This month I sat down with Dr. Mel Glenn, a physiatrist in Boston who specializes in physical medicine and rehabilitation (PM&R) and brain injury medicine, to talk about post-concussion syndrome. Dr. Glenn is the Director of Outpatient and Community Brain Injury Rehabilitation at Spaulding Rehabilitation Hospital, the Medical Director at NeuroRestorative and at Community Rehab Care, a faculty member at Harvard, and a physician at Massachusetts General Hospital. You can watch the interview here.
As an introduction to the topic, here’s some background on what post-concussion syndrome is.
Post-concussion syndrome (PCS) occurs after a concussion and consists of a wide variety of symptoms that may persist for weeks, months, or even years after the initial trauma.
Symptoms may be related to cognitive, behavioral, emotional, or physical health. They often include:
- neck pain
- poor memory
- poor concentration
- sleep problems
- sensitivity to light
- sensitivity to noise
These are also the most common symptoms associated with concussion, which is also known as a mild traumatic brain injury (mTBI). Two things distinguish post-concussion syndrome from a concussion.
One is the time frame: the initial symptoms caused by a concussion typically appear soon after the trauma and resolve on their own within two to four weeks, while PCS symptoms either persist from the time of injury or begin to appear several weeks after the injury and they may continue for months or even years.
The other difference is the intensity and progression of symptoms: while symptoms from the initial injury are bad at first and get better over time, symptoms of PCS may instead get worse over time.
Post-Concussion Syndrome Is Common
Post-concussion syndrome is common, though the exact numbers are hard to know. One study found that as many as 50% of patients reported symptoms for up to three months after a concussion, and 10–15% after a year. (You can find the abstract of that study here.)
Post-Concussion Syndrome Affects Quality of Life
Seth Fischer, the medical student and concussion survivor who was the subject of my March interview, described firsthand how PCS affected his life. His symptoms of headaches, body aches, dizziness, blurry vision, and sensitivity to light, movement, and sound lasted off and on for a year after the bike accident that gave him a concussion. Worse yet, his inability to concentrate and memorize information made it almost impossible to study for his upcoming board exams. Seth described how the chronic pain and depression he experienced fed into one another, making them both worse. It was a very difficult time in his life.
Seth’s story is just one of many. For people with PCS, life can be an ongoing battle of chronic pain and other symptoms that are hard to treat, and every aspect of life can be affected.
Post-Concussion Syndrome Is Controversial
It must be mentioned that PCS is a controversial topic in medicine. While the data show that many people experience symptoms long after a concussion, whether PCS should be considered a separate condition is debated. The next blog will look at why this is. In the meantime, do watch my interview with Dr. Mel Glenn, which you can do right here.