9 Common Questions About Post-Concussion Dizziness

Concussions can happen to anyone and they are not only reserved for athletes and sports incidents. Concussions, medically referred to as mild Traumatic Brain Injuries (TBI) can happen from a car accident, fall, riding a bike or even on the playground. Unfortunately, concussions aren’t like a scrape on your arm, where you can noticeably see it improve day after day. Anyone who’s experienced a concussion knows the frustration of waking up everyday with the same degree of symptoms, hoping that the next day they wake up it will be gone. These prolonged effects of a concussion leave patients with many questions.

What causes Post-Concussion Syndrome?

Post-Concussion Syndrome (PCS) encompasses many of the same symptoms experienced in the days following a concussion. However, with PCS, the symptoms linger. Technically speaking, Post-Concussion Syndrome is a formal diagnosis given by a doctor after a concussion patient has gotten medical attention for their symptoms and they continue to linger after three months. Finding out where the symptoms are coming from allows patients to get the treatment they need. It’s not necessarily something one will live with for the rest of their life. However, it is a formal way of letting people know that their concussion isn’t healing and they need to give their brain the proper care it needs to heal.

How common is Post-Concussion Syndrome?

PCS affects somewhere between 10-30% of people with concussions. There’s no clear understanding as to why PCS occurs in some but not others. Changes in blood flow, inflammation, involvement of the visual and vestibular systems, neck issues and psychological components could play a role. The severity of one’s concussion has no correlation to developing PCS. However, those over the age of 40 have a slightly higher chance of getting it.

What are the symptoms of Post-Concussion Syndrome?

As stated before, the symptoms of PCS are essentially the same symptoms that occur in the days immediately following a concussion. In some patients, though, their concussion may appear to have healed, only to have PCS rear its ugly head weeks or even months later.
  • Headaches and migraines
  • Dizziness and vertigo
  • Fatigue
  • Abnormally sleepy
  • Sensitivity to light
  • Sensitivity to noise
  • Quick to have eye strain
  • Blurry vision
  • Hard time walking
  • Nausea and vomiting
  • Difficulty concentrating
  • Slow / delayed thinking
  • Memory loss
  • Anxiety
  • Depression
  • Sleep disturbances
  • Irritability
Post-Concussion Syndrome can last anywhere from weeks to months, and in the most unfortunate of cases… years. This is why concussions need to be taken extremely seriously.

How do I know I have Post-Concussion Syndrome?

There is not a single test proven to diagnose post-concussion syndrome. However, doctors might get images of the brain such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) to check for abnormalities in the brain structure. If there are symptoms of dizziness, then it is advised to follow-up with vestibular specialists. We utilize many of the same tests used To Diagnose Dizziness & Vertigo-Related Conditions. That way, we can rule out any inner ear issues or vestibular (balance) dysfunction. An additional referral to a psychologist may help for symptoms of anxiety, depression, memory or problem solving concerns. Therefore, we always start with an in-depth discussion with our patients to really understand the journey of their symptoms. If they experienced a concussion and now have at least three of the symptoms described above, then PCS is likely. And working collaboratively with their treatment team is key. Otherwise, the important thing is recognizing that a concussion occurred and the symptoms are lingering. Then, we can work on recovery therapies.

Who should I see about lingering concussion symptoms?

In most cases, your GP (general physician) can be a great resource to consult about your lingering symptoms. Your doctor will be able to address the specific symptoms you’re experiencing and point you in the treatment direction for next steps.

How is Post-Concussion Syndrome Treated?

Because headaches are almost a guarantee with PCS, most will naturally reach for the pain relievers. Use of acetaminophen (Tylenol) is typically recommended for headache or pain but aspirin and ibuprofen (Motrin or Advil) should be avoided because they can cause increased bleeding. From a medical standpoint, there’s no pill or quick fix to immediately relieve PCS. Rehabilitation is the foundation for effective clinical case management for post-concussion treatment. There are therapies that help, such as body-centered therapy, neurofeedback, vestibular rehabilitation therapy, vision therapy, treatment of the neck, exertion therapy and photobiomodulation therapy. These are fancy ways of saying a patient’s body and brain response to stimuli is monitored in order to see what is causing symptoms to worsen. Most importantly, once PCS is identified, a medical professional will advise the patient to make many lifestyle changes that allow the brain time and space to heal itself.

What lifestyle changes do I need to make?

First and foremost, concussion patients must be gentle and patient with themselves. Oftentimes, the more frustrated they get, the worse the symptoms become. Part of the brain is weakened and needs to be treated with care. If you broke your leg, you would be put in a cast, given crutches, and clear instructions to not put weight on it. Just because you can’t see your brain injury doesn’t mean it’s not there. Having said that, these are many of the lifestyle changes that are advised in order to give one’s brain the care it needs to heal. Your doctor or specialist will give specific advice that may include these recommendations:
  • Keep screen time to a minimum
  • Give your eyes a break every 15-20 minutes and look at something off in the distance
  • Reduce workload and rest frequently while working
  • Avoid strenuous activities, such as weightlifting or running
  • Stick to light activity, such as walking or yoga
  • Refrain from driving long distances, such as hour-long commutes
  • Take it easy on the stimulants (i.e. coffee, nicotine)
  • Don’t drink alcohol, especially not in excessive quantities
  • Stay hydrated always

Can Post-Concussion Syndrome go away on its own?

Concussions themselves can go away on their own. However, if your brain and body aren’t able to create new neural pathways on their own and heal the damaged area, then PCS will persist. If symptoms are lingering for many months, then it isn’t right to assume that “just one more week” will solve the problem. Seek help.

What should I do now?

At the Dizzy & Vertigo Institute, Post-Concussion Syndrome is a common condition we see, given the fact that so many PCS patients come in with dizziness and vestibular issues. You can find hope in knowing that PCS is a treatable condition that has a light at the end of the tunnel. The vast majority of PCS patients will resolve their issues within 3 months time with the help of trained professionals. Give us a call at (310) 954-2207 or schedule a consultation here if you think you might have Post-Concussion Syndrome.
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