Postconcussion Headache

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Following blunt head trauma there is often a period of between 1 and 3 months or longer where post concussion headaches are present. This is part of the post concussion syndrome, a symptom constellation where following a mild head injury the patient complaints of dizziness, headaches and problems to concentrate.

Mood changes such as depression and anxiety as well as listlessness can also be a problem. This condition is difficult to assess, but newer studies have shown using PET scanning, which measures glucose metabolism of brain cells, that there are minimal neurological scars in the brain from this trauma and this may be linked to these clinical abnormalities.

The accumulation of several of these injuries in sports injuries is under active discussion and seems to be the cause in a minority of cases for a development of a dementia later in life, something that is vehemently denied by many sports and boxing fans. Here is a simple CT scan of such a person (left side image with severe dementia, right side image of normal brain), in this case there is brain atrophy and a hydrocephalus (black space on the scan), which is readily visible to the lay person's eye. However, the more subtle changes of early concussion will only be visible on an MRI scan (better resolution than CT scan) or using a PET scan (specializing in detecting functional differences).

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. Goldman: Cecil Textbook of Medicine, 21st ed.,2000, W. B. Saunders Company

2. B. Sears: "The top 100 zone foods". Regan Books, Harper Collins,   2001.

3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 176.

4. Noble: Textbook of Primary Care Medicine, 3rd ed.,2001, Mosby, Inc.

5. Goroll: Primary Care Medicine, 4th ed.,2000, Lippincott Williams & Wilkins

6.Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th ed., 1998, Mosby-Year Book, Inc.

7. Ruddy: Kelley's Textbook of Rheumatology, 6th ed.,2001, W. B. Saunders Company

8. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

9. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

Last Modified: Oct. 12, 2011