Post-concussion syndrome is when recovery from a concussion takes an unusually long time. While most people will eventually recover completely, there are rare cases where the effects are permanent. However, the symptoms are often treatable and most people can minimize the impact of this condition on their lives.
Post-concussion syndrome (PCS) is when you have concussion symptoms that last months or even a year or more after your initial injury. The symptoms can affect you in many ways, including how your body and brain function, as well as how you experience emotions.
Usually, concussion symptoms go away within two to six weeks after you experience an injury. People receive a PCS diagnosis when their concussion symptoms continue (persist) for much longer. Some symptoms are extremely subtle. Because of that, it’s a good idea to pay attention to your body and trust your instincts if something doesn’t feel right after you’ve had a concussion.
You should get immediate help if you have thoughts about harming yourself or others, or if you suspect someone is in danger of harming themselves.
There’s only one subtype of post-concussion syndrome. Persistent post-concussion syndrome is when symptoms continue for an extremely long time. The time limit on this varies and often falls to a healthcare provider’s judgment. Providers commonly use this diagnosis when symptoms last longer than three months, six months or even a year after an injury.
Concussions are fairly common, but it’s hard for experts to estimate the exact number of people that experience one each year. Many people who suffer a concussion don’t seek medical care. Experts estimate that there are between 1.6 million and 4 million new cases of concussions in the U.S. each year.
Studies estimate that about 15% of people with a concussion will also experience PCS. However, researchers also have strong reason to believe that’s an underestimation. Some of the reasons for that include:
PCS is tricky to diagnose. Some concussion symptoms are difficult to detect. Emotional and behavioral changes are examples of this. In the hospital, they may not stand out, or a healthcare provider might not have a way to know how a person usually behaves. That can make it hard to spot behavioral changes due to a concussion.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Post-concussion symptoms themselves are usually the same as concussion symptoms — they just last for much longer.
It’s important to note that any loss of consciousness (being “knocked out”) — no matter how brief — after an impact to the head or after a body impact that causes whipping of the head (whiplash) means you probably have a concussion. If you’re with someone who becomes unconscious after a head impact or whiplash event, they need medical attention — even if they regain consciousness quickly.
Another important fact to remember is, you don’t need to lose consciousness to experience a concussion. Many people who experience the kinds of impacts or events described above say things might not seem worrying at first glance. Common statements after a concussion event that doesn’t cause a person to lose consciousness include:
The symptoms of a concussion tend to fall into four categories:
Physical concussion symptoms can include:
Sensory symptoms can affect your five main senses (vision, hearing, smell, taste and touch). They can also affect related senses, such as balance. They include:
Symptoms that affect your mental state can include:
A concussion can also affect your behavior. Possible behavioral symptoms are:
Seek help immediately if you’re having thoughts about harming yourself or others, or if someone is in danger of self-harm. Resources that can help you include:
Experts don’t know exactly why post-concussion syndrome affects only some people who experience a concussion. They suspect it’s a combination of factors adding up.
Several risk factors can make PCS more likely to happen. Some of these include:
There are many possible complications of post-concussion syndrome. They’re all tied to experiencing lingering concussion symptoms. It’s uncommon, but some people experience post-concussion symptoms that last for years or are even permanent.
Possible complications include:
There’s no way to diagnose PCS directly because no specific test can confirm a concussion. Instead, a healthcare provider diagnoses a concussion — and later, PCS — based on their clinical judgment and a person’s symptoms. They’ll do that using several tools and methods, including:
If a healthcare provider suspects you have PCS, they’ll ask you to schedule follow-up visits to track any changes in your symptoms. They may repeat many of the same tests or ask you the same questions at each follow-up visit. They do that to track your symptoms and look for any changes, even subtle ones, which signal shifts in your condition.
Other tests your provider may recommend can vary depending on your medical history and symptoms. Your healthcare provider can tell you more about their recommended tests and why they think these might help.
Concussions and PCS aren’t considered “curable,” but there are treatment plans to allow for recovery. This means there’s usually no direct treatment or cure for PCS either.
For most people, your brain simply needs time to recover. That means paying attention to your symptoms to pace yourself and taking breaks when symptoms get worse. There are also some treatments that may help your symptoms and improve your recovery.
Symptom-specific treatments fall under these categories:
Healthcare providers no longer commonly suggest pain medications to help you get through your daily activities as you recover from concussion. That’s because if your symptoms worsen with an activity, the medication will keep you from being able to tell right away. That can cause a “rebound” of your symptoms once the medication wears off.
Instead, you should try and pace yourself as the symptoms get worse. This means slowing down and resting to allow symptoms to improve before continuing an activity.
You can take medication later in the day after you’ve been active to allow for better rest and recovery. Over-the-counter (OTC) medications for pain include acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), to treat headaches at the end of the day. Your provider might prescribe additional medications if over-the-counter medications aren’t enough to manage your symptoms.
Occasionally, a provider may also consider a nerve block for the occipital nerve (at the back of your head) as a possible treatment.
Part of recovery when you have a concussion or PCS is to have a set schedule for going to bed each night. If sleep is difficult, supplements that affect your body’s natural sleep cycle, such as melatonin, may help when you take them at least an hour before bed. Some prescription and over-the-counter medications may also help. Consult with your provider before taking medications or supplements to help you sleep.
People with concussions or PCS often experience light and noise sensitivity. That can cause them to feel overwhelmed in bright, loud or crowded environments.
To help manage this, try to limit the environment’s effects on you. Some helpful accessories include a brimmed hat, sunglasses and ear protection (such as silicone ear plugs). You should also consider picking out a nearby spot that’s quiet and calm prior to an activity. That way, you can go rest there if the environment becomes overwhelming and you need a break.
Certain types of rehabilitation or therapy can also help restore your sensory abilities. Vestibular physical therapy, vision therapy and other approaches may also work to bring these systems back to balance and make your symptoms better.
Speech-language therapy may help to retrain several abilities that might be affected after a concussion. These include your ability to read, focus and process and retain information.
Stress, anxiety and depression are common in everyday life. With concussion or PCS, these stresses can feel like someone is using a magnifying glass on them. Things you previously had no trouble managing can feel more stressful and challenging.
Talking to a behavioral specialist, such as a psychologist or psychiatrist trained in concussion, can help. They can help you learn to manage these feelings. Your provider can also prescribe medications to help improve how you experience feelings of anxiety, stress, anger or depression.
People with concussions or PCS are commonly told to rest. But new research shows that after just a couple days of rest after injury, low-level exercise activities can help start the recovery process. These shouldn’t include weight training or sports activities, as these are too intense.
Some examples of low-level activities that may help are riding a stationary bike or taking a slow, gentle walk. You can do these for 20 to 30 minutes every day. These activities shouldn’t make your symptoms worse. If they do, decrease how much effort you’re putting into them. That includes slowing down and taking breaks.
The focus of these activities is how long you spend on them. Speed or distance should not be priorities. Your objective is to get moving again — and to do so slowly and easily — so you don’t make yourself feel worse. You should also talk with your provider for guidance on how to increase your physical activity levels safely.
The possible complications and side effects of treatment depend strongly on the treatments themselves, among other factors. Your healthcare provider is the best person to tell you more about what’s possible for you, what to watch out for and what you can do to minimize or manage complications or side effects from any treatments they suggest.
Post-concussion syndrome happens unpredictably. Because of that, there’s no specific way to prevent it. The best way to prevent it is to make it as easy as possible for your brain to heal after a concussion.
Follow your healthcare provider’s instructions to help your post-concussion recovery. Some of the most common guidelines include:
In general, the outlook for PCS is good. Most people with PCS eventually recover and their symptoms stop. How long this takes can vary. Some people fully recover within weeks or months. For others, it may take a year or longer.
Unfortunately, some people may have permanent effects from PCS. In these cases, managing the symptoms might be possible. Your healthcare provider will tell you more about possible treatments and how you can minimize or manage your symptoms.
If you have post-concussion syndrome, managing your symptoms will vary depending on which symptoms you’re experiencing. Your healthcare provider can suggest treatments to help your body and brain heal most effectively. They can also monitor your symptoms and determine what changes in your care you may need, if any.
Seek help immediately if you were unconscious for any length of time after a blow to the head.
You should talk to a healthcare provider anytime you still have symptoms 24 hours after an injury to your head and/or neck. You should also get medical attention if you continue having concussion-related symptoms more than two weeks after the injury.
After a healthcare provider diagnoses you with a concussion, see your provider as often as they recommend. Regular visits are important for them to track changes in your symptoms and treat them accordingly. You should also see your provider if:
Most symptoms or complications of concussions and PCS aren’t medical emergencies. However, there are two major exceptions:
The best treatment for post-concussion syndrome varies. What works for one person may not be as helpful for someone else. That’s partly because there’s no way to directly treat PCS, meaning the treatments depend on your symptoms. Your healthcare provider can tell you what treatments they recommend and why.
Headaches are the most common symptom of PCS (and concussions in general).
A note from Cleveland Clinic
For most people, PCS means recovery from a concussion takes longer than usual. But in rare cases, it can last years or even be permanent. PCS can also be frustrating because it’s an illness that isn’t visible to others. The symptoms of it can be disruptive, unpleasant or even disabling.
While concussions and PCS aren’t directly treatable, many treatments can help you manage your symptoms. You can also reduce your risk of developing PCS by following your healthcare provider’s guidance while you’re recovering from a concussion. That way, you can potentially limit how long concussion symptoms last and how they affect your life.
Last reviewed by a Cleveland Clinic medical professional on 04/11/2023.
Learn more about our editorial process.