Revisiting Post-concussion Syndrome – When healing takes longer than planned

WESTBOROUGH, MA July 2, 2015 I have recently been referred several cases of unremitting concussion.  What is that? There is a better name for unremitting concussion and its called post-concussion syndrome.  When someone sustains a concussion they can expect that the brain will heal in one to three weeks.  In some cases when the injury is a second or third concussion this timeline may be altered somewhat – generally symptoms are drawn out by days or weeks.  Post-concussion syndrome is diagnosed when the symptoms of concussion extend beyond the three to four-week estimated recovery.  Symptoms of post-concussion syndrome include:


  1. Headaches
  2. Poor concentration
  3. Fatigue
  4. Change in sleep patterns
  5. Decreased memory
  6. Dizziness and changes in balance
  7. Irritability
  8. Sensitivity to light and sound

Remember, a concussion is a traumatic brain injury resulting from a high degree of force or energy being transferred into the brain resulting in an alteration of normal cognitive functioning.  Some call it an “energy” crisis – the brain cannot efficiently access the metabolic nutrients – largely glucose – to accommodate the cerebral demand.  On the Mayo Clinic website they indicate that symptoms of concussion may last as long as 3 months to 1 year.  I can truthfully say I have seen only a handful of cases of post-concussion syndrome that continue over one year.  There are factors that contribute to a protracted course of recovery.  These include specific issues relating to the type of concussion and region of the brain most affected by the trauma.  When symptoms are prolonged it is usually the result of a failure to allow the brain to fully heal before returning to a normal routine.

What can you do if you have symptoms that linger on longer than you expected?  First, take an accounting of your symptom profile.  Be accurate and track the symptoms that seem most problematic.  Do this for 7 days.  Symptoms may be physical, cognitive, sleep-related and/or emotional.  Next, take a look at your level of activity.  If you are back to work, socializing, and exercising regularly than you may be over exerting and should make changes – even temporary ones.  Avoid alcohol while recovering and get ample sleep.  Finally, closely examine the work you are doing and see if there are changes to the work environment that may afford some degree of symptom relief.

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