Postconcussive Syndrome: The Daily PANCE Blueprint

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Postconcussive Syndrome: The Daily PANCE Blueprint

A healthy 57-year-old female with a history of hypertension sustained a ground-level fall in her slippery bathtub and was sent to the ER via EMS. She says that she hit her head. Her initial CT head without contrast was negative for any intracranial issue. She was discharged home a few days later, with all imaging and work-up unremarkable for any issues. The patient presents to your clinic 2 weeks later complaining of headaches, fatigue, some dizziness, and balance issues. Which of the following is the most likely diagnosis?

A. Post-concussion syndrome
B. Severe traumatic brain injury
C. Post-traumatic stress disorder
D. Subarachnoid hemorrhage
E. Transient ischemic attacks

Answer and topic summary

The answer is A. Post-concussion syndrome

Post-concussion syndrome (PCS) is defined by a constellation of symptoms that appear after a mild traumatic brain injury. Female and older people are more susceptible to PCS. Clinical features include: headaches, fatigue, confusion, dizziness, insomnia, trouble with concentrating, vision changes, balance issues, and changes in emotions or behaviors. Most patients do improve in 3 months. If patients with PCS who did not have previous imaging they should get an MRI if symptoms continue to persist. Treatment should be individualized to the patient’s complaints.

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Covered under ⇒ PANCE Blueprint Neurology ⇒ Closed head injuries ⇒ Postconcussion syndrome