Diagnostic procedures in mild traumatic brain injury: results of the who collaborating centre task force on mild traumatic brain injury

Abstract

We examined diagnostic procedures in mild traumatic brain injury by a systematic literature search. After screening 38,806 abstracts, we critically reviewed 228 diagnostic studies and accepted 73 (32%). The estimated prevalence of intracranial CT scan abnormalities is 5% in patients presenting to hospital with a Glasgow Coma Scale score of 15 and 30% or higher in patients presenting with a score of 13. About 1% of all treated patients with mild traumatic brain injury require neurosurgical intervention. There is strong evidence that clinical factors can predict computerized tomography scan abnormalities and the need for intervention in adults, but no such evidence for mild traumatic brain injury in children. We found evidence that skull fracture is a risk factor for intracranial lesions, but the diagnostic accuracy of radiologically diagnosed skull fracture as an indication of intracranial lesions is poor. There is only a little evidence for the diagnostic validity of cognitive testing and other diagnostic tools for mild traumatic brain injury.

The neuropsychological outcomes of concussion: A systematic review of meta-analyses on the cognitive sequelae of mild traumatic brain injury.

“…For inclusion in the systematic review of reviews, articles needed to (a) report a systematic literature review and/or meta-analysis; (b) examine neuropsychological and cognitive outcomes related to mTBI or concussion in any population (i.e., athletic, military, general, etc. ); (c) review solely observational research and not experimental interventions for mTBI (e.g., pharmacotherapy, cognitive training); (d) include only studies involving late adolescents or adults (as pediatric brain injuries involve distinct cognitive sequelae; Borg et al, 2004;Carroll et al, 2004); (e) be published in either a peer-reviewed journal or academic book; and (f) be written in the English language. …”

Dažnai tiems patiems pacientams atliekamų galvos smegenų kompiuterinės tomografijos tyrimų priežastys

“…Galvos smegenų KT tyrimas vis dažniau rutiniškai atliekamas pacientams, patyrusiems lengvą galvos smegenų traumą, kaip greitas ir patikimas būdas su trauma susijusioms komplikacijoms diagnozuoti [14]. Tačiau komplikacijos, kurios būdingos ūminei traumai, lengvos galvos smegenų traumos atveju yra santykinai retos -intrakranijinių pažei-dimų rizika apie 10% [15] (sumušimas, subdūrinė ar epidūrinė hematomos, smegenų patinimas, subarachnoidinė hemoragija).…”

Traumatic Brain Injury and Executive Functioning in an Incarcerated Sample

“…There is more variability in the literature with regard to defining mild traumatic brain injury and its incidence and outcomes than there is for moderate or severe brain (Borg et al, 2004;Holm, Cassidy, Carroll, & Borg, 2005). It contains all the same elements as the ACRM definition described above.…”

“…Efforts by the CDC, the World Health Organization (WHO), and other major organizations have led to the development of more standardized methods for defining TBI and its three severity levels: mild, moderate, and severe (Thurman, Sniezek, Johnson, Greenspan, & Smith, 1995;Borg et al, 2004). However, not all TBI research has consistently used these definitions, and the true rate of TBI and the scope of its consequences remain unknown (CDC, 2006).…”