Brain Trauma and the Postconcussional Syndrome

Kay, D. W. K.; Kerr, T. A.; Lassman, L. P.

doi:10.1016/s0140-6736(71)90377-1

Cited by 51 publications

(23 citation statements)

References 2 publications

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“…Age, socio economic status, family relationships, personality style and the person's psychological history all influence outcome [73][74][75]. Kaye et al [15] also note a number of personality factors, comprising obsessive over-achievers childhood emotional deprivation, dependent tendencies, borderline personality, and grandiose tendencies, all play a role in magnifying a person's perception of symptoms.…”

Section: Pre-accident Psychological Factorsmentioning

confidence: 99%

Understanding the ‘miserable minority’: a diasthesis-stress paradigm for post-concussional syndrome

2004

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Opinions about persisting post-concussional symptoms after minor traumatic brain injury still reflect a polarization of views around the sterile debate concerning the psychological vs organic origins of symptoms. Reviews of the experimental literature do not always integrate the often diverse perspectives that explain persisting symptoms of concussion. As a result, the disorder is still poorly understood. In this review, a diasthesis-stress paradigm examines the interaction between physiological and psychological factors that generate and maintain post-concussional symptoms. Motivational factors and different coping strategies are considered to explain why some people are at risk of developing a post-concussional syndrome. The early iatrogenic potential of GPs and hospital doctors who may create insecurity or reinforce illness perceptions is considered. Finally, the rationale and effectiveness of interventions that ameliorate the impact of early post-concussional symptoms is reviewed to see if prevention of the post-concussional syndrome is more effective than cure.

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Section: Pre-accident Psychological Factorsmentioning

confidence: 99%

Understanding the ‘miserable minority’: a diasthesis-stress paradigm for post-concussional syndrome

2004

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“…Cairns (1942), Russell (1943), Russell (1959), Lewin (1966) and Jennett (1976), it was found that the duration of disability after a concussive head injury was closely related to the length of PTA. Kay et al (1971), in a retrospective study of hospitalized head injury patients, were unable to correlate the duration of loss of consciousness, or PTA, with the presence or absence of post-concus sional symptoms when the patients were re viewed between 3 and 6 months after injury, stating that (a combination of) 'marital state, social class, type of accident and previous psychiatric illness' yielded a much better cor relation. However, their study did not distin guish between the post-concussional state on the one hand and the socially determined sta tes, especially AN, in which the patient's com plaints suggest the post-concussional syndrome but there is no correlation with the severity of injury.…”

Section: Discussionmentioning

confidence: 96%

Posttraumatic Amnesia, Post-Concussional Symptoms and Accident Neurosis

Guthkelch

1980

Eur Neurol

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This communication surveys 398 consecutive head injury patients who were in regular full-time employment at the time of injury and who were examined in connection with a claim for compensation. In uncomplicated cases there was a close correlation between the duration of posttraumatic amnesia and the length of time off work. Some common causes of prolonged organic disability are mentioned. The recovery rate of patients suffering from posttraumatic emotional disorders, such as depression or anxiety, was proportional to the initial severity of injury, whereas the indefinite invalidism associated with so-called ‘accident neurosis’ was found to be rare in severely injured patients. ‘Accident neurosis’ also was more common in manual workers sustaining accidents at work than in the same occupation group after road accidents, or in non-manual workers. It is concluded that posttraumatic emotional disorder and ‘accident neurosis’ are not the extremes of a spectrum but separate and distinguishable conditions.

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“…A syndrome, comprising diffuse headache, irritability, loss of concentration, dizziness, and disturbance of smell and vision that occurs shortly after head injury in which there is loss of consciousness, is referred to as the postconcussional or postconcussive syndrome (Kay, Kerr, & Lassman, 1971). Loss of consciousness is necessary for this term to be used.…”

Section: Postconcussional Syndromementioning

confidence: 99%

“…For instance, in the study of Ettlin et al (1992) none of the patients had lost consciousness. However, in some patients with more severe mild head injury with loss of consciousness for up to 15 minutes, impairment of the special senses is apparent (Kay et al, 1971) and migraine and cluster headache are recognised sequelae (Alexander, 1995), suggesting vascular changes resulting from the TBI. Furthermore, the effect of pain in reducing attention, memory, speed of processing and executive functioning-neuropsychological deficits 192 TYRER AND LIEVESLEY that also occur in head injury-suggest that chronic pain is a factor that increases and maintains persistent PCS (Nicholson, 2000b;Nicholson, Martelli, & Zasler, 2001).…”

Section: Postconcussional Syndromementioning

confidence: 99%

Pain following traumatic brain injury: Assessment and management

Tyrer

Lievesley

2003

Neuropsychological Rehabilitation

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Traumatic brain injury is frequently associated with painful complaints immediately after injury and subsequently. Early assessment of possible painful conditions can be made at the time of physical examination in those who are unable to give a history. Non-verbal signs of pain, including withdrawal of a painful limb or body part, irritability or tears should draw the attention of the assessing physician to a peripheral painful site. Treatment of conditions giving rise to pain can be made at this stage. Persistent pain may arise from a combination of physical and psychological factors and is best managed in a multidisciplinary pain clinic. Contributions from physicians in pain management, psychologists, physiotherapists and clinical nurse specialists enable a rehabilitation programme to take place. Treatments include analgesic drugs, graded exercise, cognitive-behavioural therapy, and transcutaneous electrical nerve stimulation. Rehabilitation of people who have ahead injury and pain takes longer than usual and separate pain management facilities should be developed for this population.

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Brain Trauma and the Postconcussional Syndrome

Cited by 51 publications

References 2 publications

Understanding the ‘miserable minority’: a diasthesis-stress paradigm for post-concussional syndrome

Understanding the ‘miserable minority’: a diasthesis-stress paradigm for post-concussional syndrome

Posttraumatic Amnesia, Post-Concussional Symptoms and Accident Neurosis

Pain following traumatic brain injury: Assessment and management

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