You were told it was “just a concussion” and that you would feel better in a week or two. Now it has been months. The headaches keep coming back, your memory is not what it was, and you get dizzy in the grocery store. You are not alone, and you are not exaggerating. Doctors have a name for this: persistent post-concussion symptoms, or PPCS.
What Counts as Persistent Post-Concussion Symptoms?
A group of brain injury experts used a formal consensus process, called the Delphi method, to agree on a clearer definition.[1] In plain terms, PPCS means:
Any post-concussion symptom that appeared within hours of a mild traumatic brain injury, is still present every day about three months after the trauma, and affects at least one area of your life, such as work, school, family, or leisure.
The definition also asks whether at least one symptom is not better explained by another condition, and whether the person has failed to return to their previous state even after following medical advice.
Common Lasting Symptoms
Symptoms Experts Consider
- Headache
- Dizziness, light-headedness, or balance problems
- Trouble concentrating and slower thinking
- Memory problems
- Fatigue
- Depressed mood or emotional ups and downs
Car Crashes Raise the Risk
Persistent symptoms are often predictable, not random. A large study published in JAMA Network Open followed 2,872 adults with mild TBI who were treated at 18 Level I trauma centers. At 30 days, 1,128 of them (39.3%) still had persistent symptoms. The researchers identified nine characteristics linked to lasting symptoms.[2]
Key finding: falls, vehicle crashes, and assaults were associated with more than twice the risk of persistent symptoms compared with other ways people were injured.[2]
Other factors the study linked to lasting symptoms included a history of headaches or migraines, depression or anxiety, a significant headache when first seen, and certain findings on the neurological exam. Risk factors do not decide the outcome. They identify who may benefit from early, targeted care.
Treatment Works Best When It Is Targeted
Every concussion is different. Doctors increasingly look for the dominant pattern, or trajectory, of a person's symptoms and match treatment to it:
- Vestibular: dizziness and balance problems, treated with vestibular therapy.
- Ocular: eye strain, blurred vision, and tracking problems, treated with vision therapy.
- Cognitive and fatigue: memory and attention problems, addressed with cognitive therapy.
- Migraine: headache, nausea, and light or sound sensitivity, addressed with headache management.
- Anxiety and mood: worry, irritability, and depression, addressed with behavioral health support.
- Cervical: neck pain and stiffness, which are especially common after a rear-end crash, addressed with cervical therapy.
That last one deserves attention. The same whipping motion that can injure the brain often injures the neck. Our Low-Speed Impact Calculator estimates the peak force on the cervical spine, which can help explain why both injuries happened together.
Still Not Better Months Later?
Long-lasting symptoms can mean ongoing treatment, missed work, and real changes to your life. Morrison & Hughes can help you pursue compensation that reflects all of it.
Frequently Asked Questions
How long is too long for concussion symptoms?
Does a car accident make lasting symptoms more likely?
What kind of doctor treats persistent post-concussion symptoms?
You Deserve to Be Believed
People with lasting concussion symptoms often struggle to be believed by employers, insurers, and sometimes even their own families. Documenting your symptoms and understanding the forces involved can help. Run your crash through our free impact calculator, then call Morrison & Hughes at 404-LAW-TEAM for a free, confidential consultation. There is no fee unless we win your injury case.
Sources
- Laguë-Legendre C, Boucher V, Robert S, et al. Persistent postconcussion symptoms: an expert consensus-based definition using the Delphi method. J Head Trauma Rehabil. 2021;36(2):96–102.
- Factors associated with persistent symptoms following mild traumatic brain injury. JAMA Netw Open. 2025;8(6):e2516619.
- Silverberg ND, Iverson GL, et al. The American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury. Arch Phys Med Rehabil. 2023;104(8):1343–1355.