March is a busy month which celebrates both international women’s day and brain health awareness week. In this industry, we see a number of brain-related injuries following a motor vehicle collision (MVC) including concussions and post concussion syndrome. Concussion symptoms normally resolve within several days to several weeks. However, we commonly see individuals who have been diagnosed with a concussion post MVC, develop a condition called post concussion syndrome (PCS). It appears that women may be more at risk for PCS.
What is Post Concussion Syndrome?
Post concussion syndrome (PCS) is “the persistence of concussion symptoms beyond the normal course of recovery” (Concussion Legacy Foundation, n.d.). If concussion symptoms continue to persist beyond several months, individuals may receive a diagnosis, from a physician, of PCS.
Individuals with post-concussion syndrome report concussion-like symptoms including:
● Headaches
● Fatigue
● Dizziness
● Nausea
● Sleep disturbances (insomnia)
● Vision problems (light sensitivity)
● Hearing problems (ringing in the ears, noise sensitivity)
● Cognitive impairment
○ Attention
○ Concentration
○ Processing speed
○ Memory problems
○ Brain fog
● Changes in mood
○ Anxiety
○ Depression
○ Irritability
○ Low motivation
The underlying cause of PCS is unknown, and therefore, it is hard to predict whether or not someone will develop PCS after a concussion. Up to 30% of individuals who had a concussion progress to develop PCS (Dennis et al., 2019), so it is important to monitor your symptoms if you have been diagnosed with a concussion following your MVC. If concussion symptoms persist after 3 months, it is highly recommended that you see your family doctor to seek formal assessment treatment.
Women and Post Concussion Syndrome
There is increasing evidence that women are more vulnerable to concussions than men. Women appear to be at a higher risk of having persistent concussion symptoms and therefore more likely to develop PCS than men (Tator et al., 2016; King, 2014).
On the other hand, women tend to be more proactive in their health care. This means that women are more likely to report concussion symptoms than men, and therefore more likely to seek consultation and receive treatment after experiencing concussion symptoms, compared to men (Tator et al., 2016).
Regardless of whether you are biologically male or female, it is important to monitor your concussion symptoms following an MVC and speak to your doctor if symptoms worsen or persist.
The brain is very complex. More research is required to determine the factors related to biological sex differences in concussion and PCS. Current research continues to explore the potential factors that differ between men and women that may indicate differences in incidence and outcomes of concussion and PCS. These potential factors include anatomical, biomechanical, hormonal, and/or behavioural differences between men and women, all of which potentially impact how the body responds to concussions and PCS.
How Can Occupational Therapists Help?
Individuals with PCS often experience disengagement from their day to day activities, which impacts their overall health. PCS can be difficult to manage without the support of your health care team. We know that women are active members of our community serving numerous meaningful roles, that require cognitive and emotional skills often impacted by PCS. Occupational therapists are well equipped to support all clients in managing PCS, while being mindful of their individual meaningful roles, through treatment focus on the following areas:
● Education about PCS
● Fatigue management and relaxation strategies
● Sleep hygiene education and coaching
● Non-pharmacological pain management
● Education/strategies for a gradual return to school, work, leisure, and social activities
● Negotiating modified duties at work and school with appropriate stakeholders
● Return to driving support
● Adapting the physical environment to support recovery and prescribing equipment to address symptoms
● Building tolerance to cognitively demanding activities through graded participation
● Psychosocial and mental health functional support
● Interventions to improve functional visual skills
For further details on how occupational therapists support individuals in these domains, please see our blog posts on sleep, health promotion, cooking skills, and psychotherapy.
References
Concussion Legacy Foundation. (n.d.). What is Post-Concussion Syndrome (PCS)?. Retrieved from: https://concussionfoundation.org/PCS-resources/what-is-PCS
Dennis, J., Yengo-Kahn, A. M., Kirby, P., Solomon, G. S., Cox, N. J., & Zuckerman, S. L. (2019). Diagnostic Algorithms to Study Post-Concussion Syndrome Using Electronic Health Records: Validating a Method to Capture an Important Patient Population. Journal of neurotrauma, 36(14), 2167–2177. https://doi.org/10.1089/neu.2018.5916
King N. S. (2014). A systematic review of age and gender factors in prolonged post-concussion symptoms after mild head injury. Brain injury, 28(13-14), 1639–1645. https://doi.org/10.3109/02699052.2014.954271
Tator, C. H., Davis, H. S., Dufort, P. A., Tartaglia, M. C., Davis, K. D., Ebraheem, A., & Hiploylee, C. (2016). Postconcussion syndrome: demographics and predictors in 221 patients. Journal of neurosurgery, 125(5), 1206–1216. https://doi.org/10.3171/2015.6.JNS15664
Varriano, B., Tomlinson, G., Tarazi, A., Wennberg, R., Tator, C., & Tartaglia, M. C. (2018). Age, Gender and Mechanism of Injury Interactions in Post-Concussion Syndrome. Can J Neurol Sci. 2018(45), 636-642
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