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  • More than just a headache. By Mariel C. Kraus

Post-Concussion Syndrome

Post-Concussion Syndrome

Everyone knows someone who has bumped their head or worse at one time or another, and many have experienced a concussion with short-term minor consequences. Parents of kids in sports have all had to sign the waiver for knowing the signs and symptoms of concussions and are mostly thought of as external contact with the head, however, concussions can also be caused by internal injury due to whiplash.

During whiplash, the brain sloshes within the skull and may hit more than two inner surfaces, thus bruising the brain and causing headaches (a hallmark of concussions). Symptoms may resolve in a week or two, but if they continue beyond a week, it is called Post-Concussion Syndrome (PCS) and may persist beyond a year.

PCS accounts for 50 percent of concussion cases after three months and 15 percent after a year*, yet Washington State Department of L&I does not recognize PCS because it is not detected by CT-Scan or MRI, so an injured worker is ordered back to work within a short time only to fail at keeping their job, and his or her personal life also suffers.

Having only a whiplash diagnosis, the injured person is usually treated for neck injury and expected to return to work, school or home management without restrictions within two weeks. There is little consideration for the symptoms that continue to impact sleep, concentration, mood and energy. Occupational therapists (OTs) are uniquely skilled in helping a person with PCS return to their pre-injury roles through task analysis and adaptation where optimal recovery may take more time.

OTs apply a variety of modalities ranging from hands-on physical rehab to mitigate pain; adaptations for light and sound sensitivity; management of vertigo (dizziness); improving balance and concentration during self-care activities. Some OTs are also trained in environmental assessments and modifications for optimal function. OTs are skilled patient advocates for school and work accommodations including extending the time for returning patients to their occupations.

Below is a list of symptoms to consider when a concussion is suspected, and I highly urge that no symptom be disregarded out of fear of overreaction. The longer a brain injury goes untreated, the more severe the consequences and the permanence of the disability.

Common Signs & Symptoms of a Concussion

• Headache: can be acute and/or persistent

• Whole body: fatigue, poor balance

• Cognitive: amnesia, disorientation, confusion, fatigue

• Sleep: sleep disturbances or sleepiness

• Gastrointestinal: nausea or vomiting

Also Common

• Irritability and/or clinginess

• Mild depression

• Ringing in the ears or sound sensitivity

• Sensitivity to light

• Dizziness (Vertigo)

Early recognition of symptoms is critical for recovery, so it is important to consult with your primary care provider/physician (PCP) who will order tests and make referrals for therapy. PCS is highly probable if symptoms persist beyond two weeks even when CT or MRI do not validate symptoms.

You are your best self-advocate. Request a referral for an occupational therapy assessment and treatment for whole-person rehabilitation by a clinician who treats Post-Concussion Syndrome.

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