Postconcussive SyndromeSymptomsPostconcussive syndrome occurs after head trauma, usually of moderate to severe intensity. A loss of conciousness, and the duration of loss of consciousness, are correlated with the risk of developing the syndrome. The syndrome is not well-defined but most would include the following symptoms: daily or very frequent headaches, decreased concentration, and dizziness (vertigo). Other symptoms, that can occur but are not required for the diagnosis, include fatigue, irritability, insomnia, or intolerance of noise and light. What is it?It is not known why postconcussive syndrome occurs. Clearly some aspect of the brain has become damaged or disorganized by the head trauma and it can take some time for it to become repaired or reorganized. Sometimes a patient's vertigo can be due to benign positional vertigo, a condition caused by floating debris within the balance organs (semicircular canals) of the inner ear. In many cases, though, a person's vertigo is 'central' in origin, that is, it has nothing to do with the inner ear and is coming from the brain itself.PrognosisMost cases of this syndrome resolve within three months. About 15% of patients, though, have symptoms as long as a year. In rarer cases the symptoms never resolve.How is it treated?Each separate symptom of the syndrome can be treated. For tension-type headaches , physicians often prescribe tricyclic antidepressant medications such as amitriptyline or nortriptyline. For the vertigo, meclizine or diazepam may help. If the vertigo is due to benign positional vertigo, then certain exercises (Semont's Maneuver or Epley's Manuever) can be helpful. Decreased concentration, if severe enough, could be treated with Provigil (modafinil) or stimulant medications.Return from POSTCONCUSSIVE SYNDROME to WORRISOME HEADACHE SYMPTOMS
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