You hit your head five, ten, maybe twenty years ago. The doctors said you were fine. The scans came back normal. Everyone told you it was "just a concussion" and you'd bounce back in a few weeks.
But here you are, still struggling.
The headaches never fully went away. Your memory isn't what it used to be. You're exhausted by 2pm, irritable with your family, and you can't shake the feeling that something in your brain just isn't right anymore.
The most frustrating part? When you mention that old head injury to doctors, many of them dismiss it. "That was years ago," they say. "It can't still be causing problems."
They're wrong.
Research published in JAMA Network Open (2023) followed over 1,100 traumatic brain injury patients for five years. The results were sobering: fewer than half achieved complete recovery, even from injuries classified as "mild." Another study found that up to 30% of concussion patients develop persistent symptoms that last months, years, or even decades.
Your symptoms are real. The connection to your old injury is real. And most importantly, recovery is still possible.
At Cognitive FX, we've treated patients whose brain injuries happened 30+ years ago. We've seen firsthand how the right treatment approach can restore brain function and reduce symptoms that other doctors said would never improve.
This guide covers everything you need to know about symptoms from old head injuries: what they look like, why they persist, and what you can actually do about them.
Take our free quiz to see if you might be a good candidate for treatment. It takes less than 5 minutes and gives you personalized results based on your specific situation.
Most people assume that if you're going to have problems from a head injury, those problems show up right away. But the brain doesn't always work that way.
When your brain sustains an injury, even a "mild" concussion, it can disrupt something called neurovascular coupling (NVC). This is the relationship between your neurons and the blood vessels that supply them with oxygen.
In a healthy brain, blood vessels deliver a surge of oxygen exactly when and where neurons need it. But when NVC gets disrupted, affected brain regions don't receive the right amount of oxygen at the right time. They struggle to complete basic tasks like forming memories, processing visual information, or regulating your emotions.
Here's what makes this tricky: your brain is remarkably good at compensating. Healthier regions pick up the slack for injured areas, routing around the damage. You might function reasonably well for years this way.
But compensation has limits. Over time, those workaround pathways can become overwhelmed. Stress, aging, hormonal changes, or another minor injury can tip the balance. Suddenly, symptoms that were barely noticeable become impossible to ignore.
This is why some people experience symptoms immediately after injury while others don't notice problems until years later. It's also why symptoms can seem to come and go, or gradually worsen over time.
Neurovascular coupling dysfunction is the primary culprit, but it's rarely acting alone. Old head injuries often cause a cascade of problems:
Autonomic nervous system dysfunction (dysautonomia): Your autonomic nervous system controls automatic functions like heart rate, blood pressure, digestion, and body temperature. Brain injury can throw this system off balance, causing symptoms that seem completely unrelated to your head.
Hormone disruption: The pituitary gland sits at the base of your brain and is vulnerable to injury. Damage here can affect thyroid function, cortisol production, growth hormone, and sex hormones, leading to fatigue, weight changes, mood problems, and cognitive difficulties.
Vestibular dysfunction: Your vestibular system helps you maintain balance and spatial orientation. When it's damaged, you might experience dizziness, vertigo, motion sensitivity, and difficulty with coordination.
Vision problems: The visual processing system is spread throughout the brain, making it vulnerable to injury. Problems with eye tracking, focusing, depth perception, and light sensitivity are common after head trauma.
The effects of a head injury are wide-reaching. They can produce symptoms that seem completely unrelated to your brain. Here are thirty-seven of the symptoms we’ve seen caused by an old head injury:
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Headaches and head pain remain one of the most common persistent symptoms. These might be constant dull aches, tension-type headaches, or full-blown migraines. Many patients notice their headaches worsen with cognitive effort, stress, or screen time.
Fatigue and exhaustion go beyond normal tiredness. You might wake up feeling unrested no matter how much you sleep. Mental tasks that used to be easy now drain you completely. By afternoon, you're running on empty.
Dizziness and balance problems can range from occasional unsteadiness to constant vertigo. Some patients feel like the room is spinning. Others simply notice they're clumsier than they used to be, bumping into doorframes or losing their balance on stairs.
Sleep disruption takes many forms: difficulty falling asleep, waking frequently during the night, sleeping too much, or never feeling rested. Poor sleep then makes every other symptom worse.
Light and noise sensitivity can make everyday environments overwhelming. Fluorescent lights, busy restaurants, or even normal conversation volumes become difficult to tolerate.
Vision problems include blurry vision, double vision, difficulty focusing, eye strain, and trouble tracking moving objects. Many patients don't connect these issues to an old head injury.
Exercise intolerance means physical activity triggers symptoms rather than helping you feel better. Your heart races too fast, you get lightheaded, or your headache spikes. This can be deeply frustrating, especially if exercise used to be a stress reliever.
Other physical symptoms: blood pressure irregularities, heart rate changes, nausea, changes in taste or smell, temperature regulation problems (feeling too hot or too cold), neck and jaw tension, gastrointestinal issues, tinnitus (ringing in ears), and an exaggerated startle response.
Brain fog is that frustrating feeling of mental cloudiness. Your thinking feels slow and murky. Simple tasks require enormous effort. You might describe it as thinking through molasses or having cotton in your head.
Memory problems often involve both short-term and long-term memory. You walk into a room and forget why. You can't remember conversations from yesterday. Names and words that should come easily get stuck on the tip of your tongue.
Difficulty concentrating makes it hard to focus on tasks, especially ones requiring sustained attention. Reading becomes difficult. Following conversations in group settings feels impossible. Your mind wanders constantly.
Slow processing speed means everything takes longer. You need extra time to understand questions, formulate responses, and complete tasks that used to be automatic. Others might mistake this for lack of intelligence when it's actually injured brain function.
Getting lost in familiar places or struggling with navigation can occur when spatial processing is affected.
Difficulty with decisions ranging from what to eat for lunch to major life choices. The mental effort required to weigh options becomes overwhelming.
Depression after head injury isn't "just being sad." It often has a distinct neurological component, caused by disrupted brain chemistry and function rather than life circumstances alone.
Anxiety can appear for the first time after injury or worsen significantly. Some patients experience panic attacks. Others have a constant low-level dread they can't explain.
Irritability and anger that seem disproportionate to the situation. You snap at loved ones over small things. Your fuse is shorter than it used to be. This often creates relationship strain and shame.
Mood swings that shift rapidly without clear triggers. You might feel fine one moment and overwhelmed with emotion the next.
Feeling overwhelmed by situations you used to handle easily. Multitasking becomes impossible. Even minor stressors feel catastrophic.
Social anxiety or withdrawal from activities you used to enjoy. Many patients describe losing interest in hobbies, avoiding social gatherings, and feeling disconnected from people they love.
Tearfulness or crying more easily than before the injury.
"Feeling anxious without anxious thoughts" is a specific phenomenon where your body experiences anxiety symptoms (racing heart, tension, restlessness) but your mind isn't worried about anything in particular. This often indicates autonomic nervous system dysfunction.
Emotional symptoms can take you by surprise after a head injury. They could start immediately after the injury or appear later in your recovery journey.
Common causes of emotional symptoms following brain injury include other physical symptoms (like headaches and poor sleep), trauma from the injury, changes in your brain from the injury, or changes in your hormone levels. If you’re having gastrointestinal (GI) symptoms, vitamin deficiency could be a contributor to emotional symptoms as well.
We’ve written several guides to emotional symptoms following head trauma:
Note: If you are experiencing suicidal thoughts, please seek help from a qualified medical professional. You matter, and you can get better. In emergencies, call the National Suicide Prevention Hotline at 1-800-273-8255.
One of the biggest challenges with old head injury symptoms is figuring out whether that's actually what's causing your problems. Many of these symptoms overlap with other conditions like depression, anxiety disorders, thyroid problems, sleep disorders, or simply getting older.
Here are some clues that point toward an old head injury as the source:
Your symptoms started or worsened after a head injury. Even if there was a delay of months or years, think back to whether the injury marked a turning point.
Multiple symptom categories are affected. Having problems in two or three areas (cognitive + physical + emotional) is more suggestive of brain injury than a single-category issue.
Your symptoms worsen with cognitive effort. If your headaches, fatigue, or brain fog get worse after concentrating, reading, or working on screens, that's a hallmark of post-concussion problems.
You've had multiple concussions. Each additional head injury increases your risk of persistent symptoms, even if individual injuries seemed minor.
Symptoms of old head injury vs. normal aging: Normal aging typically causes gradual, mild changes. Old head injury symptoms are often more pronounced, affect multiple domains, and may have started suddenly rather than progressively.
Symptoms vs. depression or anxiety alone: Depression and anxiety caused by brain injury often don't respond fully to standard treatments. You might also have accompanying physical symptoms (headaches, dizziness, exercise intolerance) that pure mood disorders wouldn't explain.
Symptoms vs. early dementia: Dementia tends to be progressive and primarily affects memory, eventually impacting daily function. Post-concussion symptoms can remain stable for years, often affect attention and processing speed more than memory storage, and may improve with appropriate treatment.
If you're unsure, seeking evaluation from a specialist who understands post-concussion syndrome is the best path forward. Standard MRI and CT scans often appear normal even when significant dysfunction exists, which is why many patients are told nothing is wrong.
One of the biggest challenges with old head injury symptoms is figuring out whether that's actually what's causing your problems. Many of these symptoms overlap with other conditions like depression, anxiety disorders, thyroid problems, sleep disorders, or simply getting older.
Here are some clues that point toward an old head injury as the source:
Your symptoms started or worsened after a head injury. Even if there was a delay of months or years, think back to whether the injury marked a turning point.
Multiple symptom categories are affected. Having problems in two or three areas (cognitive + physical + emotional) is more suggestive of brain injury than a single-category issue.
Your symptoms worsen with cognitive effort. If your headaches, fatigue, or brain fog get worse after concentrating, reading, or working on screens, that's a hallmark of post-concussion problems.
You've had multiple concussions. Each additional head injury increases your risk of persistent symptoms, even if individual injuries seemed minor.
Symptoms of old head injury vs. normal aging: Normal aging typically causes gradual, mild changes. Old head injury symptoms are often more pronounced, affect multiple domains, and may have started suddenly rather than progressively.
Symptoms vs. depression or anxiety alone: Depression and anxiety caused by brain injury often don't respond fully to standard treatments. You might also have accompanying physical symptoms (headaches, dizziness, exercise intolerance) that pure mood disorders wouldn't explain.
Symptoms vs. early dementia: Dementia tends to be progressive and primarily affects memory, eventually impacting daily function. Post-concussion symptoms can remain stable for years, often affect attention and processing speed more than memory storage, and may improve with appropriate treatment.
If you're unsure, seeking evaluation from a specialist who understands post-concussion syndrome is the best path forward. Standard MRI and CT scans often appear normal even when significant dysfunction exists, which is why many patients are told nothing is wrong.
If you've been struggling with symptoms that other doctors have dismissed, you're not imagining things. At Cognitive FX, we specialize in identifying and treating the brain dysfunction behind persistent symptoms, even from injuries that happened decades ago.
Schedule a free consultation to discuss your situation with our team and learn whether our approach might help.
Most symptoms from old head injuries, while frustrating, aren't medical emergencies. However, certain warning signs warrant prompt evaluation:
These symptoms could indicate a new problem requiring immediate attention, separate from your old injury.
Many patients with old head injuries have been through the medical system multiple times without getting answers. If this describes you, seeking care from specialists who focus specifically on post-concussion syndrome and traumatic brain injury recovery can make all the difference.
Certain factors increase the likelihood that head injury symptoms will persist or appear later:
History of multiple concussions: Each additional injury compounds the risk. The brain becomes more vulnerable with repeated trauma, even when individual injuries seem mild.
Severity of the initial injury: Moderate and severe traumatic brain injuries carry higher risks of lasting problems. However, even "mild" injuries can cause persistent symptoms in a significant percentage of patients.
Symptoms that appeared immediately: Research shows that patients who experienced difficulty concentrating in the acute phase after injury had over 3 times greater odds of developing persistent post-concussion syndrome.
Loss of consciousness or amnesia at the time of injury: These suggest more significant brain impact, though their absence doesn't guarantee protection.
Older age at injury: Adults tend to recover more slowly than children and adolescents, though pediatric brain injuries can cause problems that only become apparent as the child ages.
Pre-existing conditions: Anxiety, depression, ADHD, migraines, or prior brain injuries can increase vulnerability.
Genetic factors: The APOE-e4 gene variant, associated with Alzheimer's risk, may also increase vulnerability to lasting effects from brain injury.
Delayed or inadequate initial treatment: Early intervention improves outcomes. Unfortunately, many people with "mild" injuries were told to rest and wait without receiving active treatment.
Contact sports participation: Athletes with history of repetitive head impacts face elevated long-term risks. Research on former contact sports athletes found high rates of chronic traumatic encephalopathy (CTE) in autopsy studies, with elite-level athletes facing the greatest exposure.
By the way, we created an online course that covers which types of headaches you can get after a concussion, as well as specific techniques for coping with those types of headaches. If you want to learn how to manage your headaches at home, visit our course.
The main cause of persistent head injury symptoms is dysfunctional neurovascular coupling, though the development of dysautonomia or hormone dysfunction can also play a role. Neurovascular coupling (NVC) refers to the relationship between neurons and the blood vessels that supply them with oxygen and micronutrients.
In a healthy brain, blood vessels provide a sustained surge in oxygen when neurons demand it. But if NVC is dysregulated, affected neurons (or whole brain regions) may not get the right amount of oxygen at the right time and fail to complete the tasks they’re responsible for, such as making a decision or encoding a new memory. Healthier brain regions might try to compensate for injured brain regions, but they may or may not succeed. And it’s easy for your brain to become overwhelmed as a result.
Because of these changes, the brain develops hypoactive regions that don’t do as much as they should, and hyperactive brain regions that do more work than they should (or burn a bunch of resources trying).
If your injury was severe, you may also have some dead brain tissue. While we can’t revive dead brain cells, the brain can route around them to try to compensate as best it can. Patients with physical or cognitive impairment from a severe head injury may have lingering symptoms that do not respond to treatment. But they often make more progress than they expect during treatment.
Some people think persistent symptoms are tied to the severity of the injury. For example, many patients (and even some doctors) think a mild traumatic brain injury isn’t enough to cause lasting symptoms unless the patient experiences loss of consciousness or memory loss after the accident. But the reality is that any head injury can cause dysfunctional NVC, whether it’s a “mild concussion” or a skull fracture that causes serious brain damage.
And knowing that is important: According to the Centers for Disease Control and Prevention (CDC), mild TBI makes up roughly 75% of brain injuries in the United States. Those patients deserve accurate health information and good treatment options if their symptoms persist!
Another myth pervasive in health care is that these persistent symptoms will not go away no matter what you do. A few decades ago that was true; however, there have been many advances in both treating acute serious injury and in medical care for patients with lingering symptoms.
Some medical professionals think symptoms can’t be from a brain injury unless the damage shows up on a structural MRI or CT scan. While you can see some serious injuries requiring immediate medical attention (like blood clots, hematoma and contusion, and so forth), you cannot see dysfunctional NVC on those scans. It requires specialized imaging like fNCI to detect NVC dysfunction.
Finally, patients with a severe TBI are often told to moderate expectations for recovery. Many treatment programs end when patients regain the ability to brush their teeth and hold a basic conversation because their health care providers may not believe patients can make further recovery (or know how to help them do so).
But if you want to improve beyond basic activities of daily living, there is still hope for recovery. While severe TBI patients do have more limitations and should have lower recovery expectations than mild TBI patients, that doesn’t mean you can’t keep recovering years after a head trauma. Read about five patients who made amazing progress even after debilitating injury.
Here's the good news that many patients never hear: recovery is possible even years or decades after a head injury.
The brain retains neuroplasticity throughout life, meaning it can form new connections and reorganize itself in response to the right stimulation. The key is identifying exactly what's wrong and targeting treatment accordingly.
Many patients with old head injuries have tried various treatments with limited success:
Medications may mask symptoms without addressing underlying brain dysfunction. Painkillers help with headaches but don't fix what's causing them. Antidepressants might take the edge off mood symptoms but often don't resolve them completely.
General physical therapy helps with some symptoms but doesn't specifically target brain function.
"Rest and wait" was the standard advice for years. While rest helps in the acute phase, indefinite rest doesn't promote recovery. The brain needs appropriate challenges to heal.
Piecemeal treatment addresses symptoms one at a time through different specialists. You might see a neurologist for headaches, a psychologist for mood, a vestibular therapist for dizziness, each working in isolation. This fragmented approach misses the interconnected nature of brain injury.
Effective treatment for old head injury symptoms requires understanding exactly how your individual brain was affected and targeting those specific areas.
At Cognitive FX, we use functional neurocognitive imaging (fNCI) to see which brain regions are underperforming and which are overcompensating. Unlike standard MRI or CT scans that only show structure, fNCI reveals function. This allows us to create a treatment plan tailored to your specific injury pattern.
Our intensive EPIC Treatment program combines multiple evidence-based therapies:
Neuromuscular therapy addresses physical symptoms and prepares the brain for cognitive work through targeted exercise that improves blood flow and neurovascular coupling.
Cognitive therapy challenges affected brain regions with specific exercises designed to restore normal function rather than continuing to rely on workaround pathways.
Sensorimotor therapy retrains the connections between sensory input and motor output, helping with balance, coordination, and vestibular symptoms.
Vision therapy addresses the visual processing problems that are almost universal after head injury.
Occupational therapy helps translate improvements into real-world function.
Psychological support addresses the emotional impact of living with persistent symptoms and any mood dysfunction caused by the injury itself.
These therapies don't happen in isolation. They're integrated throughout each treatment day, with the specific combination adjusted based on your fNCI results and symptom profile.
One of the most harmful myths about brain injury is that there's a "recovery window" that closes after a certain period. You may have been told that if you didn't recover within 3 months, 6 months, or a year, you never would.
That's not true.
We've successfully treated patients whose injuries occurred 30+ years ago. Samuel Gray came to us three decades after his traumatic brain injury. Through treatment that challenged his brain to use the correct regions instead of the workaround pathways it had developed, he experienced significant improvement.
"The point is that you're occupying the parts of your brain that, at least in my case, I had mapped around," he explained. "I wasn't using the correct part of my brain for word retrieval and memory. The exercises were forcing my brain to use the correct parts. Doing that is very difficult when you haven't used those parts of your brain in 33 years!"
Most of our patients complete treatment in one week. By the end, 95% experience statistically verified restoration of brain function. On average, patients see 75% improvement on their follow-up fNCI scan and 60% improvement in symptom severity.
Recovery continues after leaving our clinic. We provide each patient with exercises and strategies to continue their progress at home. Many patients report continued improvement in the weeks and months following treatment.
Whether you're pursuing treatment or still deciding on next steps, these strategies can help you manage symptoms day to day:
If you've already experienced one head injury, preventing additional trauma becomes critical. Wear helmets for biking, skiing, and other activities with head injury risk. Address fall hazards in your home. Be cautious with activities that could result in head impacts.
Poor sleep worsens every other symptom. Create a consistent sleep schedule. Keep your bedroom cool and dark. Avoid screens for at least an hour before bed. If you have significant sleep problems, consider evaluation for sleep disorders.
Stress amplifies symptoms and makes the brain work less efficiently. Find stress management techniques that work for you, whether that's meditation, gentle exercise, time in nature, or creative activities.
If you have exercise intolerance, work with professionals who understand how to gradually increase your tolerance without triggering symptom flares. The goal is to find the level of activity that helps without causing setbacks.
Alcohol affects the brain directly and can worsen cognitive symptoms, disrupt sleep, and interfere with recovery processes. Many patients find they tolerate alcohol much less than they did before their injury.
Learn to recognize when you're approaching your limits and take breaks before symptoms spike. This isn't giving up; it's strategic management that allows you to do more overall.
Living with persistent symptoms is isolating. Connect with others who understand, whether that's through brain injury support groups, online communities, or simply finding one or two people who believe your experience.
The quick response times needed for Dynavision challenges the thalamus, a brain region Olivia needed to re-engage.
Yes. Research shows that head injury symptoms can persist or even first appear years after the initial trauma. A 2023 JAMA study found that fewer than half of mild TBI patients achieved complete recovery even five years after injury. Some patients experience symptoms that were masked by brain compensation, only to have them emerge when that compensation fails due to stress, aging, or additional injury.
Symptoms can appear immediately, develop over the following days or weeks, or emerge months to years later. Delayed symptom onset often occurs when the brain's compensatory mechanisms become overwhelmed. There's no definitive cutoff after which new symptoms can no longer be related to an old injury.
Absolutely. Studies suggest that 30-53% of concussions go undiagnosed at the time they occur. You might not have lost consciousness or experienced obvious symptoms initially. Many people dismiss head impacts as "no big deal" and don't connect later problems to the incident.
Standard imaging like CT and MRI scans often appear normal even when significant dysfunction exists. These scans show brain structure, not function. Specialized functional imaging, comprehensive neurological evaluation, and assessment of your symptom pattern provide more accurate answers. The combination of multiple symptoms across physical, cognitive, and emotional categories, especially those that worsen with mental effort, suggests brain dysfunction.
While "cure" may be too strong a word for some patients, significant improvement and even full recovery are possible with appropriate treatment. The brain retains plasticity throughout life and can form new, healthier patterns of function when given the right stimulation and support.
The brain can heal and adapt, though the process is different from how a broken bone heals. Through neuroplasticity, the brain can strengthen weakened pathways, form new connections, and reduce reliance on inefficient compensatory patterns. This is why targeted rehabilitation works even years after injury.
Research suggests a connection. Moderate TBI increases dementia risk approximately 2.3 times, while severe TBI increases risk about 4.5 times. However, this doesn't mean dementia is inevitable. Managing symptoms, treating underlying dysfunction, and protecting against additional injuries may help reduce long-term risk.
Yes. Repetitive head impacts, even without diagnosed concussions, can cause cumulative damage. Athletes in contact sports and others with repeated head trauma face elevated risks of chronic symptoms and conditions like CTE. Each injury makes the brain more vulnerable to the next.
Look for specialists with specific training and experience in post-concussion syndrome and traumatic brain injury rehabilitation. This might include neurologists, neuropsychologists, or physiatrists who focus on brain injury. A multidisciplinary clinic that addresses all aspects of brain injury, rather than just individual symptoms, often provides the most comprehensive care.
No. While earlier treatment may produce faster results, improvement is possible regardless of how much time has passed. We've successfully treated patients whose injuries occurred decades ago. The brain's neuroplasticity doesn't expire.
If you're still experiencing symptoms from a head injury that happened years ago, you're not crazy. You're not making it up. And you're not alone.
Up to 30% of people who experience concussions develop persistent symptoms. Many go undiagnosed for years, told by doctor after doctor that nothing is wrong or that they should have recovered by now.
But the absence of answers doesn't mean the absence of a problem.
The brain is complex, and injuries to it don't always follow predictable timelines. Symptoms can persist, evolve, or appear years after the initial trauma. Standard tests often miss the dysfunction. And many healthcare providers simply aren't trained to recognize and treat these lasting effects.
Specialized treatment can help. By identifying exactly how your brain was affected and targeting those specific areas with evidence-based therapies, meaningful improvement is possible, even decades after injury.
You've already shown resilience by pushing through symptoms that others can't see or understand. Now it's time to get the answers and support you deserve.
If you’d like to know if our treatment program can help you, sign up for a consultation.
Between 80,000-90,000 people who suffer traumatic brain injuries (TBIs) each year develop long-term disabilities related to their TBI. Many others suffer from a variety of long-term, problematic...
