Neurobehavioral outcome following minor head injury: a three-center study

Abstract

The majority of hospital admissions for head trauma are due to minor injuries; that is, no or only transient loss of consciousness without major complications and not requiring intracranial surgery. Despite the low mortality rate following minor head injury, there is controversy surrounding the extent of morbidity and the long-term sequelae. The authors postulated that consecutively admitted patients who fulfilled research diagnostic criteria for minor head injury and who were carefully screened for antecedent neuropsychiatric disorder and prior head injury would exhibit subacute cognitive and memory deficits that would resolve over a period of 1 to 3 months postinjury. To evaluate this hypothesis, the neurobehavioral functioning of 57 patients was compared within 1 week after minor head injury (baseline) and at 1 month postinjury with that of 56 selected control subjects at three medical centers. Quantified tests of memory, attention, and information-processing speed revealed that neurobehavioral impairment demonstrated at baseline by all means of measurement generally resolved during the first 3 months after minor head injury. Although nearly all patients initially reported cognitive problems, somatic complaints, and emotional malaise, these postconcussion symptoms had substantially resolved by the 3-month follow-up examination. The data suggest that a single uncomplicated minor head injury produces no permanent disabling neurobehavioral impairment in the great majority of patients who are free of preexisting neuropsychiatric disorder and substance abuse.

Neurobehavioral sequelae of traumatic brain injury: evaluation and management

“…Several cognitive domains are predictably impaired, including frontal executive functions (problem solving, set shifting, impulse control, self-monitoring) (33,35), attention (36,37), short-term memory and learning (38)(39)(40)(41)(42)(43), speed of information processing (44,45), and speech and language functions (46)(47)(48)(49). Obviously, these are not completely independent domains, and there is typically a mixture of deficits of varying degrees across domains.…”

Altered cross-frequency coupling in resting-state MEG after mild traumatic brain injury

“…However, up to 25% of patients (Sigurdardottir et al, 2009) suffer residual PCS, long-term impairment, and sometimes disability (Levin, 2009), so that efficient identification of alterations due to mTBI becomes particularly important. Several cognitive functions are affected by mTBI, including attention (De Monte et al, 2006;Vanderploeg et al, 2005) working memory (Vanderploeg et al, 2005), episodic memory (Tsirka et al, 2011), verbal learning (De Monte et al, 2006;Ruff et al, 1989), and visual memory (Levin et al, 1987;Raskin, 2000;Ruff et al, 1989).…”

Nonepileptic Posttraumatic Seizures

“…Early postconcussive symptoms probably have an organic basis (46,47). Symptoms persisting >3 months after mild HI (persistent postconcussive syndrome) are more likely related to preexisting psychologic disorders (48), to possible malingering (43), or to unrecognized organic damage (49,50). There are probably elements of all three in any given patient, with the relative proportion depending on the premorbid personality and the severity of the inOur patients with nonepileptic PTS resemble patients with what has been termed the persistent postconcussive syndrome (44).…”