Post Concussion Syndrome

April 8, 2014
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Post concussion syndrome (“PCS”) is a condition that may be diagnosed following a minor head injury or concussion.  Typical PCS symptoms include headaches, dizziness, fatigue, anxiety, depression and cognitive difficulties such as memory loss and reduction in concentration.  The symptoms of PCS can continue for a significant period of time, ranging from a few months to many years.  The severity of symptoms and their continuing nature can make what would appear to be a relatively minor injury, progress into something serious and debilitating.  This condition is often difficult for treating practitioners to diagnose as commonly a scan of the brain will appear normal.  This can leave the injured person feeling frustrated.

There has been debate among professionals as to whether or not PCS is psychological or physiological in nature.  Indeed, there is evidence to suggest that someone with a history of pre-existing psychological difficulties is more vulnerable to the development of PCS following a head injury than someone without such a history.  Conversely, there are some experts who believe that post concussion symptoms are caused by structural damage to the brain resulting from the impact that caused the concussion or head injury.  Interestingly, there is no correlation between the severity of the original injury and the development of PCS.

The damage to the brain resulting from repeated concussions has been widely discussed in the context of NFL American football which in 2012 saw 189 concussions in one season (an average of 11 concussions per game).  It has been stated that cumulative concussions can cause degenerative brain disease leading to memory loss, impaired judgment, depression and eventually progressive dementia.  Further, particular concerns have been raised as to the affect of concussions suffered by children during sporting activities such as rugby and football.  This is particularly so given that the frontal lobe of a young person’s brain can continue to develop up until the age of 25 years.  Studies have shown that children can take longer to recover from a concussion than adults and may suffer more severe neurological disturbances.

Whilst there is no specific treatment for PCS, there is good evidence to show that early intervention within the first few weeks of a mild head injury does significantly reduce PCS symptoms.  Treatment usually involves treating the individual symptoms of PCS and may include pain medication, anti-depressant medication and/or a talking therapy such as Cognitive Behavioural Therapy.

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