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Post Concussive Syndrome Following Minor Motor Vehicle Accident
Ani (fictitious name of a patient) was 19 years old when she was involved in a mild “fender-bender” type motor vehicle accident. While driving on a busy California highway, she was stopped by a driver who was talking on a cell phone. Since the damage to the car was so minor and there was no need for medical services, they decided to just swap insurance information and drive off. Ani was a student at the local college and she needed to go to school. The first sign that something was wrong was when she started having trouble walking to school. She had walked this path many times, there was no reason for her to get lost and nervous. She tried to call her mother, but couldn’t remember her phone number. She became dizzy, confused, started feeling pain in her neck and head. She wondered if the accident could have caused her any difficulties… but it was so minor… What was wrong with her? As the days passed, Ani’s health deteriorated to such an extent that her mother eventually took her to see her family doctor who referred her to a neurologist and neuropsychologist for diagnosis and treatment. appropriate. Subsequently, Ani was diagnosed with post-concussion syndrome (PCS).
WHAT ARE CONCUSSION AND POSTCONCUSSIVE SYNDROME?
A blow to the head or a sudden jerky movement of the neck, as in a “whiplash” type injury (the head does not need to hit anything or be hit); can disrupt the normal functioning of the brain. This type of brain injury is called concussion or mild traumatic brain injury. Concussions are not life-threatening, and in most cases brain damage has no lasting effect. Eight out of ten patients with mild traumatic brain injury show signs of the syndrome within the first 3 months after the injury. However, 15% of patients with mild head trauma continue to have symptoms of SCP 1 year after the trauma.
The brain is made up of millions of long, thin nerve fibers. Some of these fibers can stretch, snap, or break as a result of a head injury. Like any other part of the body, the brain also has blood vessels that can tear and bleed. This happens soon after the injury, it often stops on its own and heals like any cut. Additionally, due to the microscopic size of these nerve fibers, modern technology has yet to visualize them. Therefore, CT/MRI scans of the brain of a patient with DBS are usually normal. Broken nerves and broken blood vessels cause symptoms after head injury
WHAT ARE THE SIGNS AND SYMPTOMS OF POST-CONCUSSIVE SYNDROME?
Following a concussion, a wide variety of cognitive (thinking skills), physical, and psychological symptoms occur, usually in stages. Symptoms may not develop until days or even weeks after the injury. Few patients will experience all of the symptoms, but even one or two can be unpleasant. Some patients find that at first, SCP makes it difficult to work, go to school, stay home, or achieve short-term goals. Most patients with SPC do not develop symptoms until days or even weeks after the accident, but the syndrome may begin earlier.
I early stage
o Nausea and vomiting
o Blurred or double vision
II. Advanced stage
o Continuous headaches
o Irritability and anger
o Anxiety, Depression
o Short term memory loss
o Attention and concentration problems
o Difficulties in planning and organization
o Decision making and problem solving
o Ringing in the ears
o Change in behavior (impulsive)
o Personality change
WHAT IS THE RECOVERY PROCESS?
The recovery process depends on several factors; 1) age (longer if over 30), 2) severity of symptoms, 3) location of injury (area of brain damaged), 4) mental and physical health prior to accident (if you had emotional or medical issues prior to the injury, you may need more time to recover), 5) any previous head injuries (the cumulative effects of brain injury influence the course of healing) and 6 ) alcohol or drug use (interferes with the healing process). The fastest recovery occurs within the first 6 months after a mild head injury, and most patients will be back to normal after 3 months. The best way to deal with these difficulties is to pace yourself, get all the rest you need, resume your activities and responsibilities gradually, little by little, and most important of all, be PATIENT (the brain has its own mind, it will get better in time). If symptoms worsen or new symptoms develop, this is a sign that activities should be reduced. Symptoms are your body’s way of giving you information. Just like a broken bone keeps you from using it, so does PCS, it’s your brain’s way of telling you that you need to rest. Ignoring symptoms often worsens symptoms and prolongs recovery. If in doubt, consult a doctor who specializes in the diagnosis and treatment of brain disorders (i.e. a neurologist or neuropsychologist).
Dr. Haygoush Kalinian
30320 Rancho Viejo Road, Suite 5
San Juan Capistrano, CA 92675
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