Prevalence of impairments 5 years after a head injury, and their relationship with disabilities and outcome

Abstract

To determine what consequences cognitive, behavioural or somatic impairments had on disabilities and recovery after a head injury (HI), a population-based sample of 231 adult patients was studied 5 years after an HI. Eighty lower-limb-injured (LLI) patients were considered as controls. Sixty-four LLI and 176 HI patients were reviewed (114 minor, 35 moderate, and 27 severe HI). Prevalence values of headaches (44-54%), dizziness (26-37%), and anxiety (47-63%) were not significantly different in the three HI severity groups, but were significantly lower in patients with an isolated limb injury (12-15%). Memory problems and depressive mood increased with injury severity. Mental impairments were frequent in severe HI patients (18-40% of patients). In minor and moderate HI patients, most disabilities were related to associated injuries. According to the Glasgow Outcome Scale (GOS), recovery was not considered as good because of somatic, behavioural or cognitive complaints in 2.5%, 5.7% and 59.2% of surviving patients in each of the above HI groups. Somatic or behavioural complaints may have considerable consequences in some minor HI patients, and the long-term management of certain patients needs improvement because these impairments are misunderstood.

Predictors of positive growth after traumatic brain injury: A longitudinal study

“…This is consistent with previous research which indicates that brain injury is associated with irritability, a 'short-fuse', and poor social integration [2,9,30,31].…”

A Longitudinal Pilot Study of Depressive Symptoms in Concussed and Injured/Nonconcussed National Collegiate Athletic Association Division I Student-Athletes

“…[13][14][15] These effects appear to be long term, with increased depressive symptoms being reported in some patients from 3 months to 9 years postconcussion. 7,13,[16][17][18][19] Researchers 20,21 have also linked perceived stress with depressive symptoms after TBI, noting that the unsuccessful use of coping strategies or a lack of coping resources can exacerbate depressive symptoms. This can lead to additional psychological stress, which may negatively affect the individual's perception of his or her healthrelated quality of life (HRQOL).…”

Outcome after Complicated Minor Head Injury

“…Postconcussive symptoms are very common after head injury, especially in the first weeks to months after the injury. 6,7,11,12,[45][46][47][48] Because many of the reported symptoms, such as headache and fatigue, have a high base rate in the general population, patients with postconcussive symptoms are often considered malingerers, especially when no objective or imaging abnormalities can be found or, as in our study, no relationship between specific imaging findings and postconcussive symptoms can be determined. In a case-control study by Masson et al 11 of patients with head injury versus those with lower limb injury, postconcussive symptoms, except for fatigue, were significantly more often present in patients with the head injury than in those with the lower limb injury.…”

“…5 Generally, these patients make a full functional recovery, though it is not uncommon to see patients with minor head injury with long-term sequelae after the injury. [6][7][8][9][10][11][12] With the advent of routine head CT scanning of virtually all patients with head injury, it has become clear that a substantial number (6%-10%) of patients with minor head injury have evidence of neurocranial traumatic complications. [13][14][15][16][17][18] Functional outcome in these patients with so-called "complicated" minor head injury has been shown to be significantly poorer than that in patients without neurocranial traumatic complications after minor head injury.…”