PCS is not a specific injury or problem, but an umbrella term for long-lasting symptoms after a concussion. The symptoms vary from person to person, and can affect work, exercise, sleep and daily life.
Common symptoms of post-concussion syndrome
● Dizziness and unsteadiness ● Headache ● Brain fog and difficulty concentrating ● Fatigue ● Sensitivity to light and sound ● Sleep problems ● Nausea ● Increased symptoms with activity and stress
Previously, long-lasting symptoms were often explained as persistent damage in the brain. We now see this differently, and think that it is a long-lasting effect on the function of various systems in the body. Several of these can cause symptoms at the same time.
In post-concussion syndrome, one often sees involvement of
● Vestibular system (the balance organ) ● Vision and eye movements ● Neck structures ● The autonomic nervous system ● Psychological reactions
Dizziness, for example, is a common symptom after a concussion. Several systems can be involved here, including the balance organ, neck structures and autonomic regulation. Which system contributes most varies from person to person, and requires a good examination by relevant healthcare personnel.
How to start the journey towards a symptom-free everyday life
Treatment of PCS should be active and individually tailored. Modern rehabilitation often focuses on gradual exposure to activity rather than total rest. Vestibular rehabilitation, graded aerobic exercise and treatment of neck structures are examples of common measures.
Which measures are right for each individual is revealed through several tests and questions. Early help from relevant healthcare personnel has been shown to have a very positive effect on reducing long-lasting symptoms in PCS. The aim is not to avoid all symptoms, but to increase tolerance for activity gradually and safely over time. This is best done with good support from those around you, and a safe approach to the problem.
This article was written by Carl Johan Ween, chiropractor at Behandlerverket Oslo sentrum. He has further training in concussion and dizziness, and works in particular with the assessment and treatment of patients with post-concussion syndrome, vestibular problems and other causes of dizziness.
References
McCrory P, Meeuwisse W, Dvořák J et al. Consensus Statement on Concussion in Sport: The 6th International Conference on Concussion in Sport—Amsterdam, October 2022. British Journal of Sports Medicine, 2023.
Kleffelgaard I, Soberg HL, Tamber AL et al. Vestibular Rehabilitation after Mild Traumatic Brain Injury: A Systematic Review. Frontiers in Neurology, 2024.
Johnson M, Wilhelmsen K, Larsen T et al. Vestibular Rehabilitation in Persistent Postural- Perceptual Dizziness: Current Evidence and Clinical Applications. Journal of Vestibular Research, 2025.