Post-Concussion Syndrome

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Post-Concussion Syndrome



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.


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.


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 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.


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.



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 ?
A condition known as post-concussive syndrome (PCS) may result.
Samadani's future work aims to replicate eye-tracking's diagnostic potential for head injuries on a larger scale in Iraq and Afghanistan veterans with post-concussive syndrome and post-blast military brain injury.
The topics include war head injuries in besieged Sarajevo, predictors of persistent post-concussive syndrome, molecular mechanisms in traumatic brain injury, case reports of using biofeedback and neurofeedback treatments of psychiatric disturbances following traumatic brain injury, and a 12-month outcome from mild traumatic brain injury.
She was diagnosed with post-concussive syndrome after she fell from a horse on Nov.
Two years later, he says he continues to suffer from post-concussive syndrome, including frequent severe headaches, concentration lapses and memory loss.
It has been suggested that the interviewer use his or her judgment as to whether the patient is suffering from post-concussive syndrome versus PTSD based on the nature of symptoms and their time course, even if specific recollections are not available.
Tottenham physio Tony Lenaghan said: "Teddy had a bit of a thick head after the England game and suffered from what we call post-concussive syndrome.
Commonly treated conditions at the Balance and Vestibular Center include: Benign Paroxysmal Positional Vertigo (BPPV), Vestibular Neuritis, Labyrinthitis, Post-Concussive Syndrome, Cervicogenic Dizziness, Ramsey-Hunt Syndrome, Ototoxicity, Meniere's Disease, General Dizziness and Stroke.
He discusses post-concussive syndrome, biomechanical causes of trauma, and acute and chronic phases of co-morbid brain and somatic injury; the physiological basis for behavior and post-traumatic dysregulation of systems; disorders of pain, sensation, and motor activities; headaches; consciousness; cognition; cerebral personality; psychodynamic disorders; the developmental effects of children's concussive injury; blast injuries from modern war; and unfamiliar signs.
Parents, coaches, athletic trainers and school officials also need to be aware of the signs of post-concussive syndrome, said Dr.
Our decision to invest in inline bold, fMRI, and diffusion tensor imaging techniques has allowed us to image a variety of disease processes, especially multiple sclerosis, seizure disorders and post-concussive syndromes, at a level which many of our outpatient-based competitors cannot match.

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