Research Reports - Symptomatology and functional outcome in mild traumatic brain injury

J Neurotrauma. 2013 Oct 31

McMahon P, Hricik A, Yue JK, Puccio AM, Inoue T, Lingsma HF, Beers SR, Gordon WA, Valadka AB, Manley GT, Okonkwo DO, Casey SS, Cooper SR, Dams-O'Connor K, Menon DK, Sorani MD, Yuh EL, Mukherjee P, Schnyer DM, Vassar MJ

Abstract Mild Traumatic Brain Injury (mTBI), or concussion, is a major public
health concern. There is controversy in the literature regarding the true
incidence of postconcussion syndrome (PCS), with the constellation of physical,
cognitive, emotional, and sleep symptoms after mTBI. In the current study, we
report on the incidence and evolution of PCS symptoms and patient outcomes after
mTBI at 3, 6, and 12 months in a large, prospective cohort of mTBI patients.
Participants were identified as part of the prospective, multi-center
Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study. The
study population was mTBI patients (Glasgow Coma Scale score of 13-15) presenting
to the emergency department, including patients with a negative head computed
tomography discharged to home without admission to hospital; 375 mTBI subjects
were included in the analysis. At both 6 and 12 months after mTBI, 82% (n=250 of
305 and n=163 of 199, respectively) of patients reported at least one PCS
symptom. Further, 44.5 and 40.3% of patients had significantly reduced
Satisfaction With Life scores at 6 and 12 months, respectively. At 3 months after
injury, 33% of the mTBI subjects were functionally impaired (Glasgow Outcome
Scale-Extended score ≤6); 22.4% of the mTBI subjects available for follow-up were
still below full functional status at 1 year after injury. The term "mild"
continues to be a misnomer for this patient population and underscores the
critical need for evolving classification strategies for TBI for targeted

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