Overview
Persistent post-concussive symptoms are symptoms of a mild traumatic brain injury that typically last longer than three months. Persistent post-concussive symptoms also are called post-concussion syndrome. The symptoms may include headaches, dizziness, and trouble with concentration and memory. Symptoms can last weeks to months.
A mild traumatic brain injury is known as a concussion. A concussion may be caused by a fall, car accident or contact sports injury. Other causes include violent shaking and movement of the head or body.
You don't have to lose consciousness to get a concussion. And a concussion doesn't always cause persistent post-concussive symptoms. The risk of having persistent post-concussive symptoms doesn't appear to be linked to how severe the injury was.
Persistent post-concussive symptoms in most people appear within the first 7 to 10 days after an injury and typically last longer than three months. But sometimes they can last for a year or more. The goal of treatment is to manage symptoms and to improve functioning and quality of life.
Symptoms
Persistent post-concussive symptoms can be different in each person. They may include:
- Headaches.
- Dizziness.
- Fatigue.
- Irritability.
- Anxiety.
- Depression.
- Trouble falling asleep or sleeping too much.
- Poor concentration and memory.
- Ringing in the ears.
- Blurry vision.
- Noise and light sensitivity.
- Nausea or vomiting.
- Neck pain.
Headaches after a concussion most often feel like migraines. The headaches also might feel like tension-type headaches, which may be related to a neck injury that happened at the same time as the head injury.
When to see a doctor
See a healthcare professional if you experience a head injury that causes confusion, memory loss, vision changes, nausea, vomiting or a sudden, bad headache. Get medical help even if you never lost consciousness. Also see a healthcare professional if you lose feeling, can't move a part of your body, or have trouble speaking or writing.
If you get a concussion while playing a sport, don't go back into the game. Seek medical help so that the injury doesn't get worse.
Causes
More research is needed to better understand how and why persistent post-concussive symptoms happen after some injuries and in some people but not in others.
Persistent post-concussive symptoms may result directly from the impact of the injury itself. Or symptoms may trigger other conditions such as migraines. Symptoms also may be related to other factors. These may include trouble with sleep, dizziness, stress and mental health. Your healthcare professional works with you to understand the cause of your symptoms and which treatments may help.
Risk factors
Risk factors for developing persistent post-concussive symptoms include:
- Age. Persistent post-concussive symptoms usually are reported in people ages 20 to 30. But studies also show that older adults are at risk of more serious and prolonged persistent post-concussive symptoms.
- Sex assigned at birth. Women are more likely to be diagnosed with persistent post-concussive symptoms. But this may be because women are generally more likely to seek medical care.
- Anxiety. A history of anxiety is a strong risk factor.
- Prior headaches. People who have a history of headaches are at higher risk of having persistent post-concussive symptoms.
- Prior brain injury. A previous brain injury is linked to persistent post-concussive symptoms. But lasting symptoms also can happen after a single concussion.
Prevention
The only known way to prevent persistent post-concussive symptoms is to avoid a head injury in the first place. You can't always prevent a head injury. But some tips for avoiding them include:
- Wear your seat belt. Buckle up every time you ride in a car or other motor vehicle.
- Be sure children are in the right safety seats for their ages. Children under age 13 are safest riding in the back seat, especially if your car has air bags. From birth to age 4, their car seats should face the rear. After outgrowing their rear-facing car seats and until at least age 5, they can face forward in the car seats. When children outgrow their forward-facing car seats, they should be moved to buckled booster seats in the back seat. When their seat belts fit properly without booster seats, they can move to seat belts. This usually happens between ages 9 and 12. All children age 13 and under should sit in the back seat.
- Wear a helmet. Wear a helmet when biking, roller-skating or ice-skating, skateboarding, riding a motorcycle, skiing, snowboarding, or any activity that could cause a head injury. It's also a good idea to wear a helmet when horseback riding or playing football, baseball or softball.
- Get annual eye exams. This is very important for older adults because vision problems may increase the risk of falls. If needed, get new glasses or contacts.
- Make your home safer. Remove small area rugs, improve lighting, install handrails and use safety gates for children. Prevent falls in older adults by talking to a healthcare professional about medicines that might cause dizziness or affect balance.