Clinician handoff
PCS
Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.
Why this still fits
I had a head injury and my brain fog started or persisted after it. I want to know whether post-concussion syndrome is the right explanation, what evaluation would confirm or refute that, and what's typically recommended for symptoms at this stage.
What would weaken it
- -No concussion or head-injury timeline and no sensory or screen intolerance after the event.
- -The fog doesn't worsen with cognitive load, screens, or overstimulation in a post-injury way.
- -Migraine, cervical issues, sleep apnea, or anxiety explains the symptoms better than PCS does.
Key points to communicate
- •I want to know whether this is true post-concussion persistence or another issue uncovered by the injury period.
- •Please separate PCS from migraine, cervical strain, sleep disruption, and mood effects.
- •If PCS is the right lane, I want to know what rehab or testing would actually change management.
Bring this to the visit
- •Date and mechanism of head injury and any imaging done at the time.
- •A description of which symptoms appeared immediately vs weeks later.
- •Current cognitive complaints: memory, concentration, processing speed, multitasking.
- •Medication list and any headache or sleep medications.
Useful screening structure
- -SCAT6 (Sport Concussion Assessment Tool, 6th edition 2023) or ImPACT if baseline exists.
- -RPQ (Rivermead Post-Concussion Questionnaire) for structured symptom tracking.
- -Vestibular screening if dizziness or balance issues are present.
Tests and measurements to discuss
SCAT6 (Sport Concussion Assessment Tool) or PCSS symptom scale
VOMS vestibular/oculomotor screening
Neuropsychological testing (objective cognitive assessment)
Cervical spine physiotherapy assessment
Pituitary hormone panel (cortisol, TSH, testosterone, FSH, LH, IGF-1)
What this helps clarify: Primary male hormone - affects cognition, mood, energy
Range context
500–900 ng/dL (men)
How to use the result
Save the result with date and symptoms from the same week.
Orthostatic vitals (post-concussion autonomic dysfunction)
What this helps clarify: Combined HR and BP measurements with position
Range context
Stable BP/HR
How to use the result
Save the result with date and symptoms from the same week.
ImPACT computerized neurocognitive testing if baseline available
Questions to ask directly
- •Is this typical post-concussion recovery, or should we worry about persistent PCS?
- •Should I see vestibular therapy if dizziness and visual symptoms are prominent?
- •When is neuropsychological testing recommended for post-concussion fog?
- •Is graded return to activity appropriate now, or should I wait for more recovery?
Functional impact snapshot
- -Rate cognitive function weekly to track improvement trajectory.
- -Track which triggers worsen symptoms: screens, bright lights, noise, exertion.
- -Note whether graded cognitive and physical activity helps or worsens the recovery course.
Escalate instead of self-managing if
- •Worsening symptoms rather than gradual improvement - not typical of PCS.
- •New seizures, progressive weakness, or severe headache - needs urgent imaging.
- •Cognitive decline beyond 12 months with no improvement trajectory.
Peer-reviewed references