POST CONCUSSIVE SYNDROME [ back to Glossary Index ]
Post Concussive Syndrome is the name given for a cluster of common symptoms which afflict persons after they sustain a concussion. Early PCS symptoms (those which show up within minutes, hours or days of the concussion) include headache, blurry vision, nausea (with or without vomiting), dizziness, imbalance, decreased attention span, easy distractibility, decreased short term memory, insomnia and fatigue. Late symptoms (those which are first noticed weeks after the concussion, and which tend to persist longer) include anxiety, depression, obsessive-compulsive behaviors, reduced frustration tolerance, irritability and emotional lability (sudden, rapid mood swings). The medical literature shows that many people with PCS are symptom free by 3 months, and that 85% are symptom free by 12 months. The 15% who are still suffering PCS symptoms after 12 months have been dubbed the "miserable minority." The medical literature shows that anyone having significant PCS symptoms at 12 months out, is likely to remain "stable" over a 3 year period, i.e. will continue to suffer those symptoms over a 3 year period. Some of those people will eventually improve. Others will not. Because it is only the "miserable minority" (the 15% who do not get better) that pursue personal injury and workers compensation cases, the insurance companies who are defending those cases seek to blame persistence of symptoms on psychological factors separate from the physical injury to the brain, so they can escape paying for treatment and disability. They commonly attribute prolonged PCS symptoms to the stress of litigation, hysteria, somatiform disorder, pre-existing personality disorder, pre-existing depression or malingering.

The medical literature shows that people with persistent PCS continue to have it long after their lawsuit has concluded As a statistical matter it is simply not true that the ending of litigation (along with its stresses and its opportunities for financial gain) always, or even usually, brings an end to complaints of PCS symptoms. Why do some people continue to suffer PCS symptoms years after other people with concussions have gotten better? This is an area of intense interest for persons in brain injury support groups; for lawyers and insurance companies; for public health planners; and for the neuropsychologists, neurologists and neurophysiologists engaged in neuroscience research. Some of the possible explanations now being looked into, which may or may not apply to a specific individual depending on his unique history, are age; previous concussion(s); having the APOE-e4 gene for Alzheimer's Disease; and neuro-psychiatric factors.  Sometimes doing a PET scan or SPECT scan can clear up the mystery by showing that a "mild" brain injury was far more extensive than previously thought in light of short duration of LOC and negative or marginally positive MRI.