No single test will prove you have persistent post-concussive symptoms.
Your doctor may want to order a scan of your brain to check for other potential problems that could be causing your symptoms. A computerized tomography (CT) scan or magnetic resonance imaging (MRI) may be performed to detect structural brain abnormalities.
If you're experiencing a lot of dizziness, you may be referred to a doctor who specializes in ear, nose and throat complaints.
A referral to a psychologist or licensed counselor may be in order if your symptoms include anxiety or depression, or if you're having problems with memory or problem-solving.
There is no specific treatment for persistent post-concussive symptoms. Your doctor will treat the individual symptoms you're experiencing. The types of symptoms and their frequency are different for everyone.
Medications commonly used for migraines or tension-type headaches, including some antidepressants, antihypertensive agents and anti-epileptic agents, appear to be effective for post-concussion types of headaches. Medications are usually specific to the individual, so you and your doctor will discuss which are most appropriate for you.
Keep in mind that the overuse of over-the-counter and prescription pain relievers may contribute to persistent post-concussion headaches.
Memory and thinking problems
No medications are currently recommended specifically for the treatment of cognitive problems after mild traumatic brain injury. Time may be the best therapy if you have cognitive problems. Most of them go away on their own in the weeks to months after the injury.
Certain forms of cognitive therapy may be helpful, including focused rehabilitation that provides training in the specific areas that you need to strengthen. Some people may need occupational or speech therapy. Stress can increase the intensity of cognitive symptoms, and learning stress management strategies can be helpful to decrease cognitive symptoms. Relaxation therapy also may help.
Depression and anxiety
Persistent post-concussive symptoms often improve after the affected person learns that there is a cause for his or her symptoms and that the symptoms will likely improve with time. Education about the disorder can ease a person's fears and help provide peace of mind.
If you're experiencing new or increasing depression or anxiety after a concussion, some treatment options include:
- Psychotherapy. It may be helpful to discuss your concerns with a psychologist or psychiatrist who has experience in working with people with brain injury.
- Medication. To combat anxiety or depression, antidepressants or anti-anxiety medications may be prescribed.
Preparing for your appointment
An emergency room doctor often makes the initial diagnosis of a concussion. Once discharged, you may seek care from your family doctor or primary doctor.
He or she may refer you to a doctor who specializes in brain and nervous system disorders (neurologist) or a brain rehabilitation specialist (physiatrist).
If you are referred to a specialist, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment and know what to expect from your doctor.
What you can do
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of all medications, vitamins or supplements that you're taking.
- Ask a family member or friend to go with you, if possible. Sometimes it can be difficult to remember all of the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
- Write down questions to ask your doctor.
Preparing a list of questions can help you make the most of your appointment. List your questions from most important to least important in case time runs out.
For persistent post-concussive symptoms, some basic questions to ask your doctor include:
- Why are these symptoms still occurring?
- How long will they continue?
- Do I need any additional tests? Do these tests require any special preparation?
- Are there any treatments available, and which do you recommend?
- Are there any activity restrictions that I need to follow?
- Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?
- When can I return to work?
- When can I drive again?
- Is it safe to drink alcohol?
- Is it OK to take my medications that were prescribed before the injury?
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
- How did the initial injury occur?
- Have your symptoms been constant or do they come and go?
- What symptoms are you currently experiencing?
- How often do your symptoms occur?
- Does anything seem to improve your symptoms?
- What, if anything, makes your symptoms worse?
- Are your symptoms getting worse, staying the same or improving?