Assessment of Post-Concussion Syndrome

Assessment of Post Concussion Syndrome.

When clients approach us with a history of a mild traumatic brain injury, with persistent symptoms for months or years after the accident, we recommend checking for the possibility of PCS. This involves a clinical assessment of symptoms, and with their informed consent, adjunct tests as described below. 

No DSM-5 criteria for PCS

The DSM-5 (2013) and DSM-5-TR (2022) do not include PCS as a distinct diagnosis. Instead, symptoms after concussion or mild traumatic brain injury (mTBI) are often diagnosed under: Major or Mild Neurocognitive Disorder Due to Traumatic Brain Injury (TBI)

ICD-10 Criteria

ICD-10 stands for the International Classification of Diseases, 10th Revision. It’s a medical coding system developed and maintained by the World Health Organisation (WHO). Hospitals, clinics, insurance companies, and researchers around the world use ICD-10 codes to classify and record diagnoses, symptoms, and medical procedures

ICD-10 describes Postconcussional Syndrome as a diagnosis for symptoms lasting beyond the expected recovery period, typically defined as more than 3 weeks to 3 months. It represents a nonpsychotic brain syndrome involving physical, cognitive, and emotional symptoms following head trauma. 

The Clinical Criteria for an ICD-10  diagnosis of Postconcussional Syndrome (F07.81/F07.2), requires that the patient must have a history of head trauma (with or without loss of consciousness) and at least three of the following symptoms, which may be chronic or late-emerging: 

  1. Physical Complaints: Headache, dizziness, malaise, fatigue, or noise intolerance.
  2. Emotional Changes: Irritability, emotional lability, depression, or anxiety.
  3. Cognitive Complaints: Difficulty with concentration or memory.
  4. Insomnia.
  5. Reduced tolerance to alcohol or stress.

Post-concussion syndrome (PCS) poses significant challenges, as its symptoms—including cognitive difficulties, mood disturbances, and headaches—vary widely among individuals and frequently overlap with those of other neuropsychiatric conditions (Buhagiar et al., 2020).

Conventional diagnostic tools, such as clinical assessments and cognitive, memory, or attention tests, remain essential; however, these methods do not always capture the full extent of neural dysfunction (Smith & Jones, 2022).

Treatment for symptoms of Post Concussion Syndrome

Treatment for post-concussion syndrome (PCS) is mostly about managing symptoms, since there isn’t a single cure. The approach is personalised, and can involve several strategies:

Rest and Activity Management

  • Physical Rest: Avoid activities that worsen symptoms, but complete bed rest is not recommended for more than a couple of days. Gradual return to activity is encouraged.
  • Cognitive Rest: Limiting screen time, reading, or activities that strain your brain may help in the early stages.

Symptom-Specific Treatments

  • Headaches: Over-the-counter pain relievers (like acetaminophen), prescription medications (including migraine treatments), and sometimes physical therapy for neck problems.
  • Sleep Issues: Good sleep hygiene, melatonin, or, in some cases, medication prescribed by a doctor.
  • Mood Symptoms: Cognitive behavioural therapy (CBT), counselling, and consulting a medical practitioner who may consider  medications like antidepressants if anxiety or depression is persistent.
  • Dizziness/Balance Problems: Vestibular therapy from a physiotherapist  (a type of physical therapy focused on balance), and sometimes medications for vertigo.
  • Cognitive Difficulties: Working with a psychologist for cognitive and memory strategies.

Lifestyle Adjustments

  • Stress Management: Mindfulness, relaxation techniques, and counselling can help reduce stress, which often worsens PCS symptoms.
  • Nutrition and Hydration: Eating a balanced diet and staying hydrated. Consult a Clinical nutritionist or dietician for te
  • Follow-Up and Multidisciplinary Care

Many people benefit from a team approach: Neurology, physiotherapy, psychology, and sometimes vision specialists if eye symptoms persist.

What Not to Do

  • Avoid alcohol, recreational drugs, and activities that risk another concussion.
  • Avoid pushing through severe symptoms—listen to your body.

Most people recover from PCS within weeks to a few months, but some symptoms can last longer, even years. If symptoms persist or get worse, it’s important to follow up with a healthcare provider experienced in concussion management.

Updated on:  22/02/2026 by:  Dr. Jacques Duff – BA Psych; Grad Dip Psych; PhD; MAPS; MECNS; MAAAPB; MISNR; FANSA.
Reviewed on: 24/02/2026 by: Bernard Ferriere - BA; Grad Dip App Psych; Dip Clinical Hypnosis; FCCP; MAPS; MASH; Clinical Psychologist