Post-Concussion Syndrome
If you’ve ever suffered a concussion, you’ll know that a traumatic brain injury can be debilitating. While most people recover relatively well from concussion injuries, there are some cases when symptoms linger on for a year or more, significantly impacting the lives of the victims. If you were diagnosed with a concussion more than three months ago and your symptoms are persisting, you should ask your doctor about post-concussion syndrome, or PCS.
What is a concussion? The term refers to a traumatic brain injury that occurs when the victim receives a blow to the head or a violent shaking of the head or body that causes the brain to bounce and twist around in the skull. This can damage the delicate cells of the brain and affect how it functions. Common causes of concussion include motor vehicle accidents, falls, and sports injuries. Children often get concussions on the playground, while bike riding, or when playing football, basketball, hockey, or soccer. Those most at risk for concussion are:
- The elderly, due to falls.
- Children, due to falls, playground injuries, and sports injuries.
- Adolescents, due to bike, ATV, and motor vehicle accidents, as well as sports-related head injuries.
- Military personnel, due to explosive devices.
- Anyone involved in a car accident.
- Victims of physical abuse.
- Anyone who has had a previous concussion.
Contrary to popular belief, you don’t have to lose consciousness to suffer a concussion, and even the mildest concussion can cause serious symptoms.
Symptoms of concussion include:
- Headaches
- Dizziness
- Fatigue
- Irritability
- Anxiety
- Insomnia
- Loss of concentration and memory
- Ringing in the ears
- Blurry vision
- Noise and light sensitivity
- Decreases in taste and smell
For most people, these symptoms occur within the first week after the injury and dissipate within three months. However, in people with post-concussion syndrome, symptoms persist. People with PCS can experience symptoms at any time, but they often occur in response to too much physical or cognitive activity. These symptoms can disrupt their lives, impacting work, home, and social activities. However, PCS is not degenerative, and it is not progressive. Most people with PCS recover completely in time.
Diagnosis and Treatment of Post-Concussion Syndrome
Doctors don’t understand exactly why some people recover quickly from concussions while others suffer from post-concussion syndrome. Some researchers point to structural damage to the brain or the disruption of the messaging system in the nerves, while others believe post-concussion syndrome is related to psychological factors. Certain patients are at an increased risk for developing PCS; these include:
- Females. Women are far more likely to develop PCS than men.
- Elderly. Older people have an increased incidence of PCS.
- Previous concussions. The more concussions you have sustained, the more likely you are to develop PCS.
- Mental health history. Those with mood or anxiety disorders are at increased risk.
- Medical history. Those with seizure disorder or a history or migraine headaches are at increased risk.
- Impact. Patients who have sustained a severe impact or a double impact have a greater chance of developing PCS.
- Visual symptoms. Those who develop major visual symptoms soon after the injury have been shown to develop PCS more often than those who do not.
The illness can be frustrating for sufferers; since concussion is a fairly common occurrence, many people find it hard to believe that recovery from one can sometimes take a long time. Those with PCS are sometimes accused of trying to get out of working or performing difficult tasks by “faking” their symptoms. They are unable to attend activities such as parties because dealing with crowd noise and bright lights can be overwhelming and can trigger headaches and other symptoms. There are no scans that can diagnose PCS, and treatment varies widely from person to person. Coping with PCS in the COVID era has been particularly challenging, with the anxiety of the pandemic adding more stress to those dealing with the condition.
Rest is the most important therapy for concussion and for PCS, and many patients find that rest is the only thing that helps to alleviate symptoms. Sometimes doctors will recommend other therapies to help alleviate symptoms, including physical therapy, yoga, pain medication, support groups, or psychiatry. Doctors encourage people with PCS to take things day to day, and trust that recovery will happen. It’s important to try different things to see what might work for you. Some people find it useful to record their symptoms in a journal to track what activities might aggravate them and/or to track improvement. Others find that having a sympathetic friend to confide in is crucial. Still others find a routine that helps to give a healthy shape to their day, including walks outdoors, naps, yoga or meditation, and less screen time. Having a “concussion kit” with you can be useful: whenever you go out, pack a pair of sunglasses, a pair of earplugs, an eye mask, a notepad, and other items that can help you to cope.
If you have PCS, be kind to yourself, and trust that better days are on the way.