
  • Confusion, disorientation, difficulty concentrating or sleeping
  • No memory of events immediately before or after the injury
  • Irritability and behavioral changes
  • Inappropriate emotional responses

What is Post-Concussion Syndrome?

The specific symptoms appearing after a concussion vary between individuals, and can be partially dependent on the force of the head trauma and location. Post-concussion syndrome is a handy shorthand for referring to the unique set of persistent symptoms experienced by any one person after a concussion.

Some physicians use the term to describe the normal occurrence of these symptoms within the days and weeks following the injury. Others apply the term only for cases when the symptoms persist longer than three months. Symptoms lasting longer than three to six months may be referred to as persistent or prolonged post-concussion syndrome. A significant debate is still occurring regarding terminology and diagnosis.

How is Post-Concussion Syndrome Diagnosed?

Mild concussion is frequently undetectable with MRI or CT scans, so doctors rely primarily on the reporting of a head injury followed by the existence of symptoms related to concussion.

How is Post-Concussion Syndrome Treated?

Post-concussion syndrome is a collection of symptoms, and, therefore, the symptoms are treated individually as needed. For headaches, medication can be prescribed. Problems with memory or thinking are addressed by rehabilitation specialists who can help the individual develop coping strategies for dealing with particular cognitive impairments. Emotional and behavioral issues can be assessed by a psychologist or psychiatrist who can prescribe appropriate therapy or medications.

How Long Does Post-Concussion Syndrome Last?

For most people, concussion symptoms go away a few days to a few weeks after the injury. Half of all sufferers are symptom free within one month. In these cases, a post-concussion syndrome diagnosis is not likely to be applied.

Of those whose symptoms persist longer than a month, two-thirds recover within three months after the injury.

In the relatively few cases lasting longer then three months, recovery may occur within one year. If the symptoms continue beyond one year, they are often permanent.

Why is Post-Concussion Syndrome Being Debated?

The central controversy surrounding post-concussion syndrome is to what degree it is caused by a physical injury or by psychological factors. Numerous studies have produced a variety of conflicting results.

Statistically, persistent concussion symptoms are more likely to occur if the following conditions exist:

  • History of psychological problems, depression, personality disorder, or alcohol abuse before the injury
  • Pre-existing medical condition or illness
  • Previous head injury or history of headaches
  • Low socioeconomic status or low cognitive ability
  • Lawsuit related to the injury

Females and people older than forty are also more likely to suffer prolonged symptoms.

Complicating the debate is that the criteria for diagnosis can be applied to a significant number of people who have not experienced a head injury. Otherwise healthy individuals may have headaches, dizziness, insomnia, fatigue, irritability, or problems with memory or concentration completely unrelated to concussion. These symptoms can also be related to a variety of medical conditions, which can lead to a specific illness not being properly diagnosed in a head injury victim when the symptoms are summarily ascribed to post-concussion syndrome.

Finally, despite our prowess in medical imaging, it is still not clear to scientists how mild brain trauma alters brain function.

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{ 2 comments… read them below or add one }

deondria barajas December 14, 2008 at 4:39 pm

Severity of concussion should not be gauged on whether a person loss consciousness. My daughter sufferred a sever concussion, she never loss consciousness but immediately she forgot more than the events of the incident, she did not recognize her immediate family members. She did not return to playing soccer for about three months. Her behavior was child like. She recalled events ( after a few days), of things that occurred five years prior but not her current. She remember elemntary school but not high school ( she was a junior). It has been almost a year and she still has bouts with short term memory loss. People that she encounters from her past but not subsequent to the concussion, she doesn’t remember unless she saw them routinely. Some recent events remain with her and others come and she doesn’t recall them. She attended a funeral ten months after the concussion. A month after the funeral, she couldn’t recall the event.

AndrewBoldman June 4, 2009 at 8:01 am

Hi, good post. I have been wondering about this issue,so thanks for posting.

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