post concussion syndrome
Mullally WJ. This content does not have an Arabic version. The head injury may be categorized as a concussion or a mild traumatic brain injury. This period of time can range from weeks to months. [13] He suggested that the condition was due to "molecular disarrangement" to the spine. What can I do to help prevent traumatic brain injury? Post-concussion syndrome is a collection of symptoms that some people develop after they have had concussion. [16][19] Some common symptoms, such as apathy, insomnia, irritability, or lack of motivation, may result from other co-occurring conditions, such as depression. A specialist such as a neurologist and/or psychiatrist may also be involved to treat mental health symptoms associated with post-concussion syndrome. [13] Older people are at especially high risk for dizziness, which can contribute to subsequent injuries and higher rates of mortality due to falls. Proponents of the view that PCS has a physiological basis point to findings that children demonstrate deficits on standardized tests of cognitive function following a mild TBI. [11] The risk for developing PCS also appears to be increased in people who have traumatic memories of the injury or expect to be disabled by the injury. [25] Another study found that although children with PCS had poorer scores on tests of cognitive functioning after the injury, they also had poorer behavioral adjustment before the injury than children with no persistent symptoms; these findings support the idea that PCS may result from a combination of factors such as brain dysfunction resulting from head injury and preexisting psychological or social problems. About 38% of people who suffer a head injury with symptoms of concussion and no radiological evidence of brain lesions meet these criteria. [61][62] In SIS, the brain rapidly swells, greatly increasing intracranial pressure. Other tests may be given to rule out other causes of symptoms, such as infection, bleeding injury to the brain, or poisoning. [45], The existence of PCS in children is controversial. This period of time can range from weeks to months. The usual recovery period is weeks to months. These may be associated with a neck injury that happened at the same time as the head injury. In general, post-concussion syndrome follows the occurrence of an injury or trauma to the head. [51] Physical and behavioral therapy may also be prescribed for problems such as loss of balance and difficulties with attention, respectively. The majority of concussion symptoms will resolve within about two weeks, and with proper recovery almost all dissipate within a month. [13] PCS is also more prevalent in people with a history of psychiatric conditions such as clinical depression or anxiety before the injury. [69] The term postconcussion syndrome was in use by 1941. [26] In one study 64% of people with TBI, 11% of those with brain injuries, and 7% of those with other injuries met the DSM-IV criteria for post-concussion syndrome. Tips to Help You Think Clearly, Slideshow: A Visual Guide to Concussions and Brain Injuries, Video: How to Prevent a Concussion on the Field, Brain Injuries: Treatment and Recovery of Francesco Bertolotti of Modena (Italy), Bob Woodruff's Traumatic Brain Injury Recovery, Football Concussion Controversy: New Rules, Psychological symptoms such as depressed mood, irritability, and, Cognitive problems involving memory, concentration, and thinking. It can also occur with violent shaking and movement of the head or body. Because PCS symptoms are so varied and many can be associated with a large number of other conditions, doubt exists about whether the term "syndrome" is appropriate for the constellation of symptoms found after concussion. Sayegh, A. [11], The symptoms that occur after a concussion have been described in various reports and writings for hundreds of years. [53] Since stress exacerbates post-concussion symptoms, and vice versa, an important part of treatment is reassurance that PCS symptoms are normal, and education about how to deal with impairments. [4], A diagnosis may be made when symptoms resulting from concussion last for more than three months after the injury. (see diagnosis above). [3] Ongoing disabilities may be treated with therapy to improve function at work, or in social or other contexts. [13] In one study, one in four people diagnosed with PCS continued to report memory problems a year after the injury,[13][22] but most experts agree that cognitive symptoms clear within six months to a year after injury in the vast majority of individuals. Sports Medicine and Arthroscopy Review. [44] In addition to these symptoms, people that meet the ICD-10 criteria for PCS may fear that they will have permanent brain damage, which may worsen the original symptoms. Management of post-concussion syndrome typically involves treatments addressing specific symptoms;[11] for example, people can take pain relievers for headaches and medicine to relieve depression or insomnia. 2017;28:287. All rights reserved. [45] In addition, the patient must experience social problems as a result, and must not meet criteria for another disorder that explains the symptoms better. [49] PCS also shares symptoms with chronic fatigue syndrome, fibromyalgia, and exposure to certain toxins. In press. It is not known to exactly what degree the symptoms are due to physiological changes or to other factors, such as pre-existing psychiatric disorders or factors related to secondary gain or disability compensation. This means that almost 95% of concussive head injuries also lead to an upper cervical neck injury. [36], Not all people with PCS have abnormalities on imaging, however, and abnormalities found in studies such as fMRI, PET, and SPECT could result from other comorbid conditions such as depression, chronic pain, or posttraumatic stress disorder (PTSD). 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However, certain risk factors have been identified; for example, preexisting medical or psychological conditions, expectations of disability, being female, and older age all increase the chances that someone will suffer PCS. You don't have to lose consciousness to get a concussion or post-concussion syndrome. [40] Symptoms in children are similar to those in adults, but children exhibit fewer of them. Child passenger safety. Bramley H, et al. Post-concussion syndrome is a condition related to a head injury, such as a concussion or a mild traumatic brain injury, that lasts for weeks to months afterward. Headaches that occur after a concussion may feel like migraine headaches or tension-type headaches. [37] Different symptoms may be predicted by different factors; for example, one study found that cognitive and physical symptoms were not predicted by the manner in which parents and family members coped with the injury and adjusted to its effects, but psychological and behavioral symptoms were. Others believe that post-concussion symptoms are related to common psychological factors. [64] On the other hand, children's brains may be more vulnerable to the injury, since they are still developing and have fewer skills that can compensate for deficits. [8], Some experts believe post-concussion symptoms are caused by structural damage to the brain or disruption of neurotransmitter systems, resulting from the impact that caused the concussion. [60], The way in which children cope with the injury after it occurs may have more of an impact than factors that existed prior to the injury. [8], The condition is associated with a wide range of symptoms: physical, such as headache; cognitive, such as difficulty concentrating; and emotional and behavioral, such as irritability. Ferri FF. Centers for Disease Control and Prevention. Physiological and psychological factors present before, during, and after the injury are all thought to be involved in the development of PCS. [45] One complication in diagnosis is that symptoms of PCS also occur in people who have no history of head injury, but who have other medical and psychological complaints. Antidepressants and psychotherapy may be recommended. Patients need to be reassured that symptoms are often worse in the first week or two after the injury, but typically improve over a few weeks and resolve within a few months. Although you can't prepare for every potential situation, here are some tips for avoiding common causes of head injuries: Mayo Clinic does not endorse companies or products. Many of these PCS sufferers were misdiagnosed as having other unrelated conditions due to commonality of symptoms. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts. [31] Additional studies have shown, using various MRI techniques (such as Diffuse Tensor Imaging (DTI) MRI), that individuals with PCS have various abnormalities in their brain structure. Schultz BA (expert opinion). [13] At least one study with functional magnetic resonance imaging (fMRI) has shown differences in brain function during tasks involving memory after mild traumatic brain injury (mTBI) although they were not examining PCS specifically. The American Journal of Medicine. Not all people who suffer mild traumatic head injury experience post-concussion syndrome. All rights reserved. [13] In addition, the development of PCS can be predicted by having a history of alcohol abuse, low cognitive abilities before the injury, a personality disorder, or a medical illness not related to the injury. [65] PCS is rare in young children. [29], Another theory of why post-concussion syndrome persists is due to an injury to the upper cervical spine (neck), specifically to the C1 (Atlas) or C2 (Axis), which surround the brain stem. Studies using positron emission tomography have linked PCS to a reduction in glucose use by the brain. For example, migraine or pain medications may be prescribed for those with headache. They point out that the International Headache Society lists 14 known causes of headaches, as well. Accessed June 2, 2017. Estimates of the prevalence at 3 months post-injury are between 24 and 84%, a variation possibly caused by different populations or study methodologies. A risk exists that the power of suggestion may worsen symptoms and cause long-term disabilities;[55] therefore, when counseling is indicated, the therapist must take a psychological origin of symptoms into account and not assume that all symptoms are a direct result of neurological damage from the injury.


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