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Post-Concussion Syndrome

Excessive rest following concussion becomes the fuel for post-concussion syndrome.

What is Post-Concussion Syndrome? (PCS)

While the majority of concussion patients recover completely within two weeks, others experience lingering and persistent symptoms for months to years. This continuation of symptoms, following a concussion, is known as post-concussion syndrome (PCS). 

PCS occurs after the concussion has healed. If incorrectly treated, concussion patients are more likely to develop PCS. For example, many patients with concussion are told to"rest and wait it out"until they have no symptoms at all, a strategy that may lead to sleep difficulties, increased anxiety, headaches and cognitive issues.

Risk Factors of Post-Concussion Syndrome (PCS)

The most common contributing factor to PCS is what we refer to as the unplugged syndrome, also known as over-resting. Excessive rest following concussion becomes the fuel for post-concussion syndrome.

 

Any time a person greatly reduces their physical, cognitive and social activity, there can be unintended negative impacts. To illustrate, if an otherwise healthy and uninjured person was told to do nothing - no school/work, reading, texting, computer use, etc. - for days to weeks, they would feel lousy. 

 

Another risk factor for post concussion syndrome involves pre-existing conditions. Patients with migraines, ADHD and/or mood disorders tend to experience a prolonged recovery. This risk factor is often amplified when the patient has not been properly treated or diagnosed with these conditions prior to the concussion.

Symptoms of Post-Concussion Syndrome (PCS)

It can be difficult to tell concussion and PCS apart, because they involve similar symptoms and often overlap in time. Post-concussion syndrome is a complex disorder with a wide range of symptoms, such as:

  • Anxiety

  • Balance problems

  • Concentration problems

  • Depression

  • Fatigue

  • Foggy thinking

  • Headaches

  • Memory loss

  • Mood changes

  • Neck pain

  • Sleep problems

  • Sensitivity to light or noise

  • Sensitivity to movement

  • Vision problems

Diagnosis of Post-Concussion Syndrome (PCS)

When physicians evaluate patients for concussion and PCS, the approach must be thoughtful and comprehensive. In many cases there is a clear period of improvement, as the concussion was healing, followed by a plateau due to PCS. The concussion may have been the inciting event - the thing that opened the door for PCS to walk through - but the two diagnoses should not be confused.

 

A thorough neurological history is essential to an accurate PCS diagnosis and helps the physician consider any outside causes of symptoms. Equally important, a detailed neurological physical examination is essential and these complex evaluations are tailored to the patient based on their presentation, level of activity and past medical history.

In the end, more often than not, there are multiple factors involved that must be identified and treated in a comprehensive manner.

Our Approach to Post-Concussion Syndrome (PCS)

It is important to approach PCS as a combination of symptoms that influence each other rather than treating one symptom individually. Although complicated, post-concussion syndrome is treatable in the right hands. The reality is that the collection of symptoms associated with PCS will not get better (and may worsen) unless they are addressed appropriately by a trained medical professional. 

The experts at the Kutcher Clinic apply solid neurological principles with a comprehensive neurological evaluation and tailor a rehab program for each patient for their specific constellation of symptoms and lifestyle. Each recovery plan may include medications, graduated exertion, focused physical therapy, and other rehabilitative approaches to restore an active, healthy lifestyle.

From a retired professional athlete, to the weekend warrior, to the student athlete, and everyday people, we are committed to helping patients "return to life."