Post Concussional Syndrome (PCS)

by Dr. Sarah Almarzooqi on December 21, 2017

“Emergence and variable persistence of group of symptoms following a head injury” King (1997). Concussion is a temporary injury to the brain caused by a strong hit on the head, an accident blow or jolt to the head.
It usually only lasts up to few days or weeks, although it sometimes needs emergency treatment and some people can have longer-lasting problems.

Signs and symptoms of concussion

Signs of a concussion usually appear within a few minutes or hours of a head injury.
But occasionally they may not be obvious for a few days, so it’s important to look out for any problems in the days following a head injury.
Symptoms include:

  • Headache that doesn’t go away or isn’t relieved with painkillers
  • Dizziness
  • Feeling sick or vomiting
  • Feeling stunned, dazed or confused
  • Memory loss – you may not remember what happened before or after the injury
  • Clumsiness or trouble with balance
  • Unusual behaviour – you may become irritated easily or have sudden mood swings
  • Changes in your vision – such as blurred vision, double vision or “seeing stars”
  • Being knocked out or struggling to stay awake

Postconcussional symptoms overlap with psychiatric syndromes (anxiety, depression, PTSD) and other disorders (e.g. chronic fatigue) is high.

Signs and symptoms of concussion

Still, there are some individual who develop persistent PCS symptoms, and there are emotional and psychological difficulties that maybe present after the injury. Cognitive behavioural therapy is one of the recommended modalities for dealing with these issues.
Below are some examples of the behavioural and psychological issues and the recommended intervention for them:

Behavioural aspects

  • Some individuals tend to misinterpret any or various bodily sensations as serious injury issue even though their physical injury is healed. For instance: they will attribute simple headache to serious problem with their brain.
    • In therapy the ultimate goal is focussing on sustainable levels of / increasing tolerance to effort / activity, and building up.
    • Focus on cognitive/behavioural responses to symptoms (rather than attributions regarding their causes) may be more helpful.
  • Avoidance of various activities or feelings. Some individuals will tend to avoid some chores or socializing
    • In therapy: increase their understanding the role of avoidance (travel phobia, social anxiety and agoraphobia; elements of depressive apathy)
  • Preventing concussion

    There’s no guaranteed way to prevent concussion, but there are some simple things you can do that may reduce your risk of a head injury.

    • Wearing the recommended equipment when taking part in a contact sport, such as boxing
    • Making sure any contact sport you or your child are taking part in is supervised by a properly qualified and trained person
    • Wearing a seatbelt when driving
    • Wearing a helmet when riding a motorcycle, bicycle or horse

    It’s important to avoid head injuries as repeated concussions or blows to the head have been linked to serious problems, including a brain condition called chronic traumatic brain conditions

    By Dr Sarah Almarzooqi

    Clinical Psychologist

    If you would like to talk, feel free to reach out to us. An LifeWorks therapist would be able to help.

    Dr.Bassem Badr
    Dr.Bassem Badr
    Consultant Psychiatrist,Holistic Approach - Arabic and English
    Master of Science in Neuropsychiatry - Experience: 25 Years
    Ms. Afsheen Sheikh
    Ms. Afsheen Sheikh
    Board Certified Behaviour Analyst - English
    MSc in Applied Behaviour Analysis - Queens University of Belfast,UK - Experience: 5 Years
    Dr.Marwa Abd El Hamid
    Dr.Marwa Abd El Hamid
    Clinical Psychologist - Arabic and English
    Ph.D. in Psychology Ain-Shams University - Experience: 10 Years
    Iva Vukusic
    Iva Vukusic
    Clinical Psychologist - English, Croatian and German
    Master of Psychology, Training of Trainers (ToT) Community
    Jyotika Aggarwal
    Jyotika Aggarwal
    Clinical Psychologist - English
    M.A.(Clinical Psychology), RE-CBT - Experience: 7 Years
    Sailaja Menon
    Sailaja Menon
    Counseling Psychologist - English
    CAGS (Multicultural Counseling), Johns Hopkins University, USA - Experience: 25 Years
    Sneha John
    Sneha John
    Psychologist - English, French
    Masters in Clinical Psychology from University of London, UK, Bachelor of Psychology with Counselling, UK, Diploma in Child Development, UK.


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