Pots After Concussion

[summer]

Anyone ever heard of POTS developing after a concussion? I'm asking for a friend of mine. Is it possibly related, or more likely a coincidence?

[Simmy]

POTS is most commonly thought to be caused by a virus, or trauma like a car crash, so yes. Possible.

[Birdlady]

When new symptoms appear after a head injury, I'd first suspect a possible pituitary problem. It could have been damaged and/or shifted as a result of the force.

[erik]

TBI (traumatic brain injury) tends to imply something of a more severe and directly noticed nature, but MTBI (Mild) or concussion can apparently still cause lasting effects. There is this article here relating TBI & POTS:

http://www.dynakids.org/Documents/POTSfollowingTBI.pdf

Post-Concussive Syndrome points to some potential symptoms that can persist for quite a while. It seems reasonable that one can mistake the more subtle damage of concussion as being totally healed in short order (after obvious symptoms subside).

I know in my case, my first overt faint (full syncope) followed a head injury by several months so it is a logical thing to pin my orthostatic symptoms on, timing wise. There also seems potential for subtle damage to pituitary or hypothalamic areas. The hypothalamus is a key autonomic sensor, giving feedback on things such as temperature, acid/base state, CO2 levels, hormones, etc. and (to my basic level of understanding) works with the brain-stem to coordinate autonomic responses which then go out in complex CNS, vagus nerve, and pituitary (hormonal) signaling. Even a subtle misdirection there seems like it could throw things out of balance, either consistently or just intermittently.

I don't know if "simple concussion" is often thought of as having this potential... but it seems possible to me.

[Noreen]

MTBI (Mild) or concussion can apparently still cause lasting effects. There is this article here relating TBI & POTS:

http://www.dynakids.org/Documents/POTSfollowingTBI.pdf

Eric-

Thanks for the link to the article. My full faint resulting in my NMH dx 7 years ago caused a rather nasty concussion - happened at Old Navy and their tile floors are not soft. I've had other concussions from car accidents also and had no idea these all played into the dysautonomia puzzle.

Tks again,

noreen

[Brye]

I've often wondered that myself. I had 2 concussions playing college basketball close together. I never did recover enough to play again. I wasn't diagnosed with POTS at the time but looking back I think that was the reason I couldn't recover not the concussions. I had exercise intolerance, dizziness, memory problems, hand tremors, fainting spells ... all very similar symptoms. The good news for me was I did recover from the initial bout and it just re-occured 24 years later. I was VERY active during my years between though.

Brye

[summer]

Thanks, Everyone, for your replies and for the link, Erik ....very interesting article.

[kjd111]

We think this is what started my daughter's issues as well. She fell in her bathroom and sustained a fairly serious concussion. Her autonomic issues started about 1 month later. Our current endo believes that she damaged her hypothalamus when she fell and her sympathetic nervous system doesn't work properly. Interestingly, she doesn't seem to have POTs so much as NMH - low blood pressure that drops a lot lower upon standing. Her capillaries also leak - almost continuously, although its been a touch better with the meds she is on. What is super weird in her case is that because of the leaky capillaries, she "swells", between her mid-thighs and chest. i am assuming this is fluid leaking out. Every once in a while, when she is super excited, relieved, angry - intense feelings, she gets an adrenaline "rush" and all of those capillaries close up, the swelling/edema dissipates over like a half hour and she pees out a lot of water for 4 or 5 hours. Then she's tiny! This can stay for a couple hours or a couple days, but invariably her capillaries start to leak again and she reswells. Her catecholamines were low/low normal lying down and didn't change at all on standing. Her endo thinks that she has sympathetic denervation? She also tested low for growth hormone and is on GH replacement, which does seem to help a bit. All of this from one tbi, so i think that a relationship is absolutely possible.