Warning Signs Of Post-Concussion Syndrome

Post-concussion syndrome occurs when an individual has symptoms for a significant period, such as weeks or months, after a concussion-causing injury. A concussion is the mildest form of traumatic brain injury. It might also occur when an individual shakes their head violently. There doesn't appear to be a correlation between the injury's severity and the risk of post-concussion syndrome. This means individuals can still get post-concussion syndrome even if they didn't lose consciousness due to the injury. The symptoms tend to start seven to ten days after the injury, and they subside within three months. There are rare cases where symptoms persist for more than a year.

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Tinnitus, the medical term for ringing in the ears, is exceedingly common. It's estimated fifteen to twenty percent of the population experiences tinnitus. Though the phenomenon isn't a condition itself, it's a symptom of many different conditions, including concussions and post-concussion syndrome. There are some treatments for tinnitus specifically, while others focus on diagnosing and managing an underlying condition. The symptoms include humming, clicking, hissing, roaring, ringing, or buzzing in the ears. Patients might hear pitches that range from a high squeal to a low roar. Of the two types of tinnitus, the one most commonly associated with post-concussion syndrome is subjective tinnitus. This form of tinnitus is only heard by the patient. It can be caused by a problem with the auditory nerves or auditory pathways in the brain. With objective tinnitus, the doctor can also hear the tinnitus when an examination is done. This is a rare kind of tinnitus sometimes caused by problems in the blood vessels.

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Sensitivity To Light And Noise


Another common symptom is sensitivity to light and noise. Painful light sensitivity, otherwise known as photophobia, may present in up to forty-three percent of patients after a traumatic brain injury. If individuals have other risk factors, their rate of photophobia might be higher. Individuals at risk include patients who participate in high-contact sports, activities, and professions. The risk may also increase for those who have had multiple head injuries. The most notable statistic is that between sixty and seventy-five percent of soldiers who had blast-related concussions report light sensitivity. This indicates veterans have one of the highest risks of light sensitivity after a concussion. Noise sensitivity is common following a concussion, but it's unusual for the sensitivity to last for a prolonged period. Sensitivity to noise is often paired with tinnitus.

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Tension Headaches Or Migraines


Patients with post-concussion syndrome may experience tension headaches or migraines. The presentation of headaches is varied, though the most common headaches are tension-related. If a neck injury occurred alongside the head injury, it may be contributing to the headaches. When headaches persist for a long time after the injury occurs, they can become a serious complication. Some patients experience a migraine or headache that persists for over three months, longer than it takes for most post-concussion cases to resolve. About ten to twenty percent of patients have significant post-concussion symptoms, but somewhere from fifty-nine to ninety percent of individuals have significant headaches after a concussion. Headaches are also more common in older women, individuals with prior head injuries, those with a history of headaches, and patients with a family history of headache-related disorders.

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Loss of Concentration


A loss of concentration and general difficulty concentrating are common in patients with post-concussion syndrome. In fact, this is the most commonly presenting cognitive symptom. The trouble with concentration might be caused by other issues like pain in the neck, vision changes, and changes in the structure of the nerves. It may also be related to psychological symptoms, especially if the individual is experiencing anxiety after the injury. Many patients with sensitivities to light or noise find it difficult to concentrate because they're distracted by overwhelming sensory information. The loss of concentration may present in different ways. Patients might be more easily distracted, have trouble following what's being done or said, or have trouble multitasking. In addition, individuals might have to take longer to process information. Too much information may cause cognitive overload.

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Insomnia And Fatigue


Insomnia and fatigue are common signs of post-concussion syndrome. Many individuals experience insomnia immediately after the initial injury, but persistent insomnia and sleep disturbance is a sign of a deeper condition. There are multiple ways sleep disturbance may present among patients. When researching sleep disturbances in post-concussion patients, experts recommend evaluating each patient's sleep at regular intervals over the recovery process. Some patients may experience periods of hypersomnia, in which they sleep excessively or are unusually tired during the day. They may take naps or fall asleep during regular activities. These periods might be interspersed with periods of insomnia, in which patients struggle to fall asleep at night. It's common for a variety of sleep issues to present after a concussion, so persistence is key to identifying post-concussion syndrome.

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Blurry Vision


Post-concussion syndrome can come with blurry vision. Depending on the injury, affected individuals may experience blurring of their vision soon after the event or a few days afterward. Blurry vision can occur in one eye or both. Blurred vision isn't always a cause for emergency care, but it can be a warning sign to watch out for. Paired with other serious signs of post-concussion syndrome, patients should seek emergency medical treatment. Patients may find their blurred vision is serious enough to interfere with their ability to navigate, while it may also be more subtle and cause images to just seem a little fuzzy.

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Many individuals report dizziness following a concussion. The dizzy spells may occur a week or two following the event that caused the injury. Most individuals recover from these spells without any issue, but they can sometimes be a sign the concussion isn't healing the way it's supposed to. If an individual's dizziness is strong or lasts for more than a few weeks after the injury, it could be a sign of post-concussion syndrome. There are many aspects of a concussion that can cause dizziness. If patients have inner ear issues or migraines, their balance can be affected. Injuries to the nerves and muscles in the neck can also cause affected individuals to feel dizzy, as can minor changes in certain parts of the brain.

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Anxiety And Irritability


Unusual anxiety and irritability can be signs of post-concussion syndrome if they last for longer than a couple of weeks following the concussion. Depending on what caused the injury, patients may feel more anxiety about the possibility of being injured again. Other types of anxiety may be more nebulous. Affected individuals may find themselves worried about things that could happen, catastrophizing, or lying awake at night thinking about past mistakes. Unusual irritability is also common. Patients may find themselves having less patience and snapping at others over seemingly small things. They may also feel like their overall stress levels have undergone a significant increase.

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Vertigo often occurs after a concussion, and it can be associated with other balance-related issues like dizziness and trouble walking straight. When it occurs alongside post-concussion syndrome, the balance problems and vertigo may last for a long time after the traumatic brain injury. Some studies show up to eighty percent of individuals who have a concussion also experience vertigo during the first couple days following the injury. With a normal concussion, vertigo resolves within two weeks or less. But if the vertigo is lasting for longer, it could indicate post-concussion syndrome. Studies also show vertigo can become chronic for one of every five affected individuals, some of whom report they experienced symptoms for five years or more.


    Katherine MacAulay