If Concussion Symptoms Persist, You May Have Post-Concussion Syndrome

Head trauma is never good news. But with prompt treatment, most people who suffer a concussion will see symptoms go away within weeks, according to the Mayo Clinic. In some cases, however, a head injury can lead to troubling symptoms for months — a condition known as post-concussion syndrome (PCS).

"A concussion occurs any time there is a hit or force to the head that results in immediate symptoms," says Michael Alosco, PhD, an assistant professor of neurology and co-director of the Boston University Alzheimer's Disease Center. "These can include dizziness, confusion, balance problems, nausea, vomiting or headache. Even those hits that are referred to as 'dings' or getting your 'bell rung' can be concussions."

"Loss of consciousness can happen too, but certainly is not needed for a concussion to occur," Alosco says. The bottom line, he says, is that "no concussion is the same, and the symptoms — both in terms of type and onset — are very different."

And that means it's best to err on the side of caution: When in doubt, anyone with a head injury should stop whatever they're doing and get clinically evaluated right away. The good news, he says, is that when treatment is sought and administered quickly, concussion patients typically go on to a full recovery within one to two weeks.

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Despite the quick recovery for many, some concussion patients go on to have prolonged symptoms, Alosco warns. According to the Concussion Legacy Foundation (CLF), anywhere between 5 and 30 percent of people who have a concussion will develop long-lasting symptoms that endure far beyond the usual time frame for recovery.

Patient experiences vary, however. Headache is by far the most common physical symptom, CLF notes. Other people may experience neck pain, lightheadedness, dizziness and sensitivity to light or noise. Still others may be plagued with ringing in the ears, blurry vision or a decrease in the ability to taste or smell normally, Mayo notes.

Physical symptoms are only part of the problem. People with post-concussion syndrome can have difficulties with memory, attention or focus, according to CLF. Poor sleep is another common issue — sleeping too much at first and then having trouble falling asleep. Mood issues may surface that make people feel anxious, irritable or depressed, the foundation points out.

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In some instances, symptoms are constant, even while the person is completely inactive. Others with PCS experience symptoms only while actively exercising or mentally stressed.

But the persistence of symptoms means that most people with PCS suffer when it comes to their quality of life. Adult patients often find it hard to focus and are liable to experience upheavals in both their personal and professional lives. Children can end up feeling isolated, after repeatedly missing out on school and social activities.

It's not clear why some concussion patients develop post-concussion syndrome and others don't. There isn't clear proof that more severe head trauma raises the risk for PCS, according to the Mayo Clinic.

However, the clinic does say that there are some indications that people who have a history of depression, stress, anxiety, post-traumatic stress disorder or poor coping skills may face a higher risk.

"And the severity of initial symptoms is a strong predictor of who will go on to have lasting symptoms," adds Alosco. "A pre-injury history of mental health illness or headaches is also a predictor of slower recovery."

Unfortunately, there's no specific treatment that can help people with post-concussion syndrome achieve a faster recovery. The most effective way is for patients to get physical and mental rest, allowing the brain's natural recovery process to work its wonders, the foundation says.

For people who are especially slow to recover, doctors may recommend one of several "active treatments" to relieve symptoms. Someone with mood issues may go for cognitive behavioral therapy, for example. A balance issue might be treated with vestibular therapy. In addition, some peer-reviewed research, including a May 2016 review in ​Physical Medicine and Rehabilitation Clinics of North America,​ suggests light aerobic activity under doctor supervision may be helpful. The International Concussion Society agrees: exercise can help normalize post-concussion symptoms.

Caution: Do not begin an active treatment program without consulting a physician first. Encouragingly, the Concussion Legacy Foundation stresses that post-concussion syndrome is not a progressive illness, nor is it degenerative. And PCS symptoms do eventually dissipate. In fact, even if it takes longer than most would prefer, the majority of people with PCS will go on to a full recovery.