Post-Concussion Syndrome: Persistent Dizziness After Injury

Post-concussion syndrome and sequelae with dizziness symptoms lasting for 3 months?

Hello, doctor.
I was in a car accident on April 18, and I did not experience any loss of consciousness at the time.
I was able to answer all the questions from the medical staff.
However, after undergoing surgery on my clavicle on April 26, I began to experience persistent dizziness without any headache.
It seems that there hasn't been much improvement since then.
Initially, I experienced vertigo and difficulty maintaining balance while walking, but now my balance feels somewhat better, although I still feel dizzy.
I later consulted a doctor who diagnosed me with post-concussion syndrome, suggesting that the dizziness might last for about 3 to 6 months during the recovery period.
Another doctor mentioned that if it doesn't improve within 6 months, the neurological condition could stabilize and potentially lead to permanent damage.
Additionally, I was informed by another doctor that recovery might take about 6 months to a year.
I also underwent hyperbaric oxygen therapy, but it didn't seem to have any effect.
Another doctor suggested that my chronic dizziness might be anxiety-related, but I still feel dizzy throughout the day and am very concerned about the possibility of long-term damage.
I recall that during my orthopedic evaluation, X-rays showed signs of degeneration in my cervical vertebrae at levels 2 and 3.
I wonder if this could be contributing to my dizziness.

Xiao Zong, 10~19 year old female. Ask Date: 2024/07/23

Dr. Zhang Junwei reply Neurosurgery

Head trauma can also cause vestibular dizziness.
It is recommended that you visit an otolaryngologist for an examination.

Reply Date: 2024/07/23

More Info

Post-concussion syndrome (PCS) is a complex disorder that can occur after a concussion, which is a type of traumatic brain injury. Your experience of persistent dizziness following your car accident and subsequent surgery is not uncommon among individuals who have suffered concussions. It’s important to understand that PCS can manifest in various ways, including dizziness, balance issues, headaches, fatigue, and cognitive difficulties.

In your case, the dizziness you are experiencing could be attributed to several factors. First, the initial concussion from the car accident may have disrupted the normal functioning of your vestibular system, which is responsible for maintaining balance and spatial orientation. Even if you did not lose consciousness at the time of the injury, the brain can still suffer from a concussion, leading to symptoms that may not appear until days or weeks later, as you have described.

The timeline you mentioned, where symptoms began to manifest after your clavicle surgery, could suggest that the stress of the surgery and the recovery process may have exacerbated your existing symptoms. It’s also worth noting that the psychological impact of experiencing a traumatic event, such as a car accident, can contribute to feelings of anxiety and stress, which can further amplify dizziness and balance issues. This is sometimes referred to as "chronic dizziness" and can be linked to anxiety disorders.

Regarding the duration of your symptoms, recovery from PCS can indeed vary widely among individuals. While some may recover within a few weeks, others may experience symptoms for several months or even longer. The estimates you received from different healthcare providers about recovery times ranging from 3 to 12 months reflect this variability. It’s crucial to monitor your symptoms closely and maintain open communication with your healthcare team.

The mention of cervical spine degeneration (the degeneration of your cervical vertebrae) could also play a role in your dizziness. Degenerative changes in the cervical spine can lead to nerve compression or irritation, which might contribute to dizziness or balance issues. It would be beneficial to discuss this aspect with a neurologist or an orthopedic specialist who can evaluate whether your cervical spine condition is contributing to your symptoms.

As for treatment options, it’s essential to adopt a multidisciplinary approach. Physical therapy, particularly vestibular rehabilitation therapy, can be beneficial in addressing balance issues and dizziness. This type of therapy focuses on exercises that help retrain the brain to process balance information more effectively. Additionally, cognitive-behavioral therapy (CBT) may help manage any anxiety or stress that could be exacerbating your symptoms.

If you have not already done so, consider seeking a referral to a neurologist who specializes in concussion management. They can provide a comprehensive evaluation and may suggest further diagnostic tests, such as MRI or CT scans, to rule out any other underlying issues. If your symptoms persist despite conservative management, they may also discuss other treatment options, including medication to manage dizziness or anxiety.

In summary, while post-concussion syndrome can be a frustrating and challenging condition, many individuals do recover over time. It’s essential to remain proactive in your treatment, seek appropriate medical advice, and engage in therapies that can help alleviate your symptoms. Remember that recovery is often a gradual process, and maintaining a positive outlook can be beneficial for your overall well-being.

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