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Mild Traumatic Brain Injury including Concussion
Published online by Cambridge University Press: 14 December 2023
Summary
Most traumatic brain injury (TBI) cases are considered mild. Precise definitions vary, but typically, loss of consciousness and post-traumatic amnesia duration is brief (e.g. <30 minutes and <24 hours respectively), and standard imaging is normal. Prognosis in mild TBI is generally good, but disabling persistent symptoms such as headaches, dizziness, affective and cognitive issues are common. A focussed assessment tailored to each individual symptom is crucial for management. Advanced MRI and blood-based biomarkers of mild TBI are emerging and are likely to play an increasingly important role in the assessment of patients following a head injury.
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- Online ISBN: 9781009380089Publisher: Cambridge University PressPrint publication: 18 January 2024
References
National Clinical Guideline Centre (UK). Head Injury: Triage, Assessment, Investigation and Early Management of Head Injury in Children, Young People and Adults [Internet]. London: National Institute for Health and Care Excellence (UK); 2014 [cited 15 May 2022]. (National Institute for Health and Clinical Excellence: Guidance). www.ncbi.nlm.nih.gov/books/NBK248061/.Google Scholar
Lawrence, T, Helmy, A, Bouamra, O, et al. Traumatic brain injury in England and Wales: Prospective audit of epidemiology, complications and standardised mortality. BMJ Open. 24 November 2016;6(11):e012197.CrossRefGoogle ScholarPubMed
Carroll, LJ, Cassidy, JD, Holm, L, Kraus, J, Coronado, VG, WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Methodological issues and research recommendations for mild traumatic brain injury: The WHO Collaborating Centre Task force on mild traumatic brain injury. J Rehabil Med. February 2004;(43 Suppl):113–25.Google Scholar
Malec, JF, Brown, AW, Leibson, CL, et al. The Mayo classification system for traumatic brain injury severity. J Neurotrauma. September 2007;24(9):1417–24.CrossRefGoogle ScholarPubMed
Sharp, DJ, Jenkins, PO. Concussion is confusing us all. Pract Neurol. June 2015;15(3):172–86.CrossRefGoogle Scholar
Yuh, EL, Jain, S, Sun, X, et al. Pathological computed tomography features associated with adverse outcomes after mild traumatic brain injury: A TRACK-TBI study with external validation in CENTER-TBI. JAMA Neurol. 1 September 2021;78(9):1137–48.CrossRefGoogle ScholarPubMed
Hou, R, Moss-Morris, R, Peveler, R, et al. When a minor head injury results in enduring symptoms: A prospective investigation of risk factors for postconcussional syndrome after mild traumatic brain injury. J Neurol Neurosurg Psychiatry. February 2012;83(2):217–23.CrossRefGoogle Scholar
Papa, L, Mendes, ME, Braga, CF. Mild traumatic brain injury among the geriatric population. Curr Transl Geriatr Exp Gerontol Rep. 1 September 2012;1(3):135–42.CrossRefGoogle ScholarPubMed
Parker, TD, Rees, R, Rajagopal, S, et al. Post-traumatic amnesia. Pract Neurol. April 2022;22(2):129–37.CrossRefGoogle ScholarPubMed
Nakase-Richardson, R, Sherer, M, Seel, RT, et al. Utility of post-traumatic amnesia in predicting 1-year productivity following traumatic brain injury: Comparison of the Russell and Mississippi PTA classification intervals. J Neurol Neurosurg Psychiatry. May 2011;82(5):494–9.CrossRefGoogle ScholarPubMed
Ponsford, J, Janzen, S, McIntyre, A, et al. INCOG recommendations for management of cognition following traumatic brain injury, part I: Posttraumatic amnesia/delirium. J Head Trauma Rehabil. August 2014;29(4):307–20.Google ScholarPubMed
Lucas, S, Hoffman, JM, Bell, KR, Dikmen, S. A prospective study of prevalence and characterization of headache following mild traumatic brain injury. Cephalalgia. February 2014;34(2):93–102.CrossRefGoogle ScholarPubMed
Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd ed. (beta version). Cephalalgia. July 2013;33(9):629–808.Google Scholar
Sinclair, AJ, Sturrock, A, Davies, B, Matharu, M. Headache management: Pharmacological approaches. Pract Neurol. December 2015;15(6):411–23.CrossRefGoogle ScholarPubMed
Smith, RM, Marroney, N, Beattie, J, et al. A mixed methods randomised feasibility trial investigating the management of benign paroxysmal positional vertigo in acute traumatic brain injury. Pilot Feasibility Stud. 2020;6:130.CrossRefGoogle ScholarPubMed
Kaski, D, Bronstein, AM. Epley and beyond: An update on treating positional vertigo. Pract Neurol. August 2014;14(4):210–21.CrossRefGoogle ScholarPubMed
Bosanquet, K, Bailey, D, Gilbody, S, et al. Diagnostic accuracy of the Whooley questions for the identification of depression: A diagnostic meta-analysis. BMJ Open. 9 December 2015;5(12):e008913.CrossRefGoogle ScholarPubMed
Regier, DA, Kuhl, EA, Kupfer, DJ. The DSM-5: Classification and criteria changes. World Psychiatry. June 2013;12(2):92–8.CrossRefGoogle ScholarPubMed
Shekleton, JA, Parcell, DL, Redman, JR, et al. Sleep disturbance and melatonin levels following traumatic brain injury. Neurology. 25 May 2010;74(21):1732–8.CrossRefGoogle ScholarPubMed
Waldron, B, Casserly, LM, O’Sullivan, C. Cognitive behavioural therapy for depression and anxiety in adults with acquired brain injury: What works for whom? Neuropsychol Rehabil. 2013;23(1):64–101.CrossRefGoogle Scholar
Cipriani, A, Furukawa, TA, Salanti, G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: A systematic review and network meta-analysis. Lancet. 7 April 2018;391(10128):1357–66.CrossRefGoogle ScholarPubMed
Stein, MB, Jain, S, Giacino, JT, et al. Risk of posttraumatic stress disorder and major depression in civilian patients after mild traumatic brain injury: A TRACK-TBI study. JAMA Psychiatry. 1 March 2019;76(3):249–58.CrossRefGoogle ScholarPubMed
Clark, CN, Edwards, MJ, Ong, BE, et al. Reframing postconcussional syndrome as an interface disorder of neurology, psychiatry and psychology. Brain. 30 June 2022;145(6):1906–15.CrossRefGoogle ScholarPubMed
Stone, J, Zeman, A, Sharpe, M. Functional weakness and sensory disturbance. J Neurol Neurosurg Psychiatry. September 2002;73(3):241–5.CrossRefGoogle ScholarPubMed
Rajesh, S, Wonderling, D, Bernstein, I, Balson, C, Lecky, F, Guideline Committee. Head injury: Assessment and early management-summary of updated NICE guidance. BMJ. 30 May 2023;381:1130.CrossRefGoogle ScholarPubMed
Griffin, AD, Turtzo, LC, Parikh, GY, et al. Traumatic microbleeds suggest vascular injury and predict disability in traumatic brain injury. Brain. 1 November 2019;142(11):3550–64.CrossRefGoogle ScholarPubMed
MacDonald, CL, Johnson, AM, Cooper, D, et al. Detection of blast-related traumatic brain injury in U.S. military personnel. N Engl J Med. 2 June 2011;364(22):2091–100.Google Scholar
Jolly, AE, Bălăeţ, M, Azor, A, et al. Detecting axonal injury in individual patients after traumatic brain injury. Brain. 12 February 2021;144(1):92–113.CrossRefGoogle ScholarPubMed
Zimmerman, KA, Laverse, E, Samra, R, et al. White matter abnormalities in active elite adult rugby players. Brain Communications. 1 July 2021;3(3):fcab133.CrossRefGoogle ScholarPubMed
Shahim, P, Zetterberg, H, Tegner, Y, Blennow, K. Serum neurofilament light as a biomarker for mild traumatic brain injury in contact sports. Neurology. 9 May 2017;88(19):1788–94.CrossRefGoogle ScholarPubMed
Bazarian, JJ, Biberthaler, P, Welch, RD, et al. Serum GFAP and UCH-L1 for prediction of absence of intracranial injuries on head CT (ALERT-TBI): A multicentre observational study. Lancet Neurol. September 2018;17(9):782–9.CrossRefGoogle ScholarPubMed
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