Post-Concussion Syndrome Case Study: 17 Year Old Male Athlete

Original Editor - Brianna Tam Top Contributors - Jordan Murchie, Brianna Tam, Lexy Mahon, Aurora MacKenzie, Rucha Gadgil, Kim Jackson, Vidya Acharya, Kirenga Bamurange Liliane, Nupur Smit Shah and Carina Therese Magtibay

Original Editor -

Top Contributors -

Abstract

This fictional case was created for educational purposes, and highlights some of the key clinical findings of a 17-year old male athlete who experienced a concussion, and subsequently post-concussion syndrome.

Introduction

This case study presents a 17-year old hockey player who sustained a concussion and has now been diagnosed with post-concussion syndrome.  A concussion typically results in physical and cognitive symptoms that are relatively short-lived and tend to resolve spontaneously within 7-10 days.  However, some people experience persistent concussion symptoms that last beyond the general time frame of recovery and can be diagnosed with post-concussion syndrome (PCS).  This persistence of symptoms can last for months and sometimes years. Studies have suggested that 21-59% of paediatric patients (under the age of 18) who experience a concussion, will develop the long-lasting symptoms of post-concussion syndrome.

Persisting concussion symptoms can leave the athlete in a vulnerable state and increases the risk of a more debilitating injury if more trauma occurs before recovery is complete.  Physiotherapists should be familiar with post-concussion syndrome and should understand that is it important to ensure full recovery before considering a return to sport.

The purpose of this case study is to provide an example of how a patient may present with post-concussion syndrome, as well as possible interventions and outcome measures that may be used to track recovery progress.  It is important to note that there are many symptoms and clinical presentations of post-concussion syndrome, therefore intervention strategies will vary among patients according to their functional impairments, activity limitations and participation restrictions.

Client Characteristics

A 17-year old male suffered a traumatic brain injury during a hockey game when he collided with a player from the other team.  The impact of the collision resulted in a direct blow to the front of his head and he immediately lost consciousness and fell to the ice. The loss of consciousness was brief and only lasted about 2 minutes. Once he regained consciousness, he reported feeling dizziness and confusion.  He was taken by ambulance to the emergency department where he was assessed and diagnosed with a mild traumatic brain injury (a.k.a concussion). The next day, he felt even more dizzy and also reported feeling very nauseous and having an intense headache.

Over the next few months he experienced relapses in his recovery.  He reports losing his balance quite often and having constant headaches.  He has also been experiencing depression and troubles concentrating. His mother has noted that he has become quite irritable and will often lash out on his family for no reason. He reported a previous concussion about 1 year ago, but with rest the symptoms resolved within a couple of weeks. It has now been 3 months since his injury and the onset of his concussion symptoms.  He was reassessed by his family doctor and diagnosed with post-concussion syndrome (PCS).  He was referred to physiotherapy to improve his concussion symptoms and help him return to his previous function.