The incidence of traumatic brain injury in an adult population - how to classify mild cases?

Numminen, Heikki

doi:10.1111/j.1468-1331.2010.03179.x

Cited by 39 publications

(27 citation statements)

References 13 publications

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“…First, this study made use of a series of patients taken from clinical practice in a rehabilitation setting. While this does introduce some selectivity (e.g., the rate of mTBI at 55% of the patient sample is lower than in some population studies, such as Numminen, 2011), this allows for analysis of a broad range of injury severities and increases external validity. Second, patients with TBI were only included in this study if they were not engaged in compensation seeking and had passed validated measures of effort.…”

Section: Discussionmentioning

confidence: 96%

Use of the Tower of London – Drexel University, Second Edition (TOL^DX) in Adults With Traumatic Brain Injury

Krishnan

Smith

Donders

2012

The Clinical Neuropsychologist

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The Tower of London - Drexel University, Second Edition (TOL(DX)) was investigated in order to determine the efficacy of using this instrument in evaluating the impact of traumatic brain injury on cognitive functioning in adults. Performance on the TOL(DX) was compared among 56 individuals with complicated mild to severe traumatic brain injury ("sTBI"), 68 individuals with uncomplicated, mild traumatic brain injury ("mTBI"), and 124 demographically matched, healthy controls. Both TBI groups performed worse than controls on TOL(DX) measures of executive time (ET) and number of moves used (TMS), but only patients with sTBI were more likely to be impaired on TMS (i.e., performing at least 1.5 SD below the mean). Poorer performance on TMS was associated with increasing length of coma. Although poor sensitivity of this measure limits its use in isolation, the TOL(DX) may provide a complementary measurement of aspects of problem-solving deficit in TBI that may not be captured by other tests.

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Section: Discussionmentioning

confidence: 96%

Use of the Tower of London – Drexel University, Second Edition (TOL^DX) in Adults With Traumatic Brain Injury

Krishnan

Smith

Donders

2012

The Clinical Neuropsychologist

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“…In the U.S., about 7,400 deaths, over 600,000 emergency department (ED) visits, and over 60,000 hospital admissions of children between 0 and 18 years of age were caused annually by head trauma [3,4]. Mild traumatic brain injury (MTBI), also known as cerebral concussion, is much more common than moderate or severe TBI [5,6]. Data from the U.S. Centers for Disease Control and Prevention (CDC) indicated that each year in the United States, as many as 75% of persons who had a TBI were MTBI [7].…”

Section: Introductionmentioning

confidence: 99%

Clinically-Important Brain Injury and CT Findings in Pediatric Mild Traumatic Brain Injuries: A Prospective Study in a Chinese Reference Hospital

Zhu

Gao

Xia

et al. 2014

IJERPH

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This study investigated injury patterns and the use of computed tomography (CT) among Chinese children with mild traumatic brain injury (MTBI). We enrolled children with MTBI who were treated within 24 hours of head trauma in the emergency department of Wuhan Medical Care Center for Women and Children in Wuhan, China. Characteristics of MTBIs were analyzed by age and gender. Results of cranial CT scan and clinically-important brain injury (ciTBI) for children were obtained. The definition of ciTBI was: death from TBI, intubation for more than 24 h for TBI, neurosurgery, or hospital admission of 2 nights or more. Of 455 eligible patients with MTBI, ciTBI occurred in two, and no one underwent neurosurgical intervention. CT scans were performed for 441 TBI patients (96.9%), and abnormal findings were reported for 147 patients (33.3%, 95% CI 29.0–37.8). Falls were the leading cause of MTBI (61.5%), followed by blows (18.9%) and traffic collisions (14.1%) for children in the 0–2 group and 10–14 group. For children aged between 3 and 9, the top three causes of TBI were falls, traffic collisions and blows. Leisure activity was the most reported activity when injuries occurred for all age groups. Sleeping/resting and walking ranked in the second and third place for children between 0 and 2 years of age, and walking and riding for the other two groups. The places where the majority injuries occurred were the home for the 0–2 and 3–9 years of age groups, and school for the 10–14 years of age group. There was no statistical difference between boys and girls with regard to the activity that caused the MTBI. This study highlights the important roles that parents and school administrators in the development of preventive measures to reduce the risk of traumatic brain injury in children. Also, identifying children who had a head trauma at very low risk of clinically important TBI for whom CT might be unnecessary is a priority area of research in China.

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“…There are 1.7 million TBI cases diagnosed annually, 1 of which 70-80% are classified as mild. 2-6 TBI can result from motor vehicle accidents, falls, assault, strike or blows to the head, biking or sports accidents 7-16 as well as blast injuries from military conflict. 17-22 The direct and indirect cost of TBI is about $60 billion 1 annually, where 44% ($26.4 billion) 23 is associated with mild TBI.…”

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confidence: 99%

Concurrent Vision Dysfunctions in Convergence Insufficiency With Traumatic Brain Injury

Alvarez¹,

Kim²,

Vicci³

et al. 2012

Optometry and Vision Science

104

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Purpose This study assessed the prevalence of convergence insufficiency (CI) with and without simultaneous vision dysfunctions within the traumatic brain injury (TBI) sample population because although CI is commonly reported with TBI, the prevalence of concurrent visual dysfunctions with CI in TBI is unknown. Methods A retrospective analysis of 557 medical records from TBI civilian patients was conducted. Patients were all evaluated by a single optometrist. Visual acuity, oculomotor, binocular vision function, accommodation, visual fields, ocular health and vestibular function were assessed. Statistical comparisons between the CI and non-CI, as well as in-patient and out-patient subgroups, were conducted using chi-squared and Z-tests. Results Approximately 9% of the TBI sample had CI without the following simultaneous diagnoses: saccade or pursuit dysfunction; 3rd, 4th, or 6th nerve palsy; visual field deficit; visual spatial inattention/neglect; vestibular dysfunction or nystagmus. Photophobia with CI was observed in 16.3% (N=21/130) and vestibular dysfunction with CI was observed in 18.5% (N=24/130) of the CI subgroup. CI and cranial nerve palsies were common and yielded prevalence rates of 23.3% (N=130/557) and 26.9% (N=150/557), respectively, within the TBI sample. Accommodative dysfunction was common within the non-presbyopic TBI sample with a prevalence of 24.4% (N=76/314). Visual field deficits or unilateral visual spatial inattention/neglect were observed within 29.6% (N=80/270) of the TBI in-patient subgroup and were significantly more prevalent compared to the out-patient subgroup (p<0.001). Most TBI patients had visual acuities of 20/60 or better in the TBI sample (85%;N=473/557). Conclusions CI without simultaneous visual or vestibular dysfunctions was observed in about 9% of the visually symptomatic TBI civilian population studied. A thorough visual and vestibular examination is recommended for all TBI patients.

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The incidence of traumatic brain injury in an adult population - how to classify mild cases?

Abstract: The incidence rate falls within the wide range of previous published figures. Use of LOC or PTA as a criterion for mild TBI affects the incidence rate considerably as does the exclusion of mild cases treated out of hospital.

Cited by 39 publications

References 13 publications

Use of the Tower of London – Drexel University, Second Edition (TOL^DX) in Adults With Traumatic Brain Injury

Use of the Tower of London – Drexel University, Second Edition (TOL^DX) in Adults With Traumatic Brain Injury

Clinically-Important Brain Injury and CT Findings in Pediatric Mild Traumatic Brain Injuries: A Prospective Study in a Chinese Reference Hospital

Concurrent Vision Dysfunctions in Convergence Insufficiency With Traumatic Brain Injury

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The incidence of traumatic brain injury in an adult population - how to classify mild cases?

Abstract: The incidence rate falls within the wide range of previous published figures. Use of LOC or PTA as a criterion for mild TBI affects the incidence rate considerably as does the exclusion of mild cases treated out of hospital.

Cited by 39 publications

References 13 publications

Use of the Tower of London – Drexel University, Second Edition (TOLDX) in Adults With Traumatic Brain Injury

Use of the Tower of London – Drexel University, Second Edition (TOLDX) in Adults With Traumatic Brain Injury

Clinically-Important Brain Injury and CT Findings in Pediatric Mild Traumatic Brain Injuries: A Prospective Study in a Chinese Reference Hospital

Concurrent Vision Dysfunctions in Convergence Insufficiency With Traumatic Brain Injury

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Use of the Tower of London – Drexel University, Second Edition (TOL^DX) in Adults With Traumatic Brain Injury

Use of the Tower of London – Drexel University, Second Edition (TOL^DX) in Adults With Traumatic Brain Injury