What is postconcussion syndrome (PCS)?

Updated: Sep 24, 2018
  • Author: Eric L Legome, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Answer

Postconcussion (postconcussive) syndrome (PCS), a sequela of minor head injury (MHI), has been a much-debated topic. Muddled by conflicting findings regarding symptom duration, an absence of objective neurologic findings, inconsistencies in presentation, poorly understood etiology, and significant methodologic problems in the literature, PCS remains controversial. Depending on the definition and the population examined, 29-90% of patients experience postconcussion symptoms shortly after the traumatic insult. [1, 2, 3, 4]

Minor head injury and concussion are generally used interchangeably in the medical literature; however, it should be noted that the traditional definition of concussion precludes findings of intracranial hemorrhage on CT scan, whereas the definition minor head injury does not (though it does preclude the presence of a skull fracture). A minor head injury typically indicates a blow to the head with a brief period of loss of consciousness (LOC) or posttraumatic amnesia or disorientation. At presentation, the Glasgow Coma Scale (GCS) score ranges from 13-15. However, more recent literature suggests, and many clinicians concur, that a GCS score of 14 or 15 denotes an injury with a significantly less chance of intracranial injury on CT scan than a GCS score of 13.


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