Most people think of concussions as scary, but temporary, injuries to the
brain. Unfortunately, that’s not the experience of everyone who
suffers from them. Many clients of ours have been frustrated by concussion
symptoms which hang on for months or even years. Doctors even have a name
for this: post-concussive syndrome, or PCS.
Nevertheless, one of the standard defense arguments about concussions or
other “mild” traumatic brain injuries is that the symptoms
almost always go away within six months or less. When faced with a injured
person who has continuing problems, they will describe that person as
an anomaly. Defense experts will say they can’t explain or understand
why that person’s symptoms didn’t clear up. The unspoken suggestion
in this testimony, naturally, is that people inevitably do get better,
and that anyone who says otherwise is just faking it.
The truth is that research debunked this canard long ago. For example,
a 2017 analysis of 45 prior studies of concussion patients found that
55-percent of them “demonstrated long term cognitive impairment.”
These findings, the authors wrote, “highlight the need to carefully
examine the long term implications” of even a one-time mild traumatic
These were not the only worrisome findings. While one might expect symptoms
to taper off after a period of months or years, the study found that symptoms
can hang on indefinitely. While children who suffered concussions sometimes
fared better than adults, the difference was small: 50-percent of kids
had residual problems, while 58-percent of adults did.
The types of problems people suffered include executive function (basically
higher thinking) which requires judgment and complex decision-making.
Other deficits include learning and memory; processing speed, which basically
means being able to think fast; and language function, which includes
things like being able to find the right words when speaking. While more
fortunate patients had these symptoms go away within a few weeks or months,
a majority could not shake them.
No one knows why some people bounce back from TBIs and others do not. The
brain is a tremendously complex and mysterious organ, and there is still
much for us to learn about it. In the meantime, people who continue to
feel their concussion symptoms months after a blow to the head shouldn’t
think they’ve gone crazy. They are not what used to be called a
“miserable minority.” Regrettably, they are the majority,
and they shouldn’t be shy about seeking help.
For its part, the medical community should take concussion sufferers seriously
and provide them appropriate care. Health care providers need to stop
relying on old anecdotal evidence and understand that people can’t
always “just get over it.”