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Post-Concussion Syndrome

What is it?

10-15% of all concussions will go on to having long-standing symptoms. This is known as Post-Concussion Syndrome. The medical definition refers to three or more post-concussion symptoms persisting for greater than four weeks.

There are five theories to explain Post-Concussion Syndrome:

1. Persistent blood flow abnormalities in the brain

2. Ongoing inflammation

3. Underlying psychological conditions

4. Ongoing visual/vestibular (balance) difficulties

5. Ongoing cervical (neck) dysfunction

Can Post-Concussion Syndrome be treated?

Current research supports treatment focusing on the psychological, cervical (neck), visual, and vestibular (balance) systems. Treatment may include physical exercise, acupuncture, eye exercises, balance exercises, manual therapy to the neck, education, and sleep hygiene. Referral to more specialized providers in these areas may also be provided. The expanded health care team may include the following professionals:

· Clinical Psychologist

· Therapist/Counsellor

· Occupational Therapist

· Physical Therapist

· Chiropractor

· Performance Vision Optometrist

· Visual Therapist

· Neurologist

· Sleep Clinic

· Vestibular Therapist.

It is also widely thought that Post-Concussion Syndrome in some instances may be due to poor concussion management. Traditionally, patients have been told to engage in ZERO physical activity while still symptomatic. However, prolonged rest results in increased fatigue, reactive depression, and physical deconditioning.

The critical threshold for activity is two weeks. At this point treatment will focus on return to activity, even if symptoms persist. A graded exercise test will be performed at this time to determine a safe exercise heart rate. This test is referred to as the Buffalo Treadmill Test. In many post-concussion cases, the addition of a graded walking program helps to reduce symptoms overall.

What is a Baseline Concussion Test? Why should my child have it done? What is its purpose?


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