| disease | Post-concussion Syndrome |
| alias | Post-traumatic Syndrome |
After the acute trauma has resolved, patients with brain injuries often continue to experience persistent subjective symptoms, yet no definitive neurological positive {|###|}signs{|###|} are found clinically, and even examinations such as CT or MRI reveal no abnormalities. These patients typically have grade I or grade II closed head {|###|}injuries{|###|}, with generally good recovery post-injury, but symptoms like dizziness, {|###|}headache{|###|}, varying degrees of autonomic dysfunction, or psychiatric symptoms persist indefinitely. If these symptoms remain unresolved for more than three months after the injury, the condition is termed post-traumatic brain syndrome. Previously, it was referred to as post-concussion syndrome or post-traumatic brain Guanneng disorder, but whether its etiology is organic or functional remains undetermined. Current perspectives suggest it may arise from minor organic brain damage combined with the patient's psychological, physical, and social factors. Any trauma to the head, regardless of severity, can trigger a series of pathophysiological changes in brain tissue. Mild cases may involve only temporary biochemical and cerebral blood flow alterations—for instance, slowed intracranial circulation post-injury can persist for months. Severe cases, however, may lead to cerebral contusions, intracranial hematomas, cerebral ischemia, hypoxia, subarachnoid hemorrhage, axonal injuries, or other subtle {|###|}injuries{|###|}. While significant lesions are detectable in the late (third) stage, some minor pathologies remain elusive, such as traumatic scalp neuromas, intracranial-extracranial small vascular communications, meningeal adhesions, arachnoid villi occlusion, axonal tears, microhemorrhages or softening in white matter or brainstem, or injuries to craniocervical ligaments or muscles affecting cervical nerve roots—all of which can cause symptoms. It must be emphasized that the occurrence of post-traumatic brain syndrome does not correlate with the severity of brain damage; paradoxically, mild brain {|###|}injuries{|###|} without obvious neurological deficits are more likely to develop this syndrome than severe cases with functional impairments. Some studies suggest higher incidence rates among unemployed individuals compared to employed ones, while those with higher IQs or specialized knowledge are less affected. These observations underscore the significant role of psychosocial factors, life stability, and occupational status in the development of this condition.
bubble_chart Clinical ManifestationsThe clinical manifestations of post-traumatic brain syndrome are diverse, but can generally be summarized into three main categories: dizziness, headache, and neurological dysfunction. Headache is the most common symptom, accounting for about 78% of cases. Patients often experience distending pain, splitting pain, or throbbing pain in the head, with varying onset times, most frequently in the afternoon. The pain typically occurs in the frontal-temporal or occipital regions, sometimes affecting the entire head, accompanied by a sensation of pressure or a tight, ring-like constriction, leading to persistent grogginess and difficulty concentrating. Occipital headaches are often associated with neck muscle tension and pain, usually related to craniocervical injuries. Headache episodes may worsen due to insomnia, fatigue, poor mood, work-related stress, or external noise. Dizziness is also relatively common, affecting about 50% of patients. Patients often describe it as dizziness with blurred vision, though it is usually not true vertigo but rather a subjective feeling of mental fogginess, unclear thinking, or a confused and disoriented sensation. Some may feel their balance is impaired, with symptoms worsening upon head movement or changes in posture. However, neurological examinations typically reveal no clear vestibular dysfunction or ataxia. Symptoms may temporarily improve or disappear with appropriate symptomatic treatment and reassurance but often recur shortly afterward. In addition to dizziness and headache, patients frequently experience emotional instability, easy fatigue, insomnia, poor concentration, memory decline, and even mood swings or irritability. Occasionally, autonomic dysfunction may manifest as tinnitus, palpitations, blood pressure fluctuations, profuse sweating, decreased sexual function, or menstrual irregularities.
The diagnosis of post-traumatic brain syndrome must be approached with caution. First, organic sexually transmitted diseases should be carefully ruled out before considering this condition. A thorough patient history should be obtained with patience, covering the entire course of the illness from the time of injury to the present, including the results of various examinations, treatment history, surgical findings, and any previous diagnostic opinions and treatment outcomes. After comprehensively understanding the patient's condition, necessary examinations should be conducted as needed. Although neurological examinations are often negative, a meticulous physical examination remains highly significant, as it may sometimes reveal subtle clues that help identify the disease cause or rule out organic damage. Next, targeted auxiliary examinations can be arranged based on the history and physical findings: - Lumbar puncture can measure intracranial pressure to determine whether it is elevated or reduced, while also assessing the normality of cerebrospinal fluid. - Electroencephalography (EEG) helps detect focal lesions or persistent abnormal waveforms, guiding further diagnostic steps. - CT scans can clearly reveal the presence of brain atrophy, hydrocephalus, or localized sexually transmitted disease lesions. - MRI is more effective in identifying tiny hemorrhagic spots or softening lesions within the brain parenchyma. - Radionuclide cerebrospinal fluid imaging can determine whether there are any obstructions in cerebrospinal fluid circulation.
bubble_chart Treatment Measures
Treatment of Post-Traumatic Brain Syndrome: It is essential to first listen attentively to the patient's complaints, followed by a comprehensive and meticulous examination. The patient's suffering should be acknowledged with care, and they should be patiently counseled to alleviate worries, helping them build confidence to confront and overcome the illness. This is particularly important for patients who fear they have "post-concussion syndrome" and seek multiple medical opinions. From a medical perspective, explanations should be provided to dispel their doubts. Such patients often harbor misconceptions before or after the injury, especially due to iatrogenic influences. For example, inappropriate remarks by medical staff, careless treatment, or impatient attitudes during diagnosis and treatment can create mental burdens and psychological factors for the patient. Additionally, if the head injury involves socio-psychological factors such as disputes, liability, compensation, or unemployment, these may also contribute to the onset and progression of this syndrome.
To promote the patient's physical and mental recovery, they should actively participate in outdoor activities, exercise regularly, maintain a structured lifestyle, correct bad habits, and resume work as soon as possible within their capacity. Learning new knowledge and skills, engaging in social interactions, and fostering good interpersonal relationships will contribute to a cheerful mood, stable emotions, smooth work, and harmonious family life—all of which are beneficial for complete physical, mental, and social rehabilitation.
