Persistent post-concussive symptoms

Overview

Post-concussion syndrome, also known as persistent post-concussive symptoms, occurs when the aftereffects of a mild traumatic brain injury, or concussion, linger beyond the expected recovery timeframe. Such injuries, which can result from falls, vehicle accidents, playing contact sports, or any forceful shaking of the head or body, don’t necessarily lead to a loss of consciousness. Interestingly, the severity of the initial injury does not directly correlate with the likelihood of experiencing prolonged symptoms, which can include headaches, dizziness, and issues with concentration and memory. While most individuals start to see symptoms within the first week to ten days post-injury and recover within three months, there are instances where symptoms persist for over a year. Managing these symptoms effectively becomes the primary focus of treatment, aiming to alleviate the prolonged impact they have on daily life.

Symptoms

Concussions are a type of traumatic brain injury that can have a range of symptoms, often mirroring those immediately following the concussion but extending over a longer period. It’s crucial to recognize that even a brief loss of consciousness after a head impact or a whiplash event suggests a likely concussion, necessitating immediate medical attention.

Concussion symptoms are diverse, falling into four broad categories:

• Physical symptoms:
  • Persistent headaches
  • Balance issues
  • Fatigue
  • Nausea
  • Coordination problems
  • Altered sleep patterns (insomnia or hypersomnia)
• Sensory symptoms: These symptoms can impact the five main senses and related senses like balance.
  • Light sensitivity (photophobia)
  • Visual disturbances (seeing stars, visual snow)
  • Blurred or double vision
  • Dizziness and vertigo
  • Sound sensitivity (phonophobia)
  • Night vision troubles
  • Eye tracking difficulties
  • Convergence disorder (trouble focusing on close objects)
• Mental symptoms:
  • Memory loss
  • Concentration difficulties
  • Mental fog
  • Slower cognitive processing
• Behavioral symptoms:
  • Irritability
  • Depression or sadness
  • Anxiety
  • Agitation
  • Mood swings
  • Restlessness
  • Thoughts of self-harm or suicide

Immediate action is necessary if you or someone you know experiences thoughts of self-harm or suicide. 

Causes

Additional research is necessary to deepen our understanding of the underlying mechanisms responsible for persistent post-concussive symptoms following specific injuries. These symptoms might stem directly from the injury’s impact or potentially trigger other conditions like migraines. Moreover, factors such as sleep disturbances, dizziness, stress, and mental health issues could also play a role in symptom manifestation. Your healthcare provider will work with you to identify the primary cause of your symptoms and suggest suitable treatment approaches. 

Risk factors

Developing chronic post-concussive symptoms is associated with risk variables such as: 

• Age. There are studies showing that getting older increases the chance of chronic post-concussive symptoms. 
• Gender. Persistent post-concussive symptoms are more commonly diagnosed in women, although this correlation may also reflect the higher likelihood of women seeking medical attention in general. 
• Head traumas or previous concussions. With each subsequent concussion or head injury, your chance of PCS increases.
• Complications from concussions. PCS is more likely to occur if the concussion results in other issues with your skull or brain. A fractured skull, bleeding within the skull or brain, and midline shift—the brain shifting off-center inside the skull—are a few examples. 
• Experiencing other brain-related ailments. Individuals who suffer from learning disabilities or attention-deficit/hyperactivity disorder (ADHD) may be more susceptible to PCS.
• Having a history of problematic behaviors. Anxiety, depression, bipolar illness, and other disorders may also increase a person’s chance of getting PCS.
• An increase in concussion-related symptoms. Early after an incident, experiencing greater concussion symptoms may indicate a higher risk of PCS.
• Severer concussion-related symptoms. You may be more susceptible to PCS if your symptoms are more severe.