Post Concussion Syndrome (PCS)
While the jury is still out about why any concussion should last more than three months, some scientists and specialists are beginning to put the pieces of the puzzle together.
Most people diagnosed with PCS are only too aware of the symptoms and cognitive problems that plague them and just don’t seem to go away. People can become weary worrying about returning to work or education.
Symptoms can vary from one person to the next, and some can be apparent in other mental health issues making diagnosis even more problematic. If you suspect that you or someone you know has PCS, don’t rely on self-diagnosis from reading lists of symptoms, go and speak to a doctor and if necessary ask for a referral to a brain injury specialist.
PCS is generally the diagnosis given when the symptoms of concussion or a head injury last for months or even years after the initial injury.
While conventional CAT and MRI scans don’t show the microscopic damage in concussion or whiplash injuries, a Magnetoencephalography (MEG) scan will.
Although not yet used clinically as an aid to diagnosis, MEG scans will very likely become the top-ranking scanner in the future. Being able to ‘see’ the damage and knowing what is happening can bring a huge relief to people, especially those who don’t have any evidence other than their symptoms and outcomes to support why they are suffering so much.
What complicates diagnosis?
A lot of things! The things to be wary of are accusations of malingering and also of trying to get more compensation from a legal claim. Don’t let doctors write-you-off and be tenacious in getting the help you need.
It is highly likely that in the near future insurance companies and lawyers will insist on MEG scans to rule out the minority of unscrupulous people who actually undermine the seriousness of PCS for those who are genuinely struggling and whose lives have been turned upside down.
Things to consider
There are a number of pre-existing social, life and health issues that could be behind PCS.
In fact, these pre-existing conditions could explain a variety of prolonged symptoms following any severity of brain injury and are worth considering because it turns out there is possibly a lot we can do to help ourselves.
Let’s go back to MEG for a moment. MEG measures brain wave activity as well as being able to take pictures of areas of injury and over-activity as the brain works harder to perform the same tasks. MEG shows differences in executive functioning between mTBI, PTSD and mental disorders. A five-minute MEG scan gives 100% predictability of concussion diagnosis.
Scientists behind this work are aware of how the flow of energy throughout the body can be disrupted by a brain injury.
Incorrect and ineffective treatments extend suffering, and it is also recognised that while concussion symptoms resolve in around 70 to 80% of cases, it isn’t fully understood why it isn’t this way for everyone.
The role of previous history
We are all different in many ways, and these diversities could be at the root of PCS.
It is thought that pre-existing conditions affecting recovery could include diet, age, lifestyle, fitness, the health of your gut microbiome, vitamin and mineral reserves and levels, particularly vitamins B12 and D, sleep quality, underlying psychological or psychiatric conditions, personality type/attitudes and general mental health, medications and health issues, alcohol or substance misuse, level of education achieved and even genetics and epigenetics could be factors that cause a predisposition to prolonged recovery.
Well educated people with a healthy diet and lifestyle are more likely to have neuroprotective qualities existent in the brain. New research published in the Journal of Neurology shows that people with higher levels of education will fare better.
Why do any of these have an impact on how well anyone will recover from a brain injury? Generally, difficulties with recovery stem from the ‘secondary injury.‘ For example, if your gut microbiome and brain environment are already compromised by a poor diet and other factors, the inflammatory response following a brain injury significantly alters the gut microbiota weakening the immune system and damaging biological communication systems such as the central and enteric nervous systems making a recovery harder.
There is a view that poor recovery is entirely due to doing too much too soon and while over-doing it in the early days and weeks can certainly play an aggravating part, it is far from being the only culprit responsible for prolonged symptoms and cognitive changes.
While much more research is needed, another underlying factor could be the poor responses people have to the secondary injury or biochemical cascade.
All of the pre-existing conditions mentioned above can affect the delicate balances in biological functionality. The health of the gut microbiome, adrenals/hormone balance and immune system can all affect how well and how quickly we recover from inflammatory responses to injury and trauma. Those who have suffered previous trauma or a prior brain injury may already have a weakened system.
What can you do?
When the whole world seems out of control, people can struggle to keep going mentally and emotionally.
Not knowing what is wrong or why things are happening to you can add to the burden of health and cognitive issues following concussion or mTBI.
When we know the causes of our struggles, we can begin to address them. It is well documented that lifestyle changes can reverse biological damage. If we can get the body back to health, we stand a greater chance of getting the brain back to health.
The health of your brain environment is crucial to recovery and is dependent on your overall physical health, so when you read that exercise and fresh air are beneficial following a brain injury, it is worth taking notice of and making the appropriate changes.
Sleep is also a crucial factor in how well the brain will recover so if you are having problems it is essential to seek help and deal with these as early on as possible.
The health of your brain environment is also a key factor in rewiring your brain and plasticity.
Change your diet, and include prebiotics and probiotics and avoid foods that worsen inflammation.
Introduce scientifically proven neuroprotectors such as black seed oil and omega-3.
Talk to your doctor about medications as the injured brain is much more sensitive to prescription drugs.
Learn everything you can about healing your brain. A lot of public literature focuses on problems rather than solutions. Recovery from a brain injury involves educating yourself and understanding as much as you can about the causes underlying your problems. When you know what is behind the things you are struggling with, you are empowered to make the best changes you can.
Treatments such as cognitive behavioural, physical, balance, exertion and vision therapy and neuro-optometric rehab can all play a part. Speak to your doctor or specialist about other things that can help.