Post-concussive syndrome after mild head trauma: epidemiological features in Tunisia

Chakroun-Walha, Olfa; Rejeb, Imen; Boujelben, M.; Chtara, Kamilia; Mtibaa, A.; Ksibi, Hichem; Chaari, Adel; Bouaziz, Mounir; Rekik, Noureddine

doi:10.1007/s00068-016-0656-7

Cited by 7 publications

(4 citation statements)

References 26 publications

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“…Studies have suggested that somatic domain PCSs (eg, headache and dizziness) are most commonly reported during the acute phase (<1 week postinjury), whereas cognitive and affective domain PCSs are more common during the subacute and chronic postinjury phases for young adults following an mTBI. 23,24 Our findings suggest a similar phenomenon in the acute phase; however, cognitive symptoms (not affective ones) were dominant in the chronic phase among older adults with mTBIs. Copyright © 2021 Wolters Kluwer Health, Inc.…”

Section: Discussionsupporting

confidence: 55%

Postconcussion Symptoms After an Uncomplicated Mild Traumatic Brain Injury in Older Adults: Frequency, Risk Factors, and Impact on Quality of Life

Chung

Liu

et al. 2021

Journal of Head Trauma Rehabilitation

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Background: Postconcussion symptoms (PCSs) are common complaints reported by patients after a mild traumatic brain injury (TBI), and these symptoms may lower quality of life. Previous investigations have primarily focused on PCSs in children, adults, and athletes. The frequency, and risk factors, and effects of PCSs for older adults with mild TBIs are unclear. Purpose: To investigate the frequency and risk factors of PCSs, and investigate their effects on quality of life over time after mild TBI in older adults. Methods: A prospective longitudinal study was performed. All participants were enrolled from the emergency department or neurosurgical outpatient clinics of a medical center. The measurement tools were the Rivermead Post-Concussion Symptoms Questionnaire and the Quality of Life after Traumatic Brain Injury. Measurements were performed on the seventh day, at the first month, and at the sixth month after the head injury. A generalized estimating equation model was used for data analyses. Results: One hundred and one older adults (mean age of 76.0 years) with mild TBIs with negative neuroimaging findings were included. Overall, 32.7%, 4%, and 15.8% of the sample reported PCS after 7 days, 1 month, and 6 months of head injury, respectively, revealing a U-shaped trend. We observed that comorbidity measured using the modified Charlson Comorbidity Index was associated with differences in PCSs (P < .05). PCSs were an independent predictor of changes in postinjury quality of life (P < .001). Conclusions: The results indicate that PCS after a mild TBI in older adults is prevalent, even in the chronic phase after a TBI, and PCSs significantly affected the quality of life of our cohort. Therefore, to improve patient quality of life, healthcare providers should employ effective interventions to manage PCSs at different phases after a TBI.

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Section: Discussionsupporting

confidence: 55%

Postconcussion Symptoms After an Uncomplicated Mild Traumatic Brain Injury in Older Adults: Frequency, Risk Factors, and Impact on Quality of Life

Chung

Liu

et al. 2021

Journal of Head Trauma Rehabilitation

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“…The framework we have articulated is largely based on the empirically established premise that there is a stereotyped pattern of injury in mTBI 13–15,21,24 . At the same time, there is a wide range of inter-individual variability across the acute, sub-acute, and chronic phases of post-concussive recovery in terms of the pattern of signs and symptoms 66–69 . Our findings reinforce what is common across m/TBI 15,19,21 , in a way that is grounded in the biomechanics of shear wave propagation through tissue.…”

Section: Discussionmentioning

confidence: 99%

Strain concentration drives the anatomical distribution of injury in acute and chronic traumatic brain injury

Hirad,

Mix,

Venkataraman

et al. 2024

Preprint

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Brain tissue injury caused by mild traumatic brain injury (mTBI) disproportionately concentrates in the midbrain, cerebellum, mesial temporal lobe, and the interface between cortex and white matter at sulcal depths. The bio-mechanical principles that explain why physical impacts to different parts of the skull translate to common foci of injury concentrated in specific brain structures are unknown. A general and longstanding idea, which has not to date been directly tested in humans, is that different brain regions are differentially susceptible to strain loading. We use Magnetic Resonance Elastography (MRE) in healthy participants to develop whole-brain bio-mechanical vulnerability maps that independently define which regions of the brain exhibit disproportionate strain concentration. We then validate those vulnerability maps in a prospective cohort of mTBI patients, using diffusion MRI data collected at three cross-sectional timepoints after injury: acute, sub-acute, chronic. We show that regions that exhibit high strain, measured with MRE, are also the sites of greatest injury, as measured with diffusion MR in mTBI patients. This was the case in acute, subacute, and chronic subgroups of the mTBI cohort. Follow-on analyses decomposed the biomechanical cause of increased strain by showing it is caused jointly by disproportionately higher levels of energy arriving to high-strain structures, as well as the inability of high-strain structures to effectively disperse that energy. These findings establish a causal mechanism that explains the anatomy of injury in mTBI based on in vivo rheological properties of the human brain.

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“…The paper by Chakroun-Walha et al on "Post-concussive syndrome after mild head trauma-epidemiological features in Tunisia" demonstrates the ability but also the difficulties in the management of minor head injuries in situations with reduced resources [9].…”

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confidence: 99%

Focus on traumatic brain injury

Rickels

2017

Eur J Trauma Emerg Surg

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Post-concussive syndrome after mild head trauma: epidemiological features in Tunisia

Abstract: The two most important findings of this study were the huge proportion of patients having minor head injury and discharged from ED without any explanation of possible symptoms after head trauma and the unknown impacts on life activities.

Cited by 7 publications

References 26 publications

Postconcussion Symptoms After an Uncomplicated Mild Traumatic Brain Injury in Older Adults: Frequency, Risk Factors, and Impact on Quality of Life

Postconcussion Symptoms After an Uncomplicated Mild Traumatic Brain Injury in Older Adults: Frequency, Risk Factors, and Impact on Quality of Life

Strain concentration drives the anatomical distribution of injury in acute and chronic traumatic brain injury

Focus on traumatic brain injury

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