C Lefevre-Dognin1, M Cogné2, V Perdrieau3, A Granger3, C Heslot4, P Azouvi4. 1. Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 92380 Garches, France; EA 4047 HANDIReSP, université de Versailles Saint-Quentin en Yvelines, Montigny le Bretonneux, France. Electronic address: Clemence.lefevre@aphp.fr. 2. Rehabilitation medicine unit, Rennes university hospital, 2, rue Henri-le-Guilloux, 35000 Rennes, France; Hybrid team, Inria, campus universitaire de Beaulieu, 35042 Rennes cedex, France. 3. Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 92380 Garches, France. 4. Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 92380 Garches, France; EA 4047 HANDIReSP, université de Versailles Saint-Quentin en Yvelines, Montigny le Bretonneux, France.
Abstract
BACKGROUND/ OBJECTIVES: The definition of mild traumatic brain injury (mTBI), also known as concussion, has been a matter of controversy, which makes comparison between studies difficult. Incidence varies greatly from one country to another. The present article reviews definitions and epidemiology. METHODS: Literature review. RESULTS: According to the Mild TBI Committee of the American Congress of Rehabilitation Medicine, revised by the World Health Organization (WHO), mTBI is defined by a Glasgow Coma Scale score between 13 and 15 at 30minutes post-injury, and one or more of the following symptoms: <30min loss of consciousness; <24hours post-traumatic amnesia (PTA); impaired mental state at time of accident (confusion, disorientation, etc.); and/or transient neurological deficit. If a focal lesion is found on computed tomography (CT) or magnetic resonance imaging (MRI), the term "complicated mild TBI" has been proposed. Incidence of mTBI is 200-300/100,000 persons per year for hospitalized patients and probably twice as high if non-hospitalized patients are included. However, a few recent population-based studies reported a much higher rate (>700/100,000). A changing pattern of epidemiology has been found in high-income countries, related to a decrease in road-accident injuries in young adults, while conversely the proportion of falls has increased with population aging. CONCLUSION: Mild TBI is a major public health concern, the epidemiology of which has greatly changed in the last twenty years.
BACKGROUND/ OBJECTIVES: The definition of mild traumatic brain injury (mTBI), also known as concussion, has been a matter of controversy, which makes comparison between studies difficult. Incidence varies greatly from one country to another. The present article reviews definitions and epidemiology. METHODS: Literature review. RESULTS: According to the Mild TBI Committee of the American Congress of Rehabilitation Medicine, revised by the World Health Organization (WHO), mTBI is defined by a Glasgow Coma Scale score between 13 and 15 at 30minutes post-injury, and one or more of the following symptoms: <30min loss of consciousness; <24hours post-traumatic amnesia (PTA); impaired mental state at time of accident (confusion, disorientation, etc.); and/or transient neurological deficit. If a focal lesion is found on computed tomography (CT) or magnetic resonance imaging (MRI), the term "complicated mild TBI" has been proposed. Incidence of mTBI is 200-300/100,000 persons per year for hospitalized patients and probably twice as high if non-hospitalized patients are included. However, a few recent population-based studies reported a much higher rate (>700/100,000). A changing pattern of epidemiology has been found in high-income countries, related to a decrease in road-accident injuries in young adults, while conversely the proportion of falls has increased with population aging. CONCLUSION: Mild TBI is a major public health concern, the epidemiology of which has greatly changed in the last twenty years.
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