Comprehensive Clinical Picture of Patients with Complicated vs Uncomplicated Mild Traumatic Brain Injury

Abstract

To compare the acute clinical profile of patients with uncomplicated vs complicated mild TBI (MTBI), socio-demographic and medical history variables were gathered for 176 patients diagnosed with MTBI and with (complicated, N = 45) or without (uncomplicated, N = 131) positive findings on cerebral imaging. Neurological examination, neuropsychological assessment and self-evaluation of post-concussive symptoms were done at 2 weeks post trauma. Patients with complicated MTBI were more likely to show auditory and vestibular system dysfunction. Surprisingly, the uncomplicated group reported more severe post-concussive symptoms than patients with positive CT scans. The groups showed no other difference in neurological, psychological, or cognitive outcome. A complete neurological examination should be done acutely in patients with MTBI to determine more specific follow-up required.

Duration of Posttraumatic Amnesia Predicts Neuropsychological and Global Outcome in Complicated Mild Traumatic Brain Injury

“…), and the intervals at which outcomes were measured, ranging from 1 week to 1 year. Several prospective 9–11 and retrospective 4 studies have reported no or very small differences between cmTBI and mTBI in neuropsychological test performance, return to work rates, or global outcomes. Others have found worse outcomes for cmTBI on global outcome measures 12 or neuropsychological tests.…”

Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations

“…However, only a minority of survivors develops PTSD, and resilience factors help in resistance to the development of PTSD (deRoon-Cassini et al 2010). For example, in their study, anger reactions and difficulties with coping selfefficacy were associated with poorer trajectories in a sample of participants requiring level 1 trauma care, whereas education served a protective factor.…”

“…De Guise et al (2010) examined over 2 weeks the clinical profile of patients with complicated (e.g., positive cerebral imaging) and uncomplicated mTBI, including for neurological signs, neuropsychological performance, and self-reported post-concussive symptoms. The latter group reported more post-concussive symptoms, and the two groups appeared equally affected otherwise at the neuropsychological level, with many in both groups returning to work after 2 months on average.…”

Diagnostic terminology is not associated with contact-sport players’ expectations of outcome from mild traumatic brain injury

“…The results indicated that 43.9%, 62.5% and 51.2% of participants expected greater symptom disturbance than the clinical cut-score in the control, concussion and mTBI groups respectively; however, no effect of terminology was found using this criterion, 2 (2) ¼ 2.85, p ¼ 0.261 (2-tailed). Using the PCL-C cut-score of 50 [30], only 14.6%, 20.0% and 19.5% of participants expected greater PTSD symptom disturbance than the clinical cut-off in the control, concussion and mTBI groups, respectively, and there was no significant effect of terminology, 2 …”

“…Mild traumatic brain injury (mTBI) is a common neurological condition that can result in a significant financial and health burden to individuals and society [1,2]. MTBIs sustained in a sporting context are of particular concern given the increased risk of sustaining such an injury during play [3].…”