Research Reports - Neurogenic and psychogenic acute postconcussion symptoms can be identified after mild traumatic brain injury

J Head Trauma Rehabil. 2012 Jun 9

Mounce LT, Williams WH, Jones JM, Harris A, Haslam SA, Jetten J

OBJECTIVES:: As provenance of postconcussion symptoms after mild traumatic brain
injury (mTBI) is controversial, with similar rates found in other populations, we
aimed to identify postconcussion symptoms specific to mTBI compared with
controls. We also compared differences between complicated and uncomplicated
mTBIs. SETTING:: Hospital emergency department. PARTICIPANTS:: Adult individuals
(34 individuals with complicated mTBI, 76 individuals with uncomplicated mTBI,
and 47 orthopedic controls) who sought care in the emergency department and were
consecutively recruited by post at 2 weeks postinjury. MAIN MEASURES:: Rivermead
Postconcussion Symptom Questionnaire. Preinjury factors were used as covariates.
RESULTS:: Compared with orthopedic controls, complicated mTBI group reported
greater severity of headaches, dizziness, and nausea, as well as concentration
difficulties, suggesting that these are neurogenic. Severity of other symptoms
measured on the Rivermead Postconcussion Symptom Questionnaire was not
significantly different between these groups, suggesting that these are
psychogenic. Differences were evident between the 2 mTBI samples on the items of
dizziness, nausea, fatigue, sleep disturbance, and concentration difficulties.
CONCLUSIONS:: Neurogenic and psychogenic postconcussion symptoms were identified
at the acute-phase postinjury. Findings suggest that treating persons with mTBI
as a homogenous sample is not prudent. This should inform prognostic models and
follow-up support offered after leaving the emergency department.

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