Did you know that up to 30 percent of people who suffer from a concussion will continue to have neurological symptoms for months after the injury? When this happens, it is called post-concussion syndrome. This syndrome can seriously affect a person’s life and may require treatment.
If you have suffered from any blow to the head in the past few months, you need to check for symptoms of post-concussion syndrome. It’s important to understand the condition and know when to seek treatment.
What is a Concussion?
Before you can understand what post-concussion syndrome is, you must first comprehend the complexity of a concussion. Only people who have had a concussion can develop post-concussion syndrome.
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A concussion is a common type of traumatic brain injury (TBI) that can impair your brain function temporarily. People often sustain a concussion while playing sports or in a car accident. However, you can get a concussion from any hard hit to the head and even from violently shaking your head and neck.
Many people mistakenly believe that a concussion is not that serious. They think that because it doesn’t appear on CTs or MRIs that it can’t be that bad. However, concussions are real brain injuries that should be treated with care.
The side effects of concussions can range from relatively mild to worrying. Even if you’ve had a concussion before, you may experience different symptoms with subsequent concussions. However, there are a few hallmark symptoms that most people experience:
- A sense of confusion or “fogginess” that lasts for a few minutes
- An inability to remember the injury and the moments before it occurred
- Trouble with memory after the initial impact
- A headache or the feeling of building pressure in the head
Most people who suffer from a concussion experience the above symptoms and some others. For example, some people lose consciousness when they get a concussion. However, the loss of consciousness does not occur in all concussions. Below are some other symptoms you may experience:
- An uneasy feeling or anxiety
- Feeling tired, drowsy, or low on energy
- Mood swings
- Tingling or pain in the neck
- Difficulty concentrating and remembering
- Trouble with balance or dizziness
- A general feeling that something isn’t right
Most concussions are mild TBIs. However, there are some symptoms that require emergency medical attention. If an adult continues to have worsening headaches and dizziness, feels weak, or vomits repeatedly, you may keep an eye out for further warning signs.
If you cannot wake someone, seek immediate medical treatment. If a person has slurred speech, one large pupil, or has convulsions after a brain injury, he or she needs to go to the nearest emergency room.
For children, look for all the warning signs an adult may show and a few others. If a child won’t stop crying or refuses to eat after a blow to the head, he or she may need emergency medical treatment.
So, how long does a concussion last? The initial concussion can affect a person for up to several hours. It’s important to remember that every brain injury is different. The length, severity, and recovery may be completely different from person to person.
What is Post-Concussion Syndrome?
Post-concussion syndrome, also called PCS, is a set of symptoms that you may have even after you have recovered from a concussion. This syndrome usually appears within 10 days of the initial injury. Post-concussion syndrome typically last for a few weeks or months. However, it can continue for a year or even longer.
If you have had a concussion within the past few weeks, you should carefully look over the signs and symptoms of PCS to see if you have any of them. Certain treatments can help you manage these symptoms and get back to normal life. However, you can only receive these treatments if you seek help.
Signs & Symptoms
Post-concussive syndrome can cause a patient to have a variety of physical and psychological symptoms. Unfortunately, these symptoms can cause major disruptions in a person’s life. You may have to avoid certain activities that you love, miss days of school or work, and take lots of time to manage the syndrome.
In some cases, you may be eligible for programs that help you if you lose your job due to your injury. You may be able to apply for temporary assistance that can allow you to focus on recovery until you can get back to work.
The physical symptoms of post-concussion syndrome are sometimes easier to detect than the psychological ones. If you have PCS, you may experience some symptoms that feel like a continuation of the concussion itself.
You may have a constant headache or neck pain, difficulty with balance, and blurred vision. People with PCS also show sleep disturbances such as difficulty falling asleep, fatigue, and sleeping too much. You may also have nausea, and worsening symptoms with light and noise.
Physical symptoms of PCS should not continue to get worse over time. If they do, it may be a sign that you need medical attention.
The impact of PCS on your emotional and mental state can be just as profound as the physical symptoms. These problems can be particularly difficult to manage and may require medication or therapy. The psychological effects of PCS can be divided into two types: emotional and cognitive.
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The emotional symptoms of PCS can cause people to feel and act like a different person. The patient’s family and friends sometimes notice the emotional and behavioral changes before the patient recognizes them.
Many people with PCS report feeling irritable or anger more often than they normally do. Another post-concussion symptom is increased anxiety, which is particularly bothersome when you have a syndrome to manage. Alongside anxiety, patients may feel restless.
Sometimes, people with PCS can experience depression. This may be a result of the initial injury or the hopelessness that some people feel when dealing with the physical symptoms. This depression can also cause the patient to feel apathetic and lose all motivation to do things they used to love.
As you can imagine, these mood disorders can cause a person with PCS to experience mood swings. These mood swings may include periods of impulsivity followed by a time of depression. He or she may also feel completely dissociated with their own body or with loved ones.
The cognitive impairments of PCS can truly disrupt a person’s life. Someone who is known for his or her sharp intellect can become frustrated with these symptoms. Furthermore, these issues can cause a person to make mistakes in school or at work that set the person back.
People with PCS sometimes have trouble concentrating on the tasks in front of them. They may also have problems remembering things that just happened and events form the past. Unfortunately, this can also lead to patients struggling to process information.
If you suffer from PCS, you may also have trouble making decisions and solving problems. Things that used to be no trouble at all can suddenly become difficult to understand. You may have trouble speaking and writing, even if you never did before.
If you suffer from any or all of these physical, emotional, and cognitive symptoms after a head injury, you may have PCS.
Researchers have found that between five and 30 percent of people who sustain a concussion suffer from PCS. However, little is understood about why some people get PCS and others don’t. Scientists have found some physical and psychological risk factors that may make PCS more likely.
You have a higher chance of developing PCS after a concussion if you are of the female sex or if you are in your advanced years. As compared to other people with similar injuries, these demographic groups have higher rates of PCS.
The nature of the initial injury may also impact whether a person develops PCS. If the injury to the head was severe or if you were hit in the head twice in a row, you may be more likely to develop PCS after the concussion. Also, significant neck pain and tension increases the likelihood of PCS.
If you notice visual impairments right after the initial injury, this may be a sign that you will develop PCS in the future. Furthermore, the longer the concussion lasts, the more likely you are to have PCS once it subsides.
Your medical history may offer some insight into whether or not you will have PCS after a concussion. For example, if you have had concussions or whiplash before or if you have a history of migraines or neck problems, you may be more likely to develop PCS.
In addition to the physical and demographic risk factors for PCS, there may be some psychological ones as well. People with a history of mood disorders, such as anxiety, may be more likely to have PCS. Furthermore, if you have a learning disorder, you may have a higher risk as well.
Unfortunately, there is no one test to determine whether a person has PCS. Due to the complexity of the disorder and the nature of brain injuries, getting a diagnosis can be difficult and test your patience. However, a proper diagnosis can help you receive proper treatment and symptom management.
The first thing your doctor may do is ask you about your symptoms and your concussion. He or she will compare what you say to the symptoms of PCS. From there, your doctor may order a CT or an MRI. These tests look at your brain to detect abnormalities.
Unfortunately, neither a CT or an MRI can detect PCS. However, they can rule out more dangerous conditions and help your doctor determine what causes your symptoms.
Some doctors use EEG neurofeedback tests to help diagnose PCS. This highly-sensitive diagnostic tool measures reactions in your brain and senses some of the symptoms of PCS. Not all doctors perform this test and it isn’t always necessary for a diagnosis.
Post-Concussion Syndrome Treatment
If you suffer from PCS, do not feel hopeless. Although there is no single cure for the condition, you can treat and manage individual symptoms to get your life back on track. Post-concussion syndrome treatment may take some patience, but it is well worth it in the long run.
There is no single pill that can stop PCS in its tracks. Instead, your doctor may prescribe different medications based on your symptoms. These medicines are designed to treat the symptom and you can typically stop taking them once your PCS is gone.
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If you continue to have headaches and neck pain long after your concussion, your doctor may recommend pain medications. For more mild cases, you may take acetaminophen (Tylenol) to treat the pain. Other drugs like NSAIDs and ibuprofen put you at risk for bleeding and should never be taken after a suspected concussion injury.
Unfortunately, over using acetaminophen could cause your PCS to last longer. If over-the-counter medications simply don’t do the trick, your medical team may help you with some other types of drugs. For example, anti-seizure medications work to relieve the pain in some patients with PCS.
If you have mood disorders because of PCS, you may wish to take anti-anxiety and anti-depression medication. These may include SSRIs or other drugs. Your doctor will determine which medication may work for you based on your history, current symptoms, and more.
As researchers work to understand PCS and discovering treatments, some medications are currently in the clinical trial phase. For example, gabapentin shows promising signs in treating PCS patients. It may help people with many different symptoms, which can make treatment easier.
Because mood disorders like anxiety and depression are common symptoms in PCS patients, psychotherapy is often part of the person’s treatment plan. A trained therapist can help you retrain your brain to treat your mood disorders.
Just like any other time someone may undergo therapy, psychotherapy for PCS patients may work better with or without medication. Talk to your doctor and mental health professional to determine which course of action is right for you.
Mood disorders aren’t the only symptoms that therapy can treat. Some doctors recommend cognitive remediation to help patients regain their cognitive abilities. You can improve your memory, concentration, and decision-making skills with some hard work and perseverance.
If you choose to see a neuropsychologist for your cognitive and neurological symptoms, you may find that even a single session can noticeably improve your performance. The first thing that the neuropsychologist will do is conduct an assessment. He or she will try to determine why your symptoms persist.
Your neuropsychologist may ask you questions about your mood, give you tests on your cognitive abilities, and talk to you about your symptoms over time. He or she may repeat this test throughout the duration of your treatment to measure your progress.
Once your neuropsychologist has determined a course of action, you can begin therapy for your symptoms. This therapy may include cognitive behavioral therapy to help you understand what is normal and what is an effect of your condition.
In serious cases, some neuropsychologists may recommend a full-time rehabilitation program. These programs can help patients recover more fully and get back to the life they know.
Certain exercises are known to help stimulate activity in specific areas of the brain and can be used to support the brain's healing from PCS.
A relatively new discovery in the world of concussion is the seemingly common relationship of a preexisting or concurrent neck injury and the development of post concussion syndrome. It is known that when a concussion occurs, many times the person suffers a whiplash-type injury to the neck as well. It is also known that a structural shift at the craniocervical junction (CCJ) can result in altered hydrodynamic and hemodynamic flow into and out of the skull. There is anecdotal clinical evidence that precise structural correction of the CCJ improves the symptomatic recovery for patients with PCS.
You are not helpless in the fight against PCS. In fact, there are many at-home remedies that can be a major part of your recovery. You can take charge of your own health.
The most important thing you can do is prevent head injuries altogether. Of course, this is not always possible. However, individuals can protect themselves against concussions and PCS with a few simple steps.
First, you should always wear a seat belt when in a motor vehicle. Car accidents are major causes of concussions, but wearing the appropriate safety belt can prevent one type of these injuries from impacting the head directly and even save your life. Also, be sure to keep children away from air bags and use age-appropriate safety seats.
Secondly, you can prevent some head injuries by wearing a helmet when you participate in sports. You and your loved ones should put on a helmet any time you go on a bicycle, go skating, play touch-sports, or even ride a horse. Anytime there is a risk of falling, you should wear protective gear.
Finally, you can prevent falls for young children and the elderly with a few small changes to the environment. Increased lighting and handrails can help elderly people get around without a fall. Remember, senior citizens are more likely to get PCS in the first place.
Even with the very best prevention methods, some people will sustain concussions, and a percentage of those patients will develop PCS. Seat belts and helmets are powerless in preventing impulse concussions, the movement of the brain inside the skull due to a whiplash-like movement. In that case, there are plenty of things you can do to speed up your recovery and get through this trying time.
The most important self-care tool is rest. Until a doctor clears you, you should avoid activities that may worsen your symptoms. Instead, try to find restful ways to spend your days, and be sure to get plenty of sleep.
Resting doesn’t have to mean sitting around doing nothing. You can keep your mind occupied without worsening your condition. In fact, keeping your mind busy can help you ward off anxiety attacks and depression. You may try fun games or time with friends to keep you busy. Rest doesn't mean to be a couch potato, however. Get outside and walk, everyday. Movements like walking are nourishing to the brain, and the fresh air will help too.
The next most important thing you can do for yourself as you recover from PCS is to create a support system. You do not have to suffer alone and you shouldn’t. Chances are, there are people who want to help you but aren’t quite sure how.
Reach out to the people you trust in your life and let them know you are struggling. Remember, there is no shame in needed help, especially when your brain is at risk. Get together with your family, friends, and other loved ones to determine how you can work as a team to get you back to your life.
You may find that as much as your friends and family want to help, they just can’t understand what you’re going through. If that’s the case, you should reach out to people who have suffered from PCS before or who are in the same boat as you. Online and in-person support groups can help tremendously.
When to See a Doctor
If you have any signs or symptoms of a concussion after a head injury, be sure to see a doctor right away. The medical staff can help you with initial symptoms and tell you what to expect during your recovery. However, if you have PCS, your recovery may not go as planned.
Once it has been two or three weeks since the initial concussion, you should seek medical care. Even if you no longer have symptoms, a follow-up can help you know when to get back into your normal routine. If symptoms do persist longer than two weeks, you many require medical intervention.
After your concussion, your symptoms should remain the same or get better. If your pain or cognitive abilities worsen, have someone take you to an emergency room. This may be something more dangerous than PCS.
Brain injuries are serious, even mild concussions. If you feel “off” in any way or think you need medical attention, book an appointment or head to the emergency room. It is always better to be safe than sorry, especially when it comes to your brain.
Scientists do not yet understand the full post-concussion syndrome long-term effects. If you continue to have lingering pain or problems, you should feel comfortable reaching out to your doctor.
When people talk about concussions, they rarely discuss the aftermath that these brain injuries can cause. However, up to 30 percent of people who suffer a concussion will have lingering symptoms for weeks, months, or even a year. That’s why information about PCS is important.
If you have had a concussion recently, or think you might have had one, check yourself for the symptoms of PCS. If you have any of them, see a doctor as soon as you can. Proper treatment and self-care can help you get back to your normal routine and get your life on track.
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