Persistent post-concussive symptoms

Diagnosis

Diagnosing post-concussion syndrome (PCS) involves a multi-faceted approach due to the absence of a singular test that can definitively confirm a concussion. Healthcare professionals rely on a combination of clinical judgment and the evaluation of symptoms to diagnose a concussion and, subsequently, PCS.

The process typically includes the following steps:

• Physical and neurological examination: This initial assessment focuses on your nervous system’s functionality, checking for signs that are indicative of a concussion.
• Medical history and symptom discussion: Your healthcare provider will discuss the injury leading to the suspected concussion and any symptoms you’ve experienced since the incident.
• Imaging scans: Tools like computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, or X-rays are employed. Although they cannot diagnose PCS directly, they are crucial for identifying or ruling out complications such as skull and neck fractures, brain bleeds, and other brain injuries.

For those suspected of having PCS, ongoing monitoring is essential:

• Follow-up visits: Your healthcare provider will likely schedule regular follow-ups to monitor any symptom changes. These appointments may involve repeating tests or revisiting questions to detect subtle changes in your condition.
• Additional tests: Depending on your symptoms and medical history, your provider may suggest other tests to gain a deeper understanding of your condition. These tests are selected based on their potential to provide valuable insights into your symptoms and overall health.

Your healthcare provider will guide you through the recommended tests and explain their relevance to your situation, ensuring a comprehensive approach to managing and understanding PCS.

Treatment

There isn’t a one-size-fits-all treatment plan for managing persistent post-concussive symptoms. Instead, your healthcare provider will tailor the treatment to address your specific symptoms. The nature and frequency of these symptoms can vary greatly from person to person. 

Headaches

Medications commonly prescribed for migraines or tension-type headaches have shown effectiveness in treating headaches associated with post-concussion syndrome. These medications may include those typically used for managing depression, high blood pressure, and seizures. However, the selection of medication is typically tailored to each individual’s needs, and you will collaborate with your doctor to determine the most suitable options for you. 

It’s important to note that excessive use of pain medication may exacerbate persistent post-concussion headaches. This risk applies to both prescription pain medication and over-the-counter options purchased without a prescription. 

Memory and thinking problems.

Currently, there are no prescribed medications for addressing memory and cognitive issues following mild traumatic brain injury. In many cases, the passage of time proves to be the most effective form of therapy, with symptoms typically diminishing naturally within weeks to months post-injury. 

Certain types of cognitive therapy may offer assistance, such as targeted rehabilitation aimed at strengthening specific areas of concern. Additionally, individuals may benefit from occupational or speech therapy as needed. Given that stress can exacerbate cognitive symptoms, learning stress management techniques can be beneficial. Furthermore, relaxation therapy may also provide relief. 

Depression and anxiety

When patients realize what is causing their symptoms and that they will probably go away with time, their symptoms frequently get better. Knowledge can calm anxieties and promote tranquility.

Following a concussion, some therapeutic options if you’re dealing with new or worsening depression or anxiety include:

• Psychotherapy. Speaking with a psychologist or psychiatrist who has experience treating patients with brain injury might be beneficial in addressing your worries.
• Medications. To help treat anxiety or depression, doctors may prescribe antidepressants or anxiety medications.