Causes & Symptoms of Post-Concussion Syndrome

Post-Concussion Syndrome symptoms can include attention deficits, concentration difficulties, learning difficulties, impulsivity, mood, and anger problems, as well as headaches and fatigue that persist for years after the advent of a minor closed head injury. Often, sufferers are treatment non-responsive. Frequently, patients are also diagnosed with co-morbid ADHD, Adjustment Disorder, Depression, and other psychiatric illnesses that have persistent symptoms.

Minor closed head TBI
Minor closed head injury  (MTbI)

After the head receives a sharp blow, the force produces differences in the movement between the brain and the skull that can result in traumatic brain injuries (TBI). Although most injury is at the site of impact, the frontal and temporal regions become vulnerable to contusions due to percussion and the impact of shearing forces on delicate brain tissue [1]. A percussion wave which travels through brain matter can cause a ‘contre-coup’ (further contusion diagonally across the skill), and shear forces at the boundary between white and grey matter can result in axonal shearing [1].

The terms Post-Concussion Syndrome, or Post-Concussional Disorder, are used to describe a range of long-term residual symptoms. Although minor head injuries are generally considered benign, a significant number of people report persistent symptoms for weeks, months [2], or years after the injury itself [3-17]. There is a lack of evidence for these brain abnormalities on MRI and CT scans. The core functional deficits associated with Post-Concussion Syndrome overlap with those of Attention Deficit Disorder, Adjustment Disorder and Mood Disorders. In addition, sufferers often report memory and socialisation problems, frequent headaches, and personality change.

This cluster of symptoms is referred to as ‘Post-Concussion Syndrome’.

Symptoms of Post-Concussion Syndrome

The following are amongst the most reported symptoms of Post-Concussion Syndrome:

  • Attention deficits, difficulty sustaining mental effort.
  • Fatigue and tiredness.
  • Impulsivity.
  • Irritability and a low frustration threshold.
  • Temper outbursts.
  • Changes in mood.
  • Learning and memory problems.
  • Impaired planning and problem-solving.
  • Inflexibility and ‘concrete’ (rather than ‘fluid’) thinking.
  • Lack of initiative.
  • Dissociation between thoughts and actions.
  • Communication difficulties.
  • Socially inappropriate behaviours.
  • Self-centeredness and lack of insight.
  • Poor self-awareness.
  • Impaired balance, dizziness, and headaches [6, 15, 18, 19].
  • Personality changes [20, 21].

Despite the existence of several chronic symptoms, the associated brain abnormalities cannot be detected in conventional structural neuroimaging tests, such as CT scans and MRI. Thus, the sufferer is often unfairly labelled as ‘hot headed’, having a ‘short fuse’, anger problems or, in some cases, misdiagnosed with a mood, personality, or psychological disorder.

Symptoms with an Organic Basis

The fact that the sufferer’s complaints seem to contradict ‘negative’ medical findings has been a source of controversy. The debate surrounds whether Post-Concussion Syndrome has an organic or psychological basis [4]. However, over the past 30 years, evidence points to an organic (brain based) aetiology (original cause) for Post-Concussion Syndrome. Evidence includes studies of cerebral blood flow, neuropsychological deficits and evoked potential recordings, as well as PET, SPECT, MRI, EEG and QEEG measures [22-30]. Most of the theoretical concepts that have been discussed and formulated are clearly supported by QEEG findings [31, 32].

The scientific literature indicates that Post-Concussion Syndrome can be identified with a high degree of specificity using QEEG neuroimaging and treated most effectively using Neurotherapy.

Here is a peer reviewed paper on the use of QEEG and Neurotherapy for Post Concussion Syndrome by Dr Jacques Duff.


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