What Happens When the Symptoms of Concussion Last Longer Than Expected?
What happens if you (or your child) has had a concussion but symptoms last for weeks or even months beyond the normal recovery time? The culprit could be Post Concussive Syndrome. We spoke to Dr. Kate Mullin with the New England Institute for Neurology and Headache (NEINH) about what you need to know.
What are the symptoms?
Symptoms include headache, dizziness, fatigue, light sensitivity, nausea, sleep disturbances and irritability.
What is the treatment?
“The old treatment of concussions used to stand on the theory that “Rest is Best”. Patients would be cocooned with minimal physical activity or social interactions, until all symptoms dissipated. However, we have learned that a gradual reintroduction of physical and mental activities after a brief period of strict rest (24-48 hours) is best. If a patient is able to escalate their activity, without exacerbation of symptoms, generally medications are not required,” explains Dr. Mullin. She also says that while there are no pharmacologic treatments that are recommended for Post Concussive Syndrome, many patients with more long lasting symptoms are treated symptomatically. “For example, as sleep is often times an issue, Melatonin can be used to help regulate sleep cycles. For issues with imbalance and dizziness, often times vestibular rehabilitation is recommended to help strengthen the balance center of the brain. Patients with headache as a pronounced feature are often times treated with migraine medications,” she says.
What is something that surprises patients/family members?
Concussive symptoms can last a very long time regardless of the degree of impact. Dr. Mullins explains, “Additionally, even if a patient is very symptomatic, their neurologic exam and testing, including MRIs, can be normal. This does not mean they don’t have a concussion. Another very important thing to keep in mind is that no matter how disabled a person may be, there is always a chance for a complete recovery.”
What is the outlook for someone with Post Concussive Syndrome?
Dr. Mullin says that as for the outlook, it’s difficult to predict the prognosis of people that develop Post Concussive Syndromes. “The most active thing we can do for now to prevent it is to avoid head injuries by wearing appropriate protective gear, always fastening our seatbelts, holding onto railings etc. Should you hit your head despite those measures, it is important that you see a physician to walk you through the appropriate next steps to help you recover without prolonged symptoms,” she says.
Is this becoming more common or just diagnosed more frequently?
“Luckily, we, as a society, are much more aware and sensitive to concussions in light of our new knowledge about CTE (Chronic Traumatic Encephalopathy). Coaches on the sidelines are screening more as the impact happens, parents are taking their children for follow ups to get neurocognitive testing,” explains Dr. Mullin. “Concussions as a whole are actually less frequent now because society is increasingly aware of the effects of repeated head trauma. Subsequently helmets are being required in more sports, are more properly fitted, and student athletes are benched more often than not until an appropriate evaluation can be made,” she explains.
NEINH has a Personalized Concussion Care Center with a fully integrated clinical and research center providing individualized care to children, adolescents and adults who have suffered a concussion. The team consists of neurologists, neuropsychologists, psychologists, nurses, vestibular physical therapist, massage therapists and dietitians are experts in the field of concussion assessment and management.
Their program has 3 main goals:
- Providing the highest level of medical care to children, adolescents and adults with concussions, to allow for the fastest safest return to school, sports or work.
- Increasing research-based knowledge, skills and instrumentation used in evaluation and treatment of concussion
- Improving the general knowledge of our community in regard to early recognition of concussion signs and symptoms and proper management of concussion to prevent long term complications.
This post is sponsored by the New England Institute for Neurology & Headache, located at 30 Buxton Farm Road (Ste 230) in Stamford. To find out more or book an appointment, go to neinh.com or call (203) 914-1900.
(Photos c/o Unsplash)