Post-concussion Syndrome

Lingering symptoms following concussion

WESTBOROUGH, MA  February 15, 2014 Post-concussion Syndrome or PSC results in a small number of cases of traumatic brain injury that go on to have symptoms like headache 1-3 months after onset of injury.  Concussive injuries are a common and sometimes lingering affliction in as many as 15 percent of patients.  Some believe when litigation is involved the symptoms of concussion may linger even longer!
Concussion occurs with and without a lapse in consciousness.  Any force hitting the skull can induce the cascade of physiological effects of concussion.  These symptoms generally last 3-14 days with the subtle cognitive consequences being most lingering.  The Concussion Assessment and Management Program (CAMP) keeps track of patient’s who require support after concussion.  CAMP is now located at Whittier Rehabilitation Hospital in Westborough and offers a complete range of concussion assessment and management protocols.  Many people wrongly believe that they may return to practice and then games without first being cleared by a physician.  Most states require this clearance before an athlete may return to play. Rhode Island was the first state in New England to require concussion education for all parents, athletes, coaches, and referees.  Most states have followed suit.  The state of Connecticut has an outstanding concussion training program for coaches.
Symptom profile
Post concussion has a range of symptoms associated with those who are diagnosed with lingering, unresolved symptoms.  Typically, PCS has a range of possible symptoms in three domains: physical, cognitive, and psychological.  The physical symptoms of post-concussion or mild traumatic brain injury are usually short-lived.  But a small subset of patients with concussion go on to have a prolonged course of recovery and persistent symptoms – as many as 5-15 percent.  Symptoms include headache, poor concentration, poor balance, changes in mood, sleep disturbance, poor concentration and attention, and decreased short-term memory. This is known as post-concussion syndrome and has been shown to be a significant barrier to fully independent functioning to those with this affliction.
Fatigue – hypersomnia
Sensitivity to light and noise
Feelings of fogginess
Poor concentration
Changes in sleep
Decreased frustration tolerance – irritability
Depression and mood changes
“PCS may interfere with the patient’s return to work by reducing productivity and perhaps the blossoming of symptoms later on.  This should be followed by a physician or concussion specialist”, according to Michael Sefton, Ph.D.
Treatment and recovery
Recovery from a brain injury requires time and patience.  It is important for an injured person to get enough rest in the immediate aftermath of concussion but there is growing consensus that athletes should begin to exert themselves soon afterward.  Rest can allow the brain to regain its homeostatic balance.  Returning to work or play before fully healed can add to the risk of Second Impact Syndrome, a rare but potentially life threatening condition.  Treatment may consist of short-term physical and cognitive therapy for balance, dizziness, and problems with thinking.  Routinely, patients may be referred to Whittier Rehabilitation Hospital or other Whittier Network facility for physical therapy evaluation and treatment, as needed.  The outpatient service at Whittier is uniquely staffed with therapists with expertise in balance and vestibular conditions that may be a sign of post-concussion syndrome.  Return to work and returning to athletic competition is something that requires care and significant rest.  A particular hinderance to these are postconcussive headaches, poor attention, and sometimes decreased short-term memory.

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