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Post Concussion Syndrome

Overview - Causes - Treatment

General Overview:

A patient may be diagnosed with Post Concussion Syndrome (PCS) when concussion symptoms persist for longer than two weeks (adults)  / four weeks (children).  It is estimated that 30% of individuals who suffer a concussion will develop PCS. It is important that you seek medical advice as soon as possible after sustaining a head injury, as early intervention may reduce your chance of developing PCS. 

 

Causes of PCS: 

The risk of developing post-concussion syndrome is not necessarily linked to the severity of the initial concussion. Although the biological cause of PCS is not completely clear, there are 5 main factors that scientists believe contribute to the development PCS. Each factor may be present individually, or in conjunction with another factor(s). 

 

 1.Reduced blood flow to the brain 

After a concussion,  your autonomic nervous system (ANS) may become dysregulated. The ANS is responsible for your ‘rest’, ‘fight’, or ‘flight’ status and has a big impact on our heart rate and blood flow. If your ANS is not working properly, the blood flow to your brain also becomes dysregulated. Reduced blood flow to the brain will reduce the available amount of oxygen and glucose within the brain that is necessary for energy production. Studies show that reduced blood flow to the brain may be one of the main reasons why a patient experiences exercise intolerance post-concussion.

 

 2. Inflammation in the brain and metabolic disruption 

After suffering a concussion, your immune system will trigger an inflammatory response in the central nervous system (CNS), which may impair brain signalling. Even after the inflammation resolves, symptoms may not subside immediately. For further information, read our blog post titled 'Unravelling the Connection between Inflammation and Concussion.'

 

A concussion can also lead to hormonal imbalances. The pituitary gland, which is responsible for releasing certain hormones, is located within the brain. If the pituitary gland is disrupted upon impact, this can result in hormonal changes that may contribute towards symptoms. 

 

 3. Visual and vestibular problems 

Trauma to the brain can lead to visual and vestibular problems if the neurones involved in these processes are not functioning properly. They can be overactive or under-active and this can contribute to symptoms such as: headaches, brain fog, nausea and balance issues. Treatment can include visual therapy, vestibular therapy, massages and more. 

 4. Neck issues 

Almost all cases of concussion are coupled with whiplash or other spinal injuries. The strain on the neck muscles can cause symptoms such as: headaches, pain, dizziness and nausea. In order to resolve a neck / spinal injury, the attention of a physiotherapist  may be required. Normally, when a doctor suspects a patient of having a concussion, they will try rule out neck/spinal injuries through either a physical examination or by taking scans. 

 

 5. Psychological issues 

Although this is often overlooked by medical professionals, there is evidence to show that many PCS patients suffer from psychological issues, such as PTSD. It can be difficult to distinguish between the symptoms of a psychological disorder and the symptoms of PCS. since symptoms are very similar: headaches, fatigue, dizziness, insomnia, brain fog, irritability, depression and anxiety.

 

Treatment:

It can seem overwhelming that so many factors may be contributing to your PCS. However, it's important to note that with the correct treatment, your condition will improve. For more information on available treatments, click here

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