Managing Post-Concussive Syndrome

Mild traumatic brain injury — often referred to as a concussion — is the most common type of TBI. Concussions typically result in disruption of brain function, with symptoms such as confusion, headache, and dizziness. Based on the medical evidence, approximately 90 percent of concussion symptoms are transient, and those symptoms typically resolve within 10–14 days. However, some symptoms (physical, cognitive, behavioral, or emotional in nature) may linger for weeks.

Post-Concussive Syndrome Symptoms — What to Watch For

Individuals experiencing PCS may face a range of physical, cognitive, emotional, and behavioral symptoms that can impact their daily functioning and overall well-being. PCS can persist beyond the acute phase of a concussion or mild TBI. 

While the exact mechanisms underlying PCS are not fully understood, it is believed to involve physiological, neurobiological, and psychosocial factors contributing to ongoing symptoms and functional impairments. Symptoms can range in severity, duration, and impact on daily functioning.

Post-Concussion Syndrome Treatment

Mild TBI and PCS are conditions that can have a significant impact on an individual’s cognitive, physical, and emotional well-being. There are a range of treatment options, medical practices, and therapies involved in managing mild TBI and PCS.

When a patient is admitted to the hospital with a concussion or mild TBI, the treatment approach typically focuses on both immediate assessment and ongoing care. Initially, health care providers conduct a thorough evaluation, which includes a neurological examination to assess cognitive function, coordination, and balance. Imaging studies, such as CT scans, may be performed to rule out any complications, such as fractures or bleeding within the brain. Once a diagnosis is confirmed, the primary treatment often involves evaluation, testing, monitoring, and managing symptoms. Often patients are referred to neuropsychologists who, in coordination with neurologists, perform evaluations and testing which can identify cognitive deficits, predict functional outcomes, and monitor patient recovery after TBI.

Patients are usually advised to rest both physically and cognitively because overexertion can exacerbate symptoms. Pain relievers may be prescribed to alleviate headaches, while antinausea medications can address those symptoms. Education about the importance of gradual return to normal activities is important, and if necessary, referrals for additional diagnosis, treatment, and counseling can be made.

Source: Schroeder et al, “Neuropsychological Evaluations in Adults,” American Family Physician 99, no. 2 (2019): 101.

The best possible outcomes are achieved when a patient and their family understand the nature and goals of a treatment plan and follow the physician orders regarding treatment and therapy.

Prognosis for PCS

Based on the medical evidence, approximately 90 percent of concussion symptoms are transient, and those symptoms typically resolve within 10–14 days. However, some symptoms (physical, cognitive, behavioral, or emotional in nature) may linger for weeks. 

Persistent PCS occurs when symptoms persist beyond three months. Persistent PCS can have lasting effects on cognition, memory, learning and executive function, and people who suffer multiple instances of TBI are at greater risk for PCS. PCS can lead to significant disability, lost earnings, and lost earnings capacity.