Living with Persistent Concussion Symptoms

This pattern is often described as Post Concussion Syndrome (PCS). It can affect adults, young people, and those recovering from concussion in sport or other everyday injuries. At our concussion clinic in Brisbane, part of Occupational Therapy Brisbane, we work with people who want to better understand their experiences and explore safe, practical strategies to support their recovery.

The concussion services supports people with concussion injuries and longer-lasting difficulties often described as post-concussion or post-concussive symptoms.

Many are looking to understand why their post-concussion recovery feels prolonged, and what practical steps might help in daily life, work, or family roles.

It’s important to know:

• PCS is recognised in the clinical literature and is not uncommon.
• Symptoms vary, and no two people will have the same profile.
• Management usually involves a combination of approaches, guided by assessment and tailored to individual needs.

What is Post Concussion Syndrome?

A concussion is a type of mild traumatic brain injury (TBI) that may occur after a bump, jolt, or hit to the head, or even from a blow to the body that makes the brain move suddenly. Concussion is sometimes called a “functional” injury because it alters how the brain works rather than leaving visible damage on scans.

Contrary to popular belief, fewer than 10% of concussions involve loss of consciousness. Many people keep functioning after the incident but notice later that something feels “off.” These concussion injuries are real, even if invisible.

Most people recover within two to four weeks. When post-concussive symptoms remain beyond this timeframe — usually two weeks for adults and four for children — the term Post Concussion Syndrome is used.

Common PCS symptoms may include:

• Cognitive changes: trouble focusing, slowed thinking, memory lapses, mental fatigue
• Vestibular and visual changes: dizziness, vertigo, blurred or double vision, sensitivity to busy environments, balance issues linked to the vestibular system or inner ear
• Emotional concerns: irritability, mood swings, low mood, anxiety
• Sleep and fatigue: disrupted sleep cycles, daytime tiredness, feeling unrefreshed
• Headaches and migraines: sometimes worsened by light, noise, or activity

It’s common to have more than one cluster. Some people experience mostly headaches, others struggle with vision or fatigue. Understanding these patterns is important for planning care.

Why Do Some Symptoms Persist?

The exact reason why symptoms continue in some people is still being studied. Current research suggests several contributing factors:

• Brain function changes: alterations in how the brain processes information and uses energy.
• Sensory system disruption: lingering issues with the vestibular (balance) and visual systems.
• Stress and rest cycles: returning to work, study, or sport too quickly can delay recovery.
• Individual factors: a history of migraines, previous concussions, or other health conditions may increase risk.
• Brain blood flow changes: Commonly referred to as perfusion, there is an observation of too much or too little in regions of the brain and this is associated with symptoms and ultimately a person’s ability to do tasks in everyday life.

It’s important to know that persistent PCS is recognised and does not reflect personal weakness. Some people try to self-manage, but structured support from healthcare professionals is often more effective.

Concussion Assessment and Screening

When someone presents with persisting concerns, the first step is a thorough assessment. At the Brain Health Clinic, we provide comprehensive concussion evaluations that consider medical history, current post-concussive symptoms, and function in daily life.

This may include:

• Concussion screening tools
• Baseline testing (helpful in sport and return-to-play planning)
• Functional assessments (e.g., memory, attention, balance)

In some cases, a neurologist, neuropsychologist, physiotherapist, as well as an occupational therapist may be involved as part of a multidisciplinary team.