Minor head injury: attempts at clarifying the confusion

Abstract

Traumatic brain injury (TBI) refers to a broad range of neurological, cognitive and emotional factors that result from the application of a mechanical force to the head. Mechanical force can be applied on a continuum from none to very severe, and the extent of brain injury is related to the severity of this force. A review of the literature reveals that, while considerable research has been done on minor head injury, there remain several major sources of confusion. First, one of the most noticeable problems relates to the fact that the mild head injury has lower limits which are vaguely defined. This leads to individuals being categorized as having sustained a mild TBI despite minimal or no neurological damage being present. A second source of confusion in the literature is related to the failure to differentiate between cognitive consequences of TBI and post-concussion symptoms (PCS). Since PCS can occur in the absence of head injury, and are often present beyond the period of cognitive recovery from mild TBI, the two clearly result from different factors. Researchers have often failed to separate these two factors when studying recovery of function, and this has led to varying findings on outcome. Finally, many pre-injury factors (age, education, emotional adjustment) and post-injury factors (pain, family support, stress) interact with cognitive functioning and significantly affect recovery from TBI. These problems are reviewed and discussed.

Functional Level During the First Year After Moderate and Severe Traumatic Brain Injury: Course and Predictors of Outcome

“…Our results may however support those studies which demonstrate that although neuropsychological impairment at baseline usually resolves within three months, moderately injured may still have selective cognitive deficits (attention and memory) one year after injury [9,18,42,43]. Finally, no agreement has been made on the predictive value of the GCS score and the PTA duration on outcome among moderately injured [44].…”

Neuropsychological and information processing deficits following mild traumatic brain injury

“…This raises the additional possibility that the deficits found in the mild TBI group may partially or completely resolve over time. Indeed, this may explain why studies often report a higher frequency of problems in the early stages after a mild TBI than in the later stages (Kibby & Long, 1996;Lishman, 1988;Van der Naalt et al, 1999). It remains to be seen whether measures designed to target the effects of diffuse damage are better able to predict which mild TBI patients will experience long-term residual problems than traditional neuropsychological tests.…”

Experimental Traumatic Brain Injury Alters Ethanol Consumption and Sensitivity

“…[1][2][3][4] Despite injury symptoms that may be subtle or even undetectable, TBI can result in a wide range of disabilities with long-lasting behavioral consequences often developing in the brain-injured patient. Care associated with TBI ranges from $600,000 to $5 million over the lifetime of a person, as stated by the AEI-Brookings Joint Center for Regulatory Studies.…”