Are Cognitive Outcome and Recovery Different in Civilian Penetrating Versus Non-Penetrating Brain Injuries?

Abstract

The present study sought to determine whether cognitive outcome and course of recovery in civilian penetrating brain injury due to gunshot can be distinguished from that of non-penetrating brain injury due to motor vehicle accident. Matched survivors of penetrating and non-penetrating brain injury were assessed with a brief neuropsychological test battery at inpatient rehabilitation, 1 year post-injury, and 2 years post-injury. The traumatic brain injury groups were found to have patterns of performance marked by reliably distinct differences in isolated areas, with different cognitive predictors of brain injury type present in early versus later recovery. The degree of recovery over the first 2 years appeared to be quite similar for penetrating and non-penetrating injuries.

Traumatic Brain Injury: Guidance in a Forensic Context from Outcome, Dose–Response, and Response Bias Research

“…Impairments in memory, processing speed, and executive functioning are often observed in patients with moderate to severe TBI (Draper & Ponsford, ; Spitz et al, ). Recovery curves vary with injury severity, but, in general, the majority of cognitive recovery occurs within the first 5 months post‐injury, fewer gains over the next 7 months, and relatively few, if any, additional gains 1–2 years post‐injury (Christensen et al, ; Schretlen & Shapiro, ; Ylioja et al, ). Studies have demonstrated continued cognitive impairment after moderate to severe TBI even 10 years post‐injury (Draper & Ponsford, ).…”

“…These cognitive impairments were not found to be related to age, education, or post‐injury time. A distinction has also been made regarding cognitive outcomes and recovery in the first 2 years in moderate to severe TBI patients with penetrating (i.e., gunshot) versus non‐penetrating (i.e., motor vehicle accident) injuries, with the penetrating TBI group having worse attention than the non‐penetrating group, but better verbal learning and fine motor dexterity (Ylioja et al, ). Both the penetrating and non‐penetrating moderate to severe TBI patients showed the greatest cognitive recovery over the first year, and many fewer improvements over the second post‐injury year.…”

Impact of day-of-injury alcohol consumption on outcomes after traumatic brain injury: A meta-analysis

“…Penetrating TBI (e.g., gunshot wound) was excluded due to differences in the causes, mechanisms and outcomes of these injuries (Ylioja, Hanks, Baird, & Millis, 2010). Participants aged 16 years and over were deemed eligible in order to accommodate the minimum legal drinking ages adopted by different countries (WHO, 2014).…”