Post-Concussion Syndrome: Headaches, dizziness, brain fog, forgetfulness, irritability lasting greater than three months after head injury


By: Dr. John Conde DC, DACNB Special to the Boca and Delray newspaper

Post-concussion syndrome (PCS) is defined as cognitive impairment and or headache lasting more than three months after a concussive event. Headache, dizziness, fatigue, irritability, nausea, insomnia, lack of concentration, short term memory difficulty, changes in affect and changes in personality are the major symptoms reported.

Most concussive symptoms resolve in about two weeks, and with proper recovery all symptoms usually resolve within one month. Demographics play a role with women and older individuals being at higher risk. Previous concussion and medical history are also important variables.

From a neuroscientific perspective, individuals with persistent concussive symptoms exhibit functional deficits in the brain regions affected by the blow. However, the neighboring nerve cells in the brain that form connections with these regions are affected as well. Thus this makes the radius of injury that much larger. If an individual had previous health concerns or if baseline neurological activity was less than normal this would increase the probability of concussion with a milder head injury as well as increase the probability of long term neurological compromise.

Neurophysiologic testing which includes videonystagmography (VNG), posturography (measure of balance), and cognitive assessment tests should be conducted with the persistence of these symptoms and should be best practices in evidence-based healthcare. The results should be interpreted and a proper treatment plan generated with a goal of increasing functionality.

Prior to the explosion of research into traumatic brain injuries including concussions, the standard of care for a concussion and post-concussion syndrome was a brain-rest approach. This included resting and restricting activities to allow the brain to recover. While this is still valid, it is only part of the total rehabilitative program that is currently best practices. Similar to a newly operated knee or hip, early and accurately targeted activity is important for the brain to heal properly. This is why an examination looking at function is so important early on as it sets the recommendations for what areas of brain need rehabilitation.

Activities such as balancing exercises, specific eye and head movements, timing exercises, and cognitive challenges are all part of the rehabilitative program. Specifically, a cutting-edge instrument termed the Dynavision D2 is utilized in the assessment and therapeutic process.  This tool is comprised of 64 LED digital targets on a board. The clinician has the ability to administer controlled testing protocols to get a baseline reading as well as create dynamic exercise sessions that work on brain processing speeds as well as timing and coordination. The Dynavison D2 was used in a study through the Ricky Williams Foundation assessing cognitive processing in retired National Football League Players. The results were astonishing. Do not let concussive symptoms keep you down, do something about it today.

Dr. John Conde is a Board Certified Chiropractic Neurologist, one of only one thousand in the country. He holds diplomate status through the American Chiropractic Neurology Board. He provides specialized care for difficult cases of back neck pain, numbness-tingling, vertigo-dizziness balance disorders, fibromyalgia, migraines, AD/HD, autism, and dyslexia. His office is located at the Atlantic Grove in Delray Beach and can be reached at 561-330-6096,,