- Following a concussion, most people fully recover with rest in about a week, but in approximately 10-20% of cases, the symptoms persist and progress to post-concussion syndrome
- The most common physical symptoms of prolonged post-concussion syndrome are headaches and/or various symptoms related to the functions of the visual and/or balance systems, such as blurred vision and dizziness
- Individualised vestibular therapy can usually treat prolonged symptoms
Concussion (mild traumatic brain injury)
A concussion is the most common type of traumatic brain injury, caused by direct or indirect trauma to the head. During a concussion, the brain moves within the skull, first toward the side of impact and then in the opposite direction. A mild brain injury can also occur as a result of a violent movement of the head without direct impact.
The type and severity of a concussion depend on the mechanism of injury, including the direction, force, and duration of the energy, as well as individual factors such as age, medical history, and overall health status. Head injuries always have both short-term and long-term effects, as they alter the structure and function of the brain at the cellular level to some extent. Fortunately, the brain also recovers from injuries, and most of the cellular-level changes do not manifest as prolonged symptoms of concussion but are so mild that they cannot be detected during activity or rest.
Concussions have become a topic of increasing discussion among athletes and active people, as the connection between concussions and various physical and psychological symptoms and neurological disorders has become better known and understood. Sometimes the consequences of a concussion can be dramatic and immediately apparent, and sometimes the effects can manifest themselves over time as subtle changes in, for example, performance, mood, thinking, and memory. Surface appearances and imaging may be normal, yet the individual often senses subtle changes in function that are difficult to describe.
Risk Factors for Developing Post-Concussion Syndrome
- Previous concussions and/or whiplash injuries
- Severe symptoms immediately after the injury
- Existing headaches or balance problems before the injury
- Psychological factors such as anxiety and/or depression
- Psychiatric disorders
- Underlying conditions that already affect neurological function, such as attention deficit disorders
- Younger people and women are more susceptible to prolonged symptoms
- Injuries sustained during leisure time
- Central sensitisation of the nervous system
Signs and Symptoms of Post-Concussion Syndrome
The brain contains hundreds of billions of nerve cells and supporting cells that receive, regulate, and control all of our functions. In practice, this means that brain damage can adversely affect or alter all of these functions. This is reflected in the length and breadth of the list of concussion symptoms, which includes a wide range of physical, psychological, and social symptoms.
The most common physical symptoms in prolonged post-concussion syndrome are
- Impaired balance, motor skills, and coordination
- Persistent mild headache
- Feeling foggy/dazed/unreal
- Impaired reaction time
- Impaired tolerance to bright lights and loud noises
- Difficulty focusing your gaze
- Ringing in the ears and tinnitus
- Mood changes
Treatment and Rehabilitation of Concussion
The treatment of post-concussion syndrome has developed over the last decade. Ten years ago, the main recommendation was rest. Rest is the best advice for the first two weeks, as brain injuries recover best with rest.
Following that, post-concussion symptoms should be treated and rehabilitated if they persist. Symptoms typically vary from day to day, but if they become consistent, it is always advisable to seek examination and treatment as soon as possible. Symptoms following a mild brain injury often lack specific names and are better described as observable changes in daily life and performance. As a specialist in neurological rehabilitation, including vestibular rehabilitation, I diagnose and treat physical functioning and performance disorders and symptoms following concussion, the most common of which are related to headaches, persistent pain and a variety of symptoms of the balance and visual systems.
Read more
What causes vertigo, dizziness and imbalance?
Read more about common causes of dizziness and imbalance
PPPD (Persistent Postural-Perceptual Dizziness)
Read more about common causes of vertigo and imbalance
Benign Paroxysmal Positional Vertigo (BPPV)
