Post-Concussion Syndrome


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Post-Concussion Syndrome

 

Definition

Post-concussion syndrome (PCS) is a common but controversial disorder that presents with variety of symptoms including—but not limited to—headache, dizziness, fatigue, and personality changes.

Description

PCS occurs in approximately 23-93% of persons with mild to severe head injuries. It is estimated that a neurologist (a physician who specializes in nerve and brain disorders) sees five patients with PCS per month. There is no accurate correlation between the severity of injury and the development of PCS symptoms, since signs of the disorder can occur in someone who was just dazed by an injury. Some studies suggest that PCS symptoms occur at a higher rate in patients who were unconscious after trauma.

Causes and symptoms

PCS is most commonly caused by minor head injury called a concussion. The majority of patients with minor head injury characteristically develop PCS with distinct symptoms. Patients may report problems with concentration, recent memory, and abstract thinking. Additionally, patients may develop dizziness, irritability, fatigue, and personality changes. Elderly patients are particularly affected by disequilibrium and chronic dizziness even after minor trauma.

Diagnosis

There are no specific or reliable tests to diagnose PCS. A neuropsychologist can perform an in-depth neuropsychologic assessment that can determine presence or absence and extent of impairment. These tests may be performed for medical purposes.

Treatment

Treatment for PCS can be extensive. Medications for headache and pain may be indicated (analgesics and muscle relaxants). Antidepressants may be given to improve insomnia, irritability, or anxiety. Pain control could be achieved with acupuncture, nerve blocks, or transcutaneous electrical nerve stimulation (TENS, electrical stimulation of muscle groups). It is important for clinicians to educate caretakers and to provide referrals for family therapy and cognitive rehabilitation for the affected person.

Prognosis

The overall outcome is difficult to assess. Limited interpretation in literature is primarily due to the subjective nature of symptoms. Patient recovery is directed and evaluated by cognitive function changes, subjective symptoms, and return to work. Most cases of PCS can be a financial strain and threaten family stability. There may be compensation and litigation claims, which is often stressful and aggravates symptoms.

Resources

Books

Coper, Paul R., and John G. Golfinos, et al, editors. HeadInjury. 4th ed. New York: McGraw-Hill, 2000.
Goetz, Christopher G., et al., editors. Textbook of Clinical Neurology. 1st ed. Philadelphia: W. B. Saunders Company, 1999.
Goldman, Lee, et al. Cecil's Textbook of Medicine. 21st ed. Philadelphia: W. B. Saunders Company, 2000.

Key terms

Disequilibrium — Difficulty with equilibrium that can mean a deficiency in balance and/or orientation.
Neuropsychologist — A clinical psychologist who specializes in assessing psychological status caused by a brain disorder.
A constellation of symptoms that follow traumatic brain injury, which is more common in athletes
References in periodicals archive ?
In professional sports, participants can suffer the cumulative effect of repeated concussions, otherwise known as post-concussion syndrome (PCS).
Toon maintains a demanding schedule in spite of his post-concussion syndrome, a result of the nine concussions he suffered over the course of his eight-year career with the New York Jets.
The NCAA never tested or followed-up with Rucks to determine whether he'd been concussed, or if he was experiencing post-concussion syndrome, the suit alleges.
Diane Roberts Stoler Neuropsychologist "If you were within a quarter mile of the Boston Marathon blasts, and are still suffering from persistent symptoms -- including headaches, fatigue, impaired concentration and decision-making ability, sleep disturbances, dizziness, loss of taste and smell, reading and communication difficulties, and emotional or behavioral problems -- then you likely sustained a concussion, a form of traumatic brain injury, and are dealing with Post-Concussion Syndrome.
It wasn't classed as a serious brain injury but as post-concussion syndrome, which lasts much longer than a normal concussion and the symptoms can carry on for an indefinite length of time.
Smith has been ruled out of the rest of the series with a post-concussion syndrome.
They describe what a concussion is and how to recognize one; how to make collision sports like ice hockey, football, and boxing safer for kids; concussions in non-collision sports like wrestling, soccer, basketball, baseball, cheerleading, mixed martial arts, skateboarding, volleyball, and tennis; baseline testing; post-concussion syndrome and second impact syndrome; chronic traumatic encephalopathy; myths about concussions; what parents should do; stories of athletes who have returned to the sport after concussion; and reforms.
Washington, Jan 20 (ANI): A new American research suggests that a specialised exercise routine can help athletes suffering with post-concussion syndrome (PCS) get back on the field.
United (0-0-1) update: The return of forward Alecko Eskandarian from post-concussion syndrome bodes well for D.
Most parents (and educators and coaches for that matter) are not aware of post-concussion syndrome, which refers to repeated concussions over an extended period of time.
VESTENT Technologies is an Austin-based ASP committed to providing widespread access for patients and physicians to newly developed revolutionary state-of- the-art integrated diagnostics and therapeutic treatment models for patients with inner ear and balance-related disorders, including vertigo, imbalance, post-concussion syndrome and related maladies.
Although the research suggests a neuro-protective effect of cannabinoid receptor activation in brain trauma induced inflammatory models, we are far from extrapolating that medical marijuana is a safe and effective method of treating humans with post-concussion syndrome.

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