Post-concussion syndrome
Though no universally accepted definition of postconcussive syndrome exists, most of the literature defines the syndrome as the development of at least 3 of the following symptoms: headache, dizziness, fatigue, irritability, impaired memory and concentration, insomnia, and lowered tolerance for noise and light. One complication in diagnosis is that symptoms of PCS also occur in people who have no history of head injury, but who have other medical and psychological complaints. In one study 64% of people with TBI, 11% of those with brain injuries, and 7% of those with other injuries met the DSM-IV criteria for post-concussion syndrome. Many of these PCS sufferers were misdiagnosed as having other unrelated conditions due to commonality of symptoms. (see diagnosis, below).
Prevention of concussions
Prevention of undiagnosed and repeat injury is of importance in sports-related concussions. Every three minutes, a child in the United States is treated for a sports-related concussion. Between 2010 and 2014, sports-related concussions experienced a 500% uptick. Rapid sideline testing using short neuropsychological tests that assess attention and memory function have been proven useful and accurate. The Maddocks questions and the Standardized Assessment of Concussion (SAC) are examples of validated sideline evaluation tools. The Return To Play (RTP) protocol aims to decrease repeat concussions within a short time frame to minimize second impact syndrome. It assures players who experience a concussion have complete cognitive and clinical recovery before returning to play. Best practices of RTP involve graduated activity intensification with each step taking at least 24 hours to assure full rehabilitation within one week (includes asymptomatic at rest and during exercise). In cases in which resources (i.e. neuropsychologists, neuroimaging) are available on-site, RTP may be more rapid. Baseline assessments, performed before concussion occurs, provide a comparison from which to measure severity of post-concussive symptoms. However, they have not been shown to decrease risk of injury. The U.S. based nonprofit National Safety Council included state-by-state concussion prevention efforts for youth-sports related concussions in its 2017 State of Safety report.