Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 09-06-2009, 11:17 PM #1
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Default Advice/help for PCS

Hi all, I'm looking for some advice/help.

To start off I got the concussion a year ago while playing soccer and was unconcious for a little while (I'm not quite sure how long). I didn't go see a doctor but I didn't go back to soccer for about 3 weeks because I didn't think it was that bad.

After the concussion I had a persistent headache from the moment I woke up till the moment I went to sleep that gradually diminished over a period of about 3 weeks. I felt mentally slow and had difficulty speaking and had problems with short term memory. I also had problems with mood swings up into mid november. I felt dizzy occasionally but the feeling was fleeting.

Then in November I got hit in the side of the head again while playing goalkeeper, but remained concious and stayed in the rest of the game. I felt dizzy and a little slow afterwards but it only lasted a day.

Around mid-November I felt fine, like my old self again.

At the beginning of December my headaches started again. I have had a headache everyday now since then. I have also been through mild depression. And I have had trouble with short term memory again. It was like getting the concussion all over again.

I am currently at college and am on topamax and propranolol both of which make me feel tired most of the day and topamax makes me feel mentally slow, so I'm thinking I should talk to a doctor and find a way to get off them.

Any recommendations for dealing with the headaches, they do not help with class or homework

Thanks
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Old 09-07-2009, 01:18 AM #2
Mark in Idaho Mark in Idaho is offline
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Before trying to get off the meds, I would suggest getting off the soccer field, permanently. Do some research into second impact syndrome or multiple impact syndrome.

I am confused as to why you are on propanolol. It is a blood pressure lowering drug. Has your Blood pressure been running high?

Topamax is a migraine headache medication. I have never heard about it being prescribed for Post Concussion headache.

You could call your doctor's office and ask if you can try not taking the Topamax for a few days and see if your headaches get worse. If they don't, then the Topamax may not be working for you.

I treat my post concussion headaches with Tylenol. Some people prefer ibuprofen. If your doctor puts you on a SSRI for your depression, ibuprofen may be contra-indicated. Be advised, many doctors will prescribe anti-depressants for concussion patients. Also, Tylenol can be hard on your liver so stay within the dosages recommended.

Your sluggishness may just be from the PCS.

Has anybody recommended getting on a good diet? It can be very helpful. Avoid diet sweeteners, MSG (monosodium glutamate), alcohol, get plenty of vitamins, especially the B's like B-12 and B-6. Plus a good healthy food regimen. Get consistent sleep. Poor sleep can be devastating to a PCS patient.

I have been there and done that after suffering a brain injury playing soccer. Any more concussions could easily drop your grades a full grade point. It did mine. Your brain will be very easy to concuss for quite some time.

Good luck to you.
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Old 09-07-2009, 05:15 AM #3
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Welcome to NT Nick,

Unfortunately, being knocked unconcious, even for a short period, can be indicative of a serious brain injury and can greatly decreases the odds of making a "full" recovery. As Mark has told you, adding a second concussion made matters worse.

If you're a varsity athlete, I know that you're under tremendous pressure to keep playing. The team doctor, sadly, may not be acting in your best interests and your brain is vastly more important to your future than your scholarship money.

If you're not under the care of a neurologist and a physical medical specialist, you should be. Have you had an MRI?

As for your homework issues, you should get all the extra help to which you are entitled. While you're recovering, what you absolutely don't need is to be staying up half the night trying to write papers and feeling stressed over exams. A lot of brain injured folks end up dropping out when a little assitance would have seen them through. Contact your college's disabilties officer for information.

Before you get extra help (tutor, additional time for assignments, etc...), you may be required to undergo a neuro-psychological examination. It's essentially a battery of verbal, oral and motor skills tests designed to reveal how your brain is really functioning. Frankly, it's the best thing that you could do. Getting a clear picture of what's going on helps impress upon people the importance of taking care of their brain.

Best of Luck!
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Old 09-07-2009, 01:33 PM #4
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I initially tried ibuprofen, then tylenol, then naproxen, then went to the family physician and worked my way up to vicodin for the headaches. Each of the drugs lost potency after a day or two. I have been seeing a neurologist since January. I had an MRI in January and it was normal.

He put me on imipramine, and that didn't do much for the headaches, and made the mood swings worse and actually ended up damaging my liver, so I stopped taking those in May.

The neurologist diagnosed me with migraine headaches too, despite no family history of them so that is what the topiramate is for. The propranolol was another treatment after the imipramine didn't work.

I quit soccer in November and I'm not a varsity athlete, my grades got me scholarships to go to school.
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Old 09-07-2009, 02:12 PM #5
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Hi Nick,

I'm sorry that you had to give up an activity that you enjoyed. I sure know how that feels.

I have constant headache from a diffuse axonal injury. My neurologist, the sadist, is convinced nothing can help that sort of headache, so that's what he gives me - nothing. As conventional treatment hasn't helped you, have you considered ice on the back of the neck, TENs or accupuncture? They may not work, but at least giving them a whirl won't wreck your liver.

On the MRI front, you probably know that standard MRIs are not sensative enough to detect all brain injuries. There are other imaging options that can be better. If you want the technical song and dance, let me know.

If you really want to know how your brain is, your best bet is neuro-psych testing. I can't stress enough how important that is.

Good Luck
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Old 09-07-2009, 05:45 PM #6
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Hi, first if the topamax isn't working or helping. Ask if you can try one of the other drugs that sometimes helps with migraines too.

I would suggest depakote ER as one. I would suggest this in place of both
the drugs you are taking too. I know a little about Migraines, PCS, and also wanting to play soccer and having been hit by the ball. My son who is now
23 was hit with the ball and it didn't register with us that this could have
been some of his problems. But part of the reason was because Migraines and seizures run in our family. So when he was in 5th grade the migraines
got bad, so that he was missing lots of school. And nothing started to
work for the migraines.

By the time he got to high school, and the times after he would have gotten
hit with the soccer ball and could have had the concussions, he had missed
many more days of school. But also started having seizures.

His neurologist chose to try depakote ER because it works on both migraines and seizures. And we wanted to see if it would stop them. But so does
topamax, but the reason we chose the depakote ER was his older brother
had good experiences with it, for other reasons. And his younger brother
had once been on it for seizures for over 5 years. So its track record
for our family was the better.

Even though I take and took at the time topamax for migraines. But it is
only a maintenance drug for me.

Also another to try is amtrypline. ITs something that helped him a lot in the
younger grades. Till he started sleeping to much. And then wouldn't take it, and didn't tell me till to late why.

Donna
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Old 09-10-2009, 03:44 PM #7
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I'm trying to get a referral to a specialist when I go back home for the breaks, or at least to get a neuro psych test.

I think for the time being after I come off the drugs, I will see how my head is, and see if the pain is bearable or not.
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Old 09-11-2009, 10:40 AM #8
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hi omega 3/6 multi vits hydration coffee all things you can do , the HAs really grind you down, unfortunately there is as yet no magic bullet pill, for this only time, you are young so your out come is likely to be good in the long run , try not to focus on it, improvement is so slow we some times don,t notice them

no more bangs to the head period
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Old 09-13-2009, 10:28 AM #9
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Default Hi Nick- Topamax

Hi Nick,

Firstly, I'm sorry you are dealing with PCS. 3 months ago I fell and hit my head, and became unconscious. It was in the middle of the night, and I'm not sure how it happened. My husband just found me bleeding from the back of my head on the ground. He woke me immediately, and in the weeks that followed, I was diagnosed with PCS.

Every day I wake up with a headache, nausea, unsteadiness, and fatigue. I also have trouble focusing for long periods of time. I took a leave of absence from work, and eventually lost my job. So, that's my background.

I see a neurologist every 2-3 weeks and he has been using different medications to try and ease my symptoms. I was put on Topamax at one point, which is an anti-seizure medication that is supposed to prevent migraines. It made me very tired and slow as well, and that's why I asked my neurologist if we could stop it. I also had 9 migraines in the 2 weeks I was on it.

I take Treximet when I begin to get a migraine or even when it has already started and it really kicks my migraines well. I still have 3-4 a week, and a constant dull headache all day. There isn't anything to be done for the dull ache, but at least I can battle the migraines.

In addition to the Treximet, I am on Amitriptyline, an antidepressant, at night to help me sleep and help with the moodiness and anxiety that this thing gives me. It helps me stay asleep longer, but it doesn't give me a rested feeling when I wake up. I just started Nuvigil yesterday, today is my second dose. It is supposed to help you feel more alert and awake during the day.

I would definitely see a neurologist if you haven't already.

Good luck!
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Old 09-13-2009, 08:42 PM #10
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Kate

You might also like to know that some find amtripyline causes drowsiness.

I also wonder if you have applied for SSDI because of the loss of your job.

I definately would.

Donna
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