Mild traumatic brain injury

Revision as of 17:19, 12 October 2014 by Ostermayer (talk | contribs)

Background

  • Concussion (mild TBI) is defined as GCS 14-15 w/ assoc signs or symptoms after a blunt force or acceleration-deceleration injury
  • Types
    • Simple concussion
      • Gradual resolution of symptoms w/in 7-10d
    • Complex concussion
      • Persisting symptoms or cognitive impairment
      • Symptoms with exertion

Diagnosis

  • Any alteration in the mental state at the time of event or subsequent to the event
    • Symptoms may be delayed by days-weeks
  • Most consistent abnormality is subtle impairments in cognitive function
    • Attention, concentration, memory, processing speed, reaction time
  • Physical signs/symptoms
    • HA, dizziness, insomnia, fatigue, uneven gait, N/V, blurred vision, seizures
  • Behavioral changes
    • Irritability, depression, anxiety, sleep disturbances, problems related to school/work

Treatment

  • Simple
    • Limitations on playing and training while symptomatic
    • F/u with PMD
  • Complex
    • Refer to sports medicine or concussion specialist

Prognosis

  • At 3 mo after injury <30% are symptomatic
  • At 1 yr after injury 15% are symptomatic

Disposition

  • Upon discharge from the ER all patients with a diagnosis of concussion should receive educational materials on activities to avoid and symptoms to anticipate during recovery. There are better long term outcomes in patients who receive such materials[1]

See Also

Source

Tintinalli

  1. Ronsford J, et al. Impact of early intervention on outcome after mild traumatic head in adults. 2002