Persistent Post-Concussive Symptoms: Diagnosis and Introduction Concussions, which are generally categorized as a form of mild traumatic brain injury (mTBI), are a very hot topic in sports medicine.
Persistent Post-Concussive Symptoms: Diagnosis and Concussions, which are generally categorized as a form of mild traumatic brain injury (mTBI), are a very hot topic in sports medicine. They are defined in the 2019 AMSSM position statement as “a traumatically induced transient disturbance of brain function and involves a complex pathophysiological process”. Clinical recovery is defined as a return to normal activities, including school, work and sport, after the injury.
The majority of adult patients, ranging from 85 to 90 percent, will recover in 7-10 days. More recent evidence has caused an increase in expected recovery time for children between 10 days and 4 weeks, with the understanding that a sizeable minority of youth, high-school and collegiate athletes take much longer than 10 days to clinically recover. This is due to many reasons including increasing recognition of concussions, elimination of same day return to play, increased time with return to play guidelines and medical management of concussion.
Breakdown of types of post-concussive syndrome symptoms The definition of post-concussion syndrome (PCS) is somewhat controversial and there is disagreement among sports medicine physicians regarding the diagnosis. Many think of post-concussion syndrome as symptoms of concussion that occur after the average recovery period. It is difficult to define when post-concussion syndrome begins but many providers are comfortable with the diagnosis if symptoms have not subsided in 4 weeks according to a survey among 600 ACSM (American College of Sports Medicine) members.
A broader definition is represented by clinical criteria of the World Health Organization’s International Classification of Diseases. The criteria include history of head trauma, no objective memory loss and 3 or more of the following symptoms four weeks following a concussion: headache, dizziness, fatigue, irritability, insomnia, concentration difficulty or memory difficulty. Due to controversy regarding the term syndrome, postconcussional disorder in the DSM-5 was replaced by "neurocognitive symptoms associated with traumatic brain injury”.
The 2013 AMSSM position statement refers to post-concussion syndrome as symptoms and signs of a concussion that lasts “weeks to months”. The most recent concussion consensus statement in Berlin tried to establish a time frame of greater than 14 days in adults and greater than 4 weeks in children, did not use the term “post-concussion syndrome,” but used the terminology “persistent post-concussive symptoms”. Due to lack of consensus, definitions are inconsistent in the literature and incidence ranges widely from 1.4% to 29.3%.
If you are experiencing symptoms that may be related to persistent post-concussive symptoms (ppcs): introduction and diagnosis (part 1), it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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