Incidence, risk factors and prevention of mild traumatic brain injury: results of the who collaborating centre task force on mild traumatic brain injury

Abstract

We undertook a best-evidence synthesis on the incidence, risk factors and prevention of mild traumatic brain injury. Methods: Medline, Cinahl, PsycINFO and Embase were searched for relevant articles. After screening 38,806 abstracts, we critically reviewed 169 studies on incidence, risk and prevention, and accepted 121 (72%). Results: The accepted articles show that 70-90% of all treated brain injuries are mild, and the incidence of hospitaltreated patients with mild traumatic brain injury is about 100-300/100,000 population. However, much mild traumatic brain injury is not treated at hospitals, and the true population-based rate is probably above 600/100,000. Mild traumatic brain injury is more common in males and in teenagers and young adults. Falls and motor-vehicle collisions are common causes. Conclusion: Strong evidence supports helmet use to prevent mild traumatic brain injury in motorcyclists and bicyclists. The mild traumatic brain injury literature is of varying quality, and the studies are very heterogeneous. Nevertheless, there is evidence that mild traumatic brain injury is an important public health problem, but we need more highquality research into this area.

Global neurotrauma research challenges and opportunities

“…Even fewer LMICs have formally implemented a data-specific registry for neurotrauma. In addition, most patients with TBI have mild to moderate injury and are therefore often not reported 6,7 . CNS injuries in patients with multiple trauma, especially as a result of military or civilian conflicts, may be recorded under other causes of death or injury statistical codes.…”

Neuropsychological Sequelae of PTSD and TBI Following War Deployment among OEF/OIF Veterans

“…Studying the neuropsychological effect of mTBI is complicated by several issues including: (a) a wide range in severity of mTBIs; (b) the variability in remission of cognitive symptoms (discussed below); and (c) evidence suggesting that few individuals with mTBI are formally assessed with neuropsychological measures to quantify deficits because most mTBIs are treated in non-hospital medical settings (e.g., outpatient clinics) or not at all (e.g., Cassidy et al, 2004;NCIPC, 2003). Studies of OEF/OIF military Veterans are complicated by the variable and often lengthy duration between the time of injury(ies) and formal neuropsychological assessment, high rates of co-occurrence between mTBI and PTSD in this population (e.g., Carlson et al, 2011;Hoge et al, 2008), symptom overlap between mTBI and PTSD, as well as the potential influence of post-secondary gain (e.g., Nelson, Hoelzle, McGuire, Gerrier-Auerbach, Charlesworth, & Sponheim, 2010).…”

Altered cross-frequency coupling in resting-state MEG after mild traumatic brain injury

“…Typically, patients experience an initial brief change in mental state or consciousness that is followed by post-concussion symptoms (PCS) (Cassidy et al, 2004), such as headaches, fatigue, and dizziness, which usually emerge on the day of injury and persist for at least the first few days thereafter (Boccaletti et al, 2006). In most patients, cognition recovers and PCS resolve within three months.…”