post concussion syndrome
 Evidence from clinical studies found that high school-aged athletes had slower recoveries from concussion as measured by neuropsychological tests than college-aged ones and adults.  Others believe persistent post-concussive symptoms are related to psychological factors. In many cases, both physical damage of brain trauma and emotional reactions to these effects play a role in the development of symptoms. A protocol for PCS treatment has been designed based on the principles behind Cognitive behavioral therapy (CBT), a psychotherapy aimed at influencing disturbed emotions by improving thoughts and behaviors. The American Journal of Medicine. These symptoms may include headaches, dizziness, and problems with concentration and memory. Postconcussion syndrome. , Common symptoms associated with a diagnosis of PCS are related to cognition, attention, and memory, especially short-term memory, which can also worsen other problems such as forgetting appointments or difficulties at work. , Another theory of why post-concussion syndrome persists is due to an injury to the upper cervical spine (neck), specifically to the C1 (Atlas) or C2 (Axis), which surround the brain stem.  In addition, some pain medications prescribed for headaches can cause rebound headaches when they are discontinued. There are currently approximately 7 different chiropractic methods of repositioning the C1 bone, however the three most popular techniques are NUCCA (adjustment done by hand), Blair Technique (adjustment done by hand), and Atlas Orthogonal (adjustment done by a machine). Post-Concussion Syndrome, or PCS, is the persistence of concussion symptoms beyond the normal course of recovery. , Though no pharmacological treatments exist for PCS, doctors may prescribe medications used for symptoms that also occur in other conditions; for example, antidepressants are used for the depression that frequently follows mTBI. , Mild brain injury-related factors that increase the risk for persisting post-concussion symptoms include an injury associated with acute headache, dizziness, or nausea; an acute Glasgow Coma Score of 13 or 14; and suffering another head injury before recovering from the first. Post-concussion syndrome is a condition related to a head injury, such as a concussion or a mild traumatic brain injury, that lasts for weeks to months afterward. Some experts believe persistent post-concussive symptoms are caused by structural damage to the brain or disruption of the messaging system within the nerves, caused by the impact that caused the concussion. , A diagnosis may be made when symptoms resulting from concussion last for more than three months after the injury. Sept. 18, 2020. All rights reserved.
 The severity of these symptoms typically decreases rapidly. It can also occur with violent shaking and movement of the head or body.  Traumatic brain injury may cause damage to the hypothalamus or the pituitary gland, and deficiencies of pituitary hormones (hypopituitarism) can cause similar symptoms to post-concussion syndrome; in these cases, symptoms can be treated by replacing any hormones that are deficient.  The nature of the syndrome and the diagnosis itself have been the subject of intense debate since the 19th century.  The majority of symptoms are largely gone in about half of people with concussion one month after the injury, and about two thirds of people with minor head trauma are nearly symptom-free within three months. A physical exam, and perhaps a CT or MRI scan of the head, may be done to evaluate symptoms.  Some common symptoms, such as apathy, insomnia, irritability, or lack of motivation, may result from other co-occurring conditions, such as depression. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Persistent post-concussive symptoms (Post-concussion syndrome), See our safety precautions in response to COVID-19, Book: Mayo Clinic Family Health Book, 5th Edition, FREE book offer – Mayo Clinic Health Letter.  Recovery as measured by scores on cognitive tests frequently do not correlate with resolution of symptoms; individuals diagnosed with PCS may still report subjective symptoms after their performance on tests of cognitive functioning have returned to normal.
 CBT may help prevent persistence of iatrogenic symptoms – those that occur because health care providers create the expectation that they will.  In one study 64% of people with TBI, 11% of those with brain injuries, and 7% of those with other injuries met the DSM-IV criteria for post-concussion syndrome.  Clinical research has found higher rates of post-concussion symptoms in children with TBI than in those with injuries to other parts of the body, and that the symptoms are more common in anxious children.  The real causes of the condition remain unclear.  Since stress exacerbates post-concussion symptoms, and vice versa, an important part of treatment is reassurance that PCS symptoms are normal, and education about how to deal with impairments.  The subjectivity of the complaints complicates assessment and makes it difficult to determine whether symptoms are being exaggerated or feigned. 2016;24:123.  In one study, levels of daily stress were found to be correlated to PCS symptoms in both concussed subjects and controls, but in another, stress was not significantly related to symptoms.  In addition, for a diagnosis of PCD, patients must have neuropsychological impairment as well as at least three of the symptoms marked with a check mark in the table at right under "DSM-IV". For example, migraine or pain medications may be prescribed for those with headache. Furthermore, the headaches may be better accounted for by mechanical causes, such as whiplash, which is often mistaken for PCS.
PCS, which shares symptoms with a variety of other conditions, is highly likely to be misdiagnosed in people with these conditions. Post-concussion syndrome: clarity amid the controversy?
Post-concussion syndrome (PCS) is a condition in which the symptoms of concussion or a head injury last long after the initial injury. This content does not have an English version. Accessed May 24, 2017. Post-concussion syndrome is a complex disorder in which various symptoms — such as headaches and dizziness — last for weeks and sometimes months after the injury that caused the concussion.Concussion is a mild traumatic brain injury that usually happens after a blow to the head.
, Though no universally accepted definition of postconcussive syndrome exists, most of the literature defines the syndrome as the development of at least 3 of the following symptoms: headache, dizziness, fatigue, irritability, impaired memory and concentration, insomnia, and lowered tolerance for noise and light. Concussion. Since symptoms can be vague and attributable to other reasons, it can be difficult to diagnose post-concussion syndrome. A risk exists that the power of suggestion may worsen symptoms and cause long-term disabilities; therefore, when counseling is indicated, the therapist must take a psychological origin of symptoms into account and not assume that all symptoms are a direct result of neurological damage from the injury.
https://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/ChildPassSafety.html. Centers for Disease Control and Prevention. In fact, the risk of post-concussion s…  Loss of consciousness is not required for a diagnosis of concussion or post-concussion syndrome..  In order to meet these criteria, a patient has had a head injury "usually sufficiently severe to result in loss of consciousness" and then develop at least three of the eight symptoms marked with a check mark in the table at right under "ICD-10" within four weeks. Headache and dizziness occur immediately after the injury, but also can be long lasting.
, In 1961, H. Miller first used the term "accident neurosis" to refer to the syndrome which is now called PCS and asserted that the condition only occurs in situations where people stand to be compensated for the injury. https://www.cdc.gov/traumaticbraininjury/prevention.html.
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