Postconcussion syndrome is a group of symptoms that persist for weeks or months after a concussion. It is diagnosed clinically, and most people recover with time, gradual return to activity and treatment of each symptom.
Key symptoms
- Headache that keeps coming back
- Dizziness and trouble with balance
- Poor concentration and memory
- Fatigue and trouble sleeping
- Irritability, anxiety or low mood
What you find on exam
- Neurological exam, usually normal
- Balance and eye movement testing
- Cervical spine exam for neck sources of pain
- Mood and sleep screening
Tests
- Mainly a clinical diagnosis
- CT or MRI only if red flags or a focal deficit
- Symptom checklists to track recovery
Treatment basics
- Short rest then gradual return to activity and light aerobic exercise
- Step-by-step return to school, work and sport
- Limit pain medicine use to avoid medication-overuse headache
- Vestibular therapy, sleep care and treatment of mood symptoms
Red flags
- Worsening headache, repeated vomiting or drowsiness
- New weakness, slurred speech or seizure
- Symptoms getting worse instead of better over time
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.