Persistent post-concussion symptoms
Symptoms that last beyond the expected recovery period — weeks or months after the injury.
Common symptoms
- Headaches that keep coming back
- Ongoing dizziness or motion sensitivity
- Trouble with focus, memory or mental fatigue
- Poor sleep
- Anxiety, low mood or irritability
- Symptoms that flare with exertion or screen time
How we evaluate it
A fuller look at what keeps symptoms going. Each area — headache, sleep, mood, vestibular, vision, thinking and the neck — is assessed, along with conditions that existed before the injury and can make symptoms last longer. New symptoms that start more than a month after the injury are checked for other causes. A short validated questionnaire at the first visit scores your risk of a longer recovery, so the plan is matched to it from the start.
How we treat it
The plan focuses on the domains driving your symptoms — cognitive, vestibular, mood or autonomic — with the matching therapies, and is adjusted visit by visit.
- Cognitive: neuropsychology and cognitive rehabilitation
- Vestibular: vestibular rehabilitation therapy (VRT)
- Mood: psychiatry and counseling
- Autonomic and exertion symptoms: graded exertion therapy
- One plan, adjusted visit by visit rather than on a fixed timeline
What the guidelines say
Assess for the risk of persistent symptoms, prioritize which symptoms to target first, screen for and treat mental-health conditions, and decide if and when to refer to specialty care.
Patients whose symptoms last more than one month should be considered for referral to interdisciplinary concussion services. Headache, sleep and mood are managed first, because symptoms affect one another.
Symptoms lasting more than 4 weeks call for a multimodal clinical assessment, ideally by a multidisciplinary team, and referral to clinicians with specialized concussion skills.
Some people with chronic, persistent symptoms and co-occurring conditions may benefit from an individualized plan built by an interdisciplinary team. New symptoms after 30 days should be checked for other causes.
This page is general information, not medical advice. Your clinicians tailor evaluation and treatment to your history, symptoms and goals.
Not sure where to start?
Our care team routes your case to the right specialist after intake. See the FAQ, the clinical guidelines behind our care, or check your state.