Research Reports - Cognitive impact of traumatic axonal injury (TAI) and return to work

Brain Inj. 2013;27(5):521-8

Esbjörnsson E, Skoglund T, Mitsis MK, Hofgren C, Larsson J, Sunnerhagen KS

Objective: Axonal injury (AI) after traumatic brain injury (TBI) is often
overlooked as an explanation for cognitive complaints when no damage is detected
by computed tomography. The purpose was to assess cognition during the 12 months
following a TBI and suspected traumatic axonal injury (TAI). Methods: The sample
included 17 patients younger than 65 years old, however one died. In the acute
phase and at 6 and 12 months, cognition, reaction time, psychomotor performance
and finger tapping speed were assessed. Working memory and work status were added
at 12 months. Acute MRI findings were recorded. Results: After 1 year, all
patients still showed cognitive dysfunction. A recovery had been noted at 6
months, but a cognitive decline was indicated for the majority at 12 months. The
sick-listed patients had TAI located in the corpus callosum and the brainstem.
They were cognitively more impaired and in more areas than the four patients who
had returned to work. Conclusion: Cognitive screening can identify the long-term
impact of TAI identified by conventional MRI, used as a routine clinical
technique. For rehabilitation and for insurance-related matters, these injuries
must be taken seriously, as a deterioration over time might occur. Further
research is needed.

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