Post-concussion syndrome

Post-concussion syndrome (PCS) is a set of symptoms that can appear after a concussion. Sometimes they stay for several weeks or months.

Doctors don't know the exact cause of PCS. One theory is that it comes from a chemical imbalance in the brain, set off by the injury that caused the first concussion. Another theory is that PCS may be caused by damage to nerve cells in the brain.

Post-concussion syndrome (PCS) can cause physical, psychological or cognitive symptoms. Cognitive means it affects your ability to think. You may have more than one type at the same time, but it's unlikely you'll have all of them.

• headaches that last a long time, and can be mild or severe
• dizziness
• nausea (feeling sick)
• sensitivity to bright lights
• sensitivity to loud noises
• tinnitus (ringing in the ears)
• double or blurred vision
• fatigue (tiredness)
• a changed or reduced sense of smell and taste

• depression
• anxiety
• irritability
• lack of energy
• loss of interest in activities you normally enjoy
• problems sleeping
• changes in appetite
• sudden outbursts of emotion, like crying for no clear reason

• decreased concentration
• forgetfulness
• difficulty remembering things or learning new information
• difficulties with reasoning (working out problems)

These symptoms can make it hard for you to work and to look after yourself.

Post-concussion syndrome (PCS) doesn't show up on any scans or blood tests. So your doctor will diagnose it by looking at three things:

• your medical history (that you've had a recent head injury)
• the types of symptoms you're having
• when your symptoms began (before or after a head injury)

There's no specific treatment that cures post-concussion syndrome (PCS). But there are a lot of strategies that can help, and for most patients the symptoms gradually improve over time.

Pacing strategies are often used to manage PCS. They let you increase your activities gradually, and they can help you get back to work and leisure activities.

Some activities can make PCS symptoms worse, so you should avoid anything overstimulating that does this. These might include:

• late nights
• alcohol
• crowded rooms
• conversations with multiple people at once
• vigorous exercises
• prolonged screen time

You may be prescribed antidepressants or anti-migraine medicine. This doesn't mean your doctor thinks you're depressed or having migraines. These medicines work by reducing abnormal nerve activity in the brain, so they can help with the physical symptoms of PCS.

If you have psychological symptoms, antidepressants can help with these too. Your doctor may also suggest talking treatments (like psychological therapy).