OBJECTIVES: To identify parameters at first presentation after mild traumatic brain injury (MTBI) that are predictive of the severity of post-traumatic complaints (PTC) after six months. Early recognition of patients with MTBI who are at risk of developing PTC would be useful because early follow up at the outpatient clinic may help to reduce the severity of these complaints in the long run. METHODS: The presence of symptoms in the emergency room (ER) (headache, dizziness, nausea, vomiting, and neck pain) and biochemical markers (neurone specific enolase and S-100B) in serum were assessed as possible predictive variables for the severity of PTC. Outcome variables were the severity of 16 PTC six months after the trauma. RESULT: After six months, the severity of most complaints had declined to pretrauma levels but medians for headache, dizziness, and drowsiness were still increased. In a series of 79 patients, 22 (28%) reported one or more PTC after six months. After adjustment for baseline variables, an at least twofold increased severity of all PTC subgroups was reported by those patients reporting headache, dizziness, or nausea in the ER. A twofold increased severity of "cognitive" and "vegetative" PTC was also found in those with increased concentrations of biochemical serum markers at first presentation. The prevalence of full recovery after six months increased from 50% in patients with three symptoms to 78% in those with no symptoms in the ER. Inclusion of biochemical markers showed that all 10 patients with no symptoms in the ER and normal markers recovered fully. CONCLUSIONS: The presence of headache, dizziness, or nausea in the ER after MTBI is strongly associated with the severity of most PTC after six months. Identifying MTBI patients in the ER without headache, dizziness, nausea, or increased serum marker concentrations may be a promising strategy for predicting a good outcome.
OBJECTIVES: To identify parameters at first presentation after mild traumatic brain injury (MTBI) that are predictive of the severity of post-traumatic complaints (PTC) after six months. Early recognition of patients with MTBI who are at risk of developing PTC would be useful because early follow up at the outpatient clinic may help to reduce the severity of these complaints in the long run. METHODS: The presence of symptoms in the emergency room (ER) (headache, dizziness, nausea, vomiting, and neck pain) and biochemical markers (neurone specific enolase and S-100B) in serum were assessed as possible predictive variables for the severity of PTC. Outcome variables were the severity of 16 PTC six months after the trauma. RESULT: After six months, the severity of most complaints had declined to pretrauma levels but medians for headache, dizziness, and drowsiness were still increased. In a series of 79 patients, 22 (28%) reported one or more PTC after six months. After adjustment for baseline variables, an at least twofold increased severity of all PTC subgroups was reported by those patients reporting headache, dizziness, or nausea in the ER. A twofold increased severity of "cognitive" and "vegetative" PTC was also found in those with increased concentrations of biochemical serum markers at first presentation. The prevalence of full recovery after six months increased from 50% in patients with three symptoms to 78% in those with no symptoms in the ER. Inclusion of biochemical markers showed that all 10 patients with no symptoms in the ER and normal markers recovered fully. CONCLUSIONS: The presence of headache, dizziness, or nausea in the ER after MTBI is strongly associated with the severity of most PTC after six months. Identifying MTBI patients in the ER without headache, dizziness, nausea, or increased serum marker concentrations may be a promising strategy for predicting a good outcome.
Authors: L Persson; H G Hårdemark; J Gustafsson; G Rundström; I Mendel-Hartvig; T Esscher; S Påhlman Journal: Stroke Date: 1987 Sep-Oct Impact factor: 7.914
Authors: H S Levin; S Mattis; R M Ruff; H M Eisenberg; L F Marshall; K Tabaddor; W M High; R F Frankowski Journal: J Neurosurg Date: 1987-02 Impact factor: 5.115
Authors: Brandon P Lucke-Wold; Aric F Logsdon; Linda Nguyen; Ahmed Eltanahay; Ryan C Turner; Patrick Bonasso; Chelsea Knotts; Adam Moeck; Joseph C Maroon; Julian E Bailes; Charles L Rosen Journal: Nutr Neurosci Date: 2016-10-05 Impact factor: 4.994
Authors: Sahil Bajaj; Natalie S Dailey; Isabelle M Rosso; Scott L Rauch; William D S Killgore Journal: Hum Brain Mapp Date: 2018-01-22 Impact factor: 5.038
Authors: Maja Stulemeijer; Sieberen van der Werf; Gijs Bleijenberg; Jan Biert; Jolanda Brauer; Pieter E Vos Journal: J Neurol Date: 2006-05-17 Impact factor: 4.849
Authors: Jennifer M Medina McKeon; Scott C Livingston; Ashley Reed; Robert G Hosey; Williams S Black; Heather M Bush Journal: J Athl Train Date: 2013-10-23 Impact factor: 2.860
Authors: Lindsay D Nelson; Robyn E Furger; Jana Ranson; Sergey Tarima; Thomas A Hammeke; Christopher Randolph; William B Barr; Kevin Guskiewicz; Christopher M Olsen; E Brooke Lerner; Michael A McCrea Journal: J Neurotrauma Date: 2017-11-17 Impact factor: 5.269