Emerg Med J doi:10.1136/emermed-2012-201667
  • Review

Postconcussion syndrome (PCS) in the emergency department: predicting and pre-empting persistent symptoms following a mild traumatic brain injury

  1. Phil Yates4
  1. 1Emergency Department, Royal Devon and Exeter Hospital, Exeter, UK
  2. 2Peninsula Medical School, Exeter, UK
  3. 3Department of Psychology, University of Exeter, Exeter, UK
  4. 4Department of Psychology, Marldon Unit, Royal Devon and Exeter Hospital, Exeter, UK
  1. Correspondence to Dr Adam Reuben, Emergency Department, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK; Adam.reuben{at}
  • Received 13 July 2012
  • Revised 5 November 2012
  • Accepted 8 November 2012
  • Published Online First 6 March 2013


Head injuries across all age groups represent an extremely common emergency department (ED) presentation. The main focus of initial assessment and management rightly concentrates on the need to exclude significant pathology, that may or may not require neurosurgical intervention. Relatively little focus, however, is given to the potential for development of post-concussion syndrome (PCS), a constellation of symptoms of varying severity, which may bear little correlation to the nature or magnitude of the precipitating insult. This review aims to clarify the aetiology and terminology surrounding PCS and to examine the mechanisms for diagnosing and treating.