Prevalence and Risk Factors of Neuropsychological Issues Following Acute Mild Traumatic Brain Injury

Abstract

BACKGROUND Traumatic brain injury (TBI) is one of the major causes of neurological disability in India 1 , 80-90% of TBIs are mild 2,3. Mild traumatic brain injury (mTBI) participants may present with post concussive symptoms especially deficits in cognition which is commonly ignored. Unidentified cognitive deficits in the acute phase of mTBI may result in long term functional problems and poor quality of life. Aim of the present study is to determine the prevalence and risk factors of neuropsychological issues in mild traumatic brain injury. METHODS Ninety persons with mild traumatic brain injury admitted to the emergency unit of neurosciences in a Chennai based tertiary care hospital aged between 20 and 60 years with Glasgow Coma Scale Score of 13-15 were assessed with PGI battery of brain dysfunctions within 48 hours of admission. Impairment in memory, verbal intelligence, performance intelligence, visual acuity and visuospatial functions were assessed using the battery. Cognitive dysfunction was evaluated using dysfunction rating scale scores in each test. RESULTS Data were analysed using IBM SPSS Version 21. Cognitive dysfunction was found to be higher in memory such as delayed recall, visual and verbal retention of new information, mental balance and constructional ability. Male participants (30%) between 50-60 years (70%) with lower educational qualification (44.4%) had severe cognitive impairment compared to others. Housewives (57.1%) had severe dysfunction in learning and retaining new information. Abnormality in CT report (35.9%) was found to have significant effect on visual retention. CONCLUSIONS There is significant cognitive impairment in various domains of memory and constructional abilities in the acute phase of single mTBI. Factors such as age, gender, years of education, occupation and structural abnormality were found to be risk factors for individual vulnerabilities. Younger age, higher educational qualifications and good occupational skills with uncomplicated CT reports were found to play protective roles as cognitive reserves in preventing cognitive dysfunction after traumatic brain injury.