THE PERSISTENT POST-CONCUSSION SYNDROME

In a mild head injury, it is impossible to prove that a specific brain injury has occurred.

The assumption of a mild traumatic brain injury is usually based solely on a post-concussion syndrome diagnosis.

These subjective symptoms include: headaches, problems with concentration and memory, dizziness, nausea, visual blurring and irritability.

The symptoms of the post-concussion syndrome can all be caused by trauma to vestibular system structures located outside of the brain in the inner ear..

Vestibulo-ocular symptoms include: light sensitivity (photophobia), blurred vision, difficulty with sustained visual focusing, problems in reading for more than 15-20 minutes and secondary fatigue and headaches.

Vestibulo-balance reflex symptoms include: movement sensitive dizziness, nausea, feelings of disequilibrium and secondary anxiety.

Persistent post-concussion syndrome symptoms, especially in the context of very mild head injuries, are often due to unrecognized vestibular system trauma.

Patients have difficulty describing their vestibular system symptoms because we lack perceptual awareness of the functioning of this major sensory system.

Physicians often fail to consider a vestibular etiology when they evaluate the persistent post-concussion syndrome.