topic 10 - PPCS

Question 1

what is the difference between persisting and long term symptoms

Answer 1

persisting = symptoms extending beyond the recovery window (28 days)

long term = chronic (years) changes associated with a history of concussion

Question 2

is there a definitive test to say yes or no to persisting symptoms

Answer 2

no
multi assessment protocol with symptom eval is still best practise

Question 3

what is the difference in reporting between girls and boys

Answer 3

girls may be more aware of symptoms and more likely to report

boys and girls may disclose at different rates due to different motivations

hormonal differences may influence TBI (progesterone, estrogen, and testosterone) even timing within the menstrual cycle may modulate recovery

Question 4

what are the domains that need to be evaluated as part of complete concussion care

Answer 4

somatic (headache)
cognitive
affective / mental health
physiological (exercise intolerance)
cervical spine
vestibular
oculomotor
autonomic
sleep
hormonal
loss of cognitive and/or physical stamina

Question 5

what is the relationship between symptoms and recovery

Answer 5

more symptoms = longer recovery

persistance of symptoms following SRC does not reflect a single pathophysiological entity

Question 6

is exercise safe/beneficial in those with PPCS

Answer 6

yes - individualised, symptom limited aerobic exercise in treatment of patients with physiological PPCS

Question 7

which treatments should be used based on the different deficits in PPCS

Answer 7

cervicogenic / vestibulo ocular deficits = physio
affective deficits = psych (cognitive behavioural therapy)
physiologic deficits = exercise

Question 8

is pharmacotherapy benefical in treating PPCS

Answer 8

no
- can cause more symptoms
- just blunts pain and awareness of what’s happening

Question 9

what is the relationship between symptom length and recovery

Answer 9

reporting symptoms 2-3 years out = very little recovery often