Post Concussion Syndrome

History of Post Concussion Syndrome (PCS) dates back to the late 19th century when a British surgeon published a paper detailing symptoms persisting after mild head trauma. This condition was originally called Railroad Spine, as many of his subjects were railroad workers. Debate amongst other surgeons carried on into the 20th century, with the most vocal outcry stated these symptoms were psychological in origin, or that the patients even feign their suffering. During World War I, the term shell-shock came into play after soldiers near explosions with or without head wounds presented with odd symptoms. The term shell-shock was banned during World War II (to prevent over diagnosis) and post concussion syndrome eventually took root into the mid 1940s.

The Wall Street Journal recently reported (8/31/10- Dooren) that concussions are on the rise in student athletes. As published in the journal of Pediatrics, concussions have steadily risen between 1997 and 2007 in basketball, football, ice hockey, and soccer despite the fact that participation in these sports has actually declined. Because younger brains heal more slowly than adolescents and adults, the American Academy of Pediatrics is calling for the injured to take a more conservative approach. Researchers debate that the younger the brain when injured, the more severe and longer lasting the damage may be, including development and cognitive issues. Symptoms may linger for one to two weeks (or longer) and usually include headaches, nausea, vomiting, memory loss, balance issues, judgment, and sleep patterns. Many high schools have adopted strict guidelines for its student athletes who have been injured in the course of play or practice. For example, any individual who is injured during play must be removed from the game and not allowed back to play or practice until cleared by a doctor. It is also debated whether sports are becoming more competitive or if injuries are being reported more regularly. In Providence, Rhode Island, between 2001 and 2005, emergency room visits for children ages 8-19 for concussion, approximately half were sport-related injuries (502,00 total, 252,000 sport-related). It must be recognized, however that not all concussions present to the ER. The National Institutes of Health estimate one million concussions annually in both children and adults.

A controversial issue and sport is women lacrosse. The sport is becoming more popular and more violent all without the use of helmets. The leagues are currently in disagreement about ruling the female players to start playing with helmets, for fear the game will get even more violent. Even the NFL is putting their foot down. The league enacted a new concussion policy in December 2009 regarding back to play. The NFL is standing by their new rules that if any player is showing signs or symptoms of a concussion (the inability to remember assignments or plays, persistent dizziness or headaches, memory loss) the player is not allowed back on the field until cleared by a doctor. The Associated Press reported in November 2009 that 1/5 of 160 players surveyed have hidden the effects of a concussion so they could stay in the game.

Post concussion syndrome often affects individuals after a motor vehicle crash. It’s common in the office to have a patient after a crash, come in complaining of persistent headaches and memory loss in addition to sore necks or low backs. Quite often there is sprain or strain of the low back or neck (often referred to as a whiplash injury) following the sudden deceleration of a vehicle. The patient presents with pain and a loss in range of motion. If headaches or memory loss accompanies these symptoms, we might be dealing with something more serious, PCS. All symptoms should be taken seriously and followed up by a doctor (primary, chiropractor, or neurologist).

Think with your head. If you or someone you know took a hit and isn’t acting themselves, contact someone who can help