Postconcussion Syndrome

(PCS; Persistent PCS)

Definition

Postconcussion syndrome (PCS) refers to continued symptoms of mild traumatic brain injury. Most often it resolves within a month but sometimes the symptoms persist for much longer.

Getting treated early for PCS may help you get better faster. If you think you have PCS, contact your doctor right away.

The Brain

Causes

The exact cause of PCS is unknown. Several factors contribute to PCS, including:

Microscopic brain damage from a mild brain injury
Psychological or emotional stress that results from a mild brain injury

Risk Factors

These factors increase your chance of developing PCS. Tell your doctor if you have any of these risk factors:

A mild concussion or brain injury caused by a car accident or assault
Feeling depressed or being diagnosed with depression after a mild brain injury
Low social support, including not having a lot of close friends or people to confide in after a mild brain injury

Symptoms

PCS symptoms vary from person-to-person. If you experience any of these symptoms do not assume it is due to PCS. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your doctor. Symptoms include:

Headache
Dizziness
Balance problems
Nausea
Vision problems
Being very sensitive to noise and/or light
Depression
Mood swings—a quick change in mood (eg, being happy to becoming very sad)
Anxiety
Becoming easily irritated or annoyed for little or no reason
Trouble remembering things
Trouble concentrating or paying attention
Trouble sleeping
Feeling tired all the time

Diagnosis

PCS is hard to diagnose. The brain damage caused by a mild brain injury is so slight that many tests cannot detect it. It is important to see a doctor with special training in brain injury. These doctors are called neurologists, neuropsychologists, and neurosurgeons. To find one of these doctors, call a local head injury foundation for a referral.

Your doctor will ask questions about:

Your personal and family medical history
Your head injury
Sleep habits
Recent missed work or school
Recent memory or relationship problems
Recent emotional problems, such as irritability, anxiety, and depression

Tests may include:

Memory and attention tests—to assess your memory and attention abilities
CT scan —a type of x-ray that uses a computer to make pictures of structures inside the head; to look for signs of persistent injury and/or to see if surgery may improve the symptoms
MRI scan —a test that uses magnetic waves to make pictures of structures inside the head; to look for signs of persistent injury and/or to see if surgery may improve the symptoms
Electroencephalogram (EEG)—A test which evaluates the electrical activity of the brain.

Treatment

PCS treatment depends on your symptoms. Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Over-the-counter medications to reduce the severity of headaches
Antidepressants to help reduce depression and anxiety
Nerve blocks to relieve severe, nerve-injury induced pain/headaches

Talking with a mental health professional about the problems you are having related to PCS
Learning how to cope with those problems in your life

Learning skills and training to start or resume a career

Neurotherapy (also called biofeedback) is a painless treatment using computers to help you learn how to modify your brainwaves to improve attention and memory.

In some cases, a collection of blood in an area of bruising on the brain may require surgery, which may help resolve or improve symptoms.

Prevention

There are no guidelines for preventing PCS because the cause is not known. To help reduce your chances of getting PCS, take the following steps:

Prevent brain injury by following the recommendations of the Centers for Disease Control and the Brain Injury Association of America.
See a doctor who specializes in brain injury as soon as you think you may have PCS.

Resources:

Brain Injury Association of America

National Help Line: 800-444-6443

http://www.biausa.org/

US Centers for Disease Control

http://www.cdc.gov/index.htm/

Canadian resources:

Canadian Psychiatric Association

http://www.cpa-apc.org/

Ontario Brain Injury Association

http://www.obia.on.ca/

References:

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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.