The brain is the physical seat of what makes us who we are. It houses our memories, emotions, wishes, fears, personality traits, intellectual capabilities, and relationships, as well as regulating and controlling the rest of our bodies. As such, traumatic brain injuries (TBIs) are some of the most dangerous and potentially life-altering types of injuries a person can sustain.
One report by the Centers for Disease Control (CDC) covering the years 2002-2006 found that 1.7 million U.S residents sustain TBIs each year, a figure that’s still frequently cited. A more recent CDC survey, however, indicates that the problem has worsened dramatically. In the survey’s latest year, 2014, approximately 2.87 million people were treated for TBIs in U.S hospitals, and 56,800 died of their injuries.
Mild, nonfatal TBIs are generally referred to as “concussions,” literally the result of a concussive impact. They can be caused by direct impacts to the head, or by violent movements of the body that cause the brain to strike the inside of the skull.
Although concussions are the least severe form of TBI, characterized by brief or nonexistent loss of consciousness and minimal detectible brain damage, many concussion patients still suffer long-term pain, impairments, cognitive changes, and other symptoms that can significantly impact quality of life.
These symptoms, while very real, can be challenging to prove. This is a particular problem for those who sustain concussions due to unsafe working conditions, hazardous premises, vehicular accidents, assaults, and other causes that merit litigation.
At the Stoddard Firm, we’re committed to making your condition understood and winning you the compensation you need and deserve.
What Is Post-Concussive Syndrome?
Post-concussive syndrome, also known as post-concussion syndrome or PCS, refers to a set of concussion symptoms that continue or worsen after the expected concussion recovery period of a few days. The effects may last for months or, in rare cases, indefinitely.
Deep damage to the brain’s white matter, disrupting communication between different areas of the brain.
Partial damage to gray matter neurons, causing changes in their metabolic activity.
The CDC recognizes both hypotheses as likely and has stated that the true cause may be a combination of both. Regardless, both possible causes present the same challenge: they can’t be detected on the standard CT or MRI scans performed on patients who’ve suffered a head injury.
Consequently, patients with PCS are typically advised to go home and “sleep off” what appears to be only superficial damage, and are not correctly diagnosed until they later return to a health care provider with persistent symptoms. At this point, diagnosis is possible through the use of neuropsychological tests, which assess memory, language, concentration, and other commonly affected functions.
Common Signs and Symptoms
Because the brain plays a role in every human function, psychological or physical, the effects of brain injuries can vary widely. American Nurse Today categorizes the common symptoms of post-concussive syndrome into three major groups: physical, cognitive, and behavioral.
The physical symptoms of PCS mirror the symptoms that health care providers initially check for when determining whether a concussion has occurred in the first place. These include:
Sensitivity to light or sound
Altered or impaired vision
PCS can also cause ongoing disruptions to the sleep/wake cycle, including insomnia and debilitating fatigue. Cognitive symptoms can sometimes be difficult to separate from the effects of fatigue, but they often exist independently in cases of PCS and can include:
Slower responses to stimuli
Difficulty with learning, recall, or problem-solving
Feeling foggy or scattered
While the physical and cognitive symptoms may be the easiest ones for patients to quantify and self-report, it’s often the behavioral symptoms that loved ones are quickest to notice. This can play a major role in motivating patients to seek help. Behavioral effects might manifest as:
Reduced emotional control
Lowered thresholds of irritation/frustration
General personality changes
Difficulty dealing with social situations
Not every patient will experience every symptom. In fact, many healthcare providers feel confident diagnosing PCS based on any combination of three or more persistent, relevant symptoms following a concussion.
Risk Factors and Prognosis
Anyone who suffers a concussion is at risk of developing post-concussive syndrome. The probability ranges from 5% to 30%, depending on the patient’s medical history and demographics.
Women are more susceptible to PCS than men are, and patients over 40 are at greater risk than their younger counterparts. A history of migraines can also indicate a predisposition toward developing PCS, as can underlying neurological or psychological issues, such as epilepsy, depression, or previous brain injuries. Alcohol abuse can raise an individual’s probability of developing PCS in the event of a concussion, and even moderate alcohol consumption can interfere with recovery after the injury has occurred.
The nature of the incident that caused the concussion can also influence the likelihood of PCS. Concussions that most frequently result in PCS are those resulting from traffic collisions, falls, assaults, and sports injuries. This may be because athletes are more likely to have sustained other concussions over the course of their careers, falls are more likely to involve older adults, and assaults and traffic collisions are more likely to result in PTSD, which can be a contributing factor in PCS risk and severity.
The good news is that, unlike some complications from more severe TBIs, post-concussive syndrome is not degenerative. It is unlikely to worsen or spread to unaffected functions after the first two weeks following the injury, when symptoms first manifest, and most patients make a full recovery in 3-6 months.
Unfortunately, for those whose symptoms last longer, there is no universal timeline for recovery, and no single treatment that works for every patient.
Post-Concussive Syndrome Can Be Extremely Difficult to Treat
There’s a great deal about PCS — and about the brain itself — that is not fully understood, and what promising advancements have been made are not yet common knowledge, even within the medical community. Patients are often given conflicting advice or told that nothing can be done for them, and many travel across continents and oceans to see doctors who specialize in PCS.
One of the leading PCS clinics in the world, located in Utah, is inundated with patients from all over the country and around the world, particularly from the Netherlands. The Netherlands’ health care system is consistently ranked one of the best in the world, far ahead of the U.S, yet visiting Dutch patients report that PCS is essentially a “dead end diagnosis” in their country.
Another international visitor to the clinic, a teenage girl from Canada who’d spent years living with constant headaches and depression, had been told by various doctors that she needed to rest, that she should work through the pain, and that her symptoms were simply her new reality. Thankfully, after a few months of a personalized therapy regimen, her symptoms abated enough for her to resume a normal life.
At present, the only known methods for treating PCS focus on addressing symptoms individually and clearing the way for the brain’s natural healing processes. In the early phases, this will typically involve lots of rest, avoiding activities that trigger or worsen symptoms, and pharmacological treatment for pain and nausea. Later in the recovery process, more mentally and physically challenging activities may be gradually incorporated into a patient’s routine, along with physical, occupational, and psychiatric therapy, depending on which symptoms remain to be treated.
It’s important to remember that PCS is not “all in the mind.” The cause and many of the symptoms are entirely physical. However, the condition can be exacerbated by certain psychological issues, including PTSD, anxiety, and depression, which many PCS patients find themselves facing concurrently. Whether these psychological conditions are preexisting, related to the initial concussion incident, or brought on by the frustrating physical and cognitive symptoms of PCS itself, some patients may find talk therapy or antidepressants helpful components in an overall recovery strategy.
The Effects on Daily Life Are Devastating
Post-concussive syndrome can interfere with virtually every aspect of a person’s life. Both physical and mental exertion may be impossible for some time, and being pressured or pressuring oneself back into challenging activities too quickly can delay improvements instead of speeding them. Patients often cannot work during recovery, or must drastically cut back their hours and avoid more demanding duties.
The headaches and extreme fatigue that are some of the most common symptoms of PCS can make performing the simplest daily tasks overwhelming, and the increased irritability and sensitivity to overstimulation can limit social interaction and strain personal relationships.
Sometimes the most discouraging part of coping with PCS is not knowing when or if the symptoms will completely abate, but even in a best case scenario where the condition is properly treated and resolves within six months, it can take far longer to repair the damage to a person’s livelihood and ambitions. Obtaining the necessary treatment can be crushingly expensive, especially if it requires travel. Combined with a sudden inability to work — even a temporary one — the financial impact can be life-shattering.
The need to take time off to recover is disruptive to a patient’s life in other ways too; students may miss months or years of coursework, athletes may never be able to compete safely in the sports they love again, and any patient with a job may be in danger of losing it permanently, in part because of a lack of understanding of PCS and other invisible health issues.
Patients Often Don’t Receive the Same Respect as Those with More Visible Injuries
Because post-concussive syndrome can’t be seen, and because it lasts longer than what many think of as a “reasonable” recovery period, patients often find themselves in the frustrating position of trying to explain their symptoms to people who underestimate them, question their existence, or think it’s time to “get over it.”
Many people with PCS report feeling isolated from or dismissed by even their closest loved ones, so it’s easy to imagine how a negligent driver or property owner — someone who has something to gain from downplaying a victim’s condition — could easily convince strangers to believe the victim is exaggerating.
Dismissal of invisible injuries is hurtful enough in a person’s private life, but when this kind of thinking crosses over into legal proceedings, it can destroy someone’s only chance at paying for treatment and rebuilding a life.
The Stoddard Firm Can Help You Get the Understanding and Compensation You Deserve
When you’re recovering from a TBI, the last thing you should have to worry about is convincing others that what you’re going through is real. We respect the seriousness of what PCS patients are facing, and we aim to take as much of the stress of the legal process off your shoulders as possible.
You deserve to feel confident that your case is in the hands of an expert, who will ensure that you receive the resources you need to get back on your feet, and that the negligent parties are held accountable for your injury. At The Stoddard Firm, we have experience presenting evidence of invisible conditions, including PCS, and successfully securing fair verdicts for our clients. We’ll work directly with you to learn the full truth of your story, so we can present it in a compelling, understandable manner.
If you’ve developed PCS from a concussion you received on unsafe premises, in a traffic collision, or in any situation arising from someone else’s negligence, call us at 678-RESULT, or reach out through our online chat for a completely free consultation on your unique case.
Tell us about your concern and request a free, no obligation, confidential legal consultation.
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