What are the risk factors for postconcussion syndrome (PCS)?

Updated: Sep 24, 2018
  • Author: Eric L Legome, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Risk factors for the development of postconcussion syndrome include nonsporting mechanisms, loss of consciousness, amnesia for the event, female sex, and abnormal neurobehavioral testing results after the incident.

  • A common perception is that patients who develop PCS from head injury are those who perceive a source of blame for the injury and desire to pursue litigation. However, a single study evaluating this did not demonstrate a correlation between blame and litigation. In fact, PCS symptoms persisted after settlement.

  • Some authors have concluded that persons with a history of depressive and anxiety disorders, certain premorbid personality types, or poor coping skills may be predisposed to PCS, but the data are conflicting.

  • Neck pain after a head injury has not been correlated with the development of PCS.

  • Although the numbers of patients tend to be relatively small, more recent studies suggest that PCS is more likely to develop in patients presenting with nausea, headache, and dizziness.

  • One study found an inverse association between number of years of education and development of PCS in adult patients. [24]

  • Patients with premorbid physical problems have also been found to have a higher incidence of PCS after minor head injury.

  • One study found that perception of the illness itself may have an effect on the development of PCS. Patients who believed that their symptoms had serious negative consequences on their lives were at increased risk of developing PCS. [25]

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