Late outcome of mild head injury: Results from a controlled postal survey

Abstract

There is insufficient information about the long-term sequelae of mild head injury (postconcussional symptoms, PCS). Therefore, a questionnaire-based investigation was carried out in patients 1-5 years after mild head injury (MHI) and in non-concussed subjects in order to study the nature of long-term complaints after MHI. A three-factor model of residual subjective and psychological complaints that contained a dysthymic factor, a vegetative/bodily complaints factor, and a cognitive performance factor were identified in the patient population. Three rating scales were constructed from the relevant items or factors, and were used to compare the MHI patients with non-concussed controls. It was found that the profile of distresses and discomforts mentioned by a population of MHI patients 1-5 years after the trauma was similar to that of a non-concussed control population. These symptoms were indistinguishable from those encountered in ordinary everyday life. These symptoms were significantly more severe in the MHI patients. Stepwise regression analysis in the patient population indicated that a number of parameters were statistically of predictive importance: comorbidity, sex, and neurological complication at the time of the trauma. The results support the hypothesis that MHI may not ever be completely reversible.

Cumulative effects of concussion in amateur athletes

“…Researchers have reported post-concussion symptoms in trauma patients who are 1 or more years post-injury [35][36][37]; however, the underlying causes of these persistent, long-term symptoms are subject to considerable debate. Moreover, a carefully controlled, large-scale, prospective study of trauma patients with uncomplicated mild traumatic brain injuries demonstrated that long-term post-concussion symptoms were rare [38].…”

Cognitive complaints after mild traumatic brain injury: Things are not always what they seem

“…In addition, similar percentages (of 12 time points) were calculated for the four distinct time periods (morning, midday afternoon, evening). 4. Emotional distress, personality, physical functioning, and fatigue.…”

“…Although most MTBI patients recover well, a minority reports cognitive difficulties for months to years after injury [2][3][4][5]. These complaints are distressing, may lead to a disabled lifestyle, and prolong medical consumption [6,7].…”

Postconcussion syndrome after minor head injury: Brain activation of working memory and attention

“…To account for spontaneous resolution of symptoms, persistence of symptoms for more than 3 months is commonly used as a diagnostic criterion, even though earlier diagnosis would be desirable [American Psychiatric Association, 1994]. Additionally, many confounding factors for the development of postconcussion syndrome have been identified, such as litigation, psychological distress or anxiety due to the traumatic event, premorbid levels of complaints, and female gender [Alexander, 1997;Bazarian et al, 1999;Bohnen et al, 1994;King, 2003]. At an individual level, the use of cognitive fMRI may make early and reliable diagnosis possible and facilitate the identification of patients suitable for therapeutic intervention.…”