Post-Traumatic Syndrome

Explain the difference between post-traumatic syndrome and post-concussional syndrome.

Basically, these terms refer to the same group of symptoms that a person may experience after a head injury or whiplash injury (the person is shaken but did not hit their head). The term concussion derives from the Latin word concussio, meaning "a shaking."

These syndromes are diagnosed when the symptoms of a concussion do not go away. The most common symptoms are headache and neck discomfort; changes in memory, concentration, and attension; dizziness; irritability, depression or anxiety; and sleep disturbance, among other symptoms.

The most common symptom following head or neck trauma is headache. Several studies have found that 6 months after an injury, headaches persist for more than 50% of head-injured people. Other studies have found headaches to persist for years.

It is important to understand that the phrase, "mild closed head injury," is utilized by health professionals to indicate the level of severity of an injury; it does not imply that an injury is not serious.

About half of head injuries occur from motor vehicle accidents, 20% from falls, and the rest are related either to violence or sport injuries.

Can a person's personality change after a concussion?

Definitely. Patients may become very depressed after an injury, socially withdrawn, and no longer interact with others as they did in the past. Anxiety levels can be quite high. For example, if a person was injured in a motor vehicle accident, they may feel afraid to drive or even get in a car.

Other patients may begin to experience anger outbursts after an injury. Some marriages become quite strained because of the change the injury can have on relationships and family dynamics.

Concentration and memory may worsen after mild head injury. Can it be "fixed"?

It is important, first of all, to perform objective neuropsychological testing to assess changes in concentration and memory for the patient. For a majority of patients, any change will improve over time.

For many patients, severe headaches as a result of a injury may impact their ability to concentrate and frustration for the patient may increase when they experience "good days and bad days." The patient's relatives may not understand why a person can function well on one day and be a disaster the next. With patients who continue to have these types of problems, we teach compensatory strategies or ways to learn how to cope. For example, there are "rehearsal" strategies that are very helpful in increasing memory functioning. Simple alterations in a patient's environment can be quite helpful, such as studying with earplugs in a quiet place.

There are also a number of prosthetic memory devices such as check lists, maps, hanging calendars, telememo watches, voice organizers, etc., which can improve functioning for patients both at home and at work. These devices all require training during neuropsychological therapy sessions.

Having a professional trained in diagnosing post-traumatic syndrome and its pervasive consequences is very important. Patients often feel very isolated in struggling with their difficulties. In addition, it is essential for a patient to "grieve" the loss of their former self, and learn new accommodation strategies to address any possible limitations they might be experiencing.