“I think I am going mad. My head is all over the place”

The above is a comment from one of my clients Sally following a road traffic accident. Sally was a front seat passenger of a car that was hit from behind. Sally was unconscious for only a few minutes but the effect on her life has been catastrophic. Usually an excellent teacher, she found concentrating for a 30 minute lesson frustrating. She was unable to process complex information and struggled to learn new facts. Sally found focusing in a noisy classroom environment near impossible and was bad tempered and irritable which was totally out of character.

Head injuries

It is estimated that 75-80% of all head injuries fall into what is categorised as a minor head injury or minor brain injury. This can be a result of something fairly commonplace such as hitting your head whilst getting into a car, a minor fall or knocking heads with another person whilst playing sport.

Whilst defined as a ‘minor’ head injury, the impact that such an injury can have on a person’s life is anything but minor. After such an injury, people can develop a condition called post-concussion syndrome (PCS) which is often referred to as the “unseen injury”. Symptoms of PCS can include headaches, dizziness and nausea, visual problems such as sensitivity to light and fatigue as well as irritability, anxiety, depression and difficulties with concentration, planning and organising and memory.

In some cases all that is needed is sleep and rest for the symptoms to resolve themselves within a few days or weeks but in other cases the symptoms can persist for months or even years with some sufferers unaware of the true cause of their symptoms or how to go about treating them.

A possible explanation for this is that the condition can be difficult to diagnose as often, any scans undertaken appear to be normal. Furthermore, the symptoms and effects of a minor head injury vary from patient to patient and there does not appear to be any link between the severity of the initial injury and the risk of developing PCS.

Symptoms following head injury

Symptoms of PCS, headaches, irritability, fatigue, hypersensitivity to noise, poor concentration etc are often associated with other problems, including stress at work, drug and alcohol issues, depression, or a more serious psychological or psychiatric condition. Experts are therefore divided on the causes of PCS. Some attribute it to structural damage caused by the initial impact or injury whilst others believe that it is linked to psychological factors.

The impact of PCS on a person’s life can be devastating from an inability to return to work for long periods causing financial hardship to the breakdown of relationships where loved ones find themselves unable to empathise, cope with or understand what is happening.

At present, there is no dedicated treatment for PCS and instead doctors focus on treating the individual symptoms, for example with painkillers for headaches or anti-depressant medication for the depression and anxiety. However, many sufferers find that a simple diagnosis helps their recovery as it often provides an explanation for their symptoms and the peace of mind of knowing that there is a solution and hope of a return to life as they knew it before their injury.

This is exactly what Sally found. Following the results of neuropsychological tests Sally was relieved to find she was not going crazy, but was actually suffering from PCS and in her case could be successfully managed with cognitive behavioural therapy. Over time Sally regained the confidence to be able to return to the classroom without fear of embarrassment or dread.

If you are concerned about symptoms lasting beyond two weeks following a minor head injury, you are not going crazy. You need to consult your GP and take advice. Often early intervention is the key to making a full recovery. Where the injury has been caused by someone else’s negligence then it is important that you seek legal advice to enable you to get access to the right treatment as soon as possible.