Advertisement

Mild Traumatic Brain Injury and Postconcussion Syndrome

  • Marcia Mitie Nagumo
  • Daniele Vieira da Silva
  • Robson Luis Oliveira de Amorim
Chapter

Abstract

Mild traumatic brain injury (TBI) has been referred to as a “silent epidemic” due to the problems experienced by patients post-injury, and very often they are not visible but may have profound consequences and cause life-long impairments in physical, cognitive, behavioral, and social functions. Mild TBI usually has a natural course of rapid resolution of symptoms within days or weeks. However a considerable proportion of patients will experience postconcussion symptoms for a prolonged period after injury (>3 months). The range of symptoms can be headache, dizziness, fatigue, irritability, sleep disturbance, difficulty to concentrate, memory loss, stress intolerance, light or sound sensibility, balance problems, anxiety, and depressive humor. The social burden of mTBI can be significant, and therefore, family education and counseling together with support of patients and carers by a transdisciplinary team is important for an effective rehabilitation.

Keywords

Mild traumatic brain injury mTBI Head trauma Brain injury brain concussion Postconcussion syndrome PCS Transdisciplinary teams Rehabilitation 

Abbreviations

ACRM

American Congress of Rehabilitation Medicine

DALY

Disability-adjusted life year

DSM-IV

Diagnostic and Statistical Manual of Mental Disorders, fourth edition

GCS

Glasgow Coma Scale

ICD-10

International Classification of Diseases, 10th revision

LOC

Loss of consciousness

mTBI

Mild traumatic brain injury

N/A

Not applicable

PCS

Postconcussion syndrome

PPCS

Persistent postconcussion syndrome

PTA

Posttraumatic amnesia

SCAT3

Sport Concussion Assessment Tool V.3

TBI

Traumatic brain injury

References

  1. 1.
    Kay T, Harrington DE, Adams R, Andersen T, Berrol S, Cicerone K, et al. Definition of mild traumatic brain injury. J Head Trauma Rehabil. 1993;8(3):86–7.CrossRefGoogle Scholar
  2. 2.
    Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2:81–4.CrossRefGoogle Scholar
  3. 3.
    Andrade AF, Paiva WS, Amorim RLO, Figueiredo EG, Rusafa Neto E, Teixeira MJ. The pathophysiological mechanisms following traumatic brain injury. Rev Assoc Med Bras [Internet]. 2009;55(1):75–81. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302009000100020&lng=en.
  4. 4.
    Bigler ED. Distinguished Neuropsychologist Award Lecture 1999. The lesion(s) in traumatic brain injury: implications for clinical neuropsychology. Arch Clin Neuropsychol. 2001;16:95–131.CrossRefGoogle Scholar
  5. 5.
    King N. Mild head injury neuropathology, sequelae, measurement and recovery. Br J Clin Psychol. 1997;36(Part 2):161–84.CrossRefGoogle Scholar
  6. 6.
    Riggio S, Wong M. Neurobehavioral sequelae of traumatic brain injury. Mt Sinai J Med. 2009;76:163–72.CrossRefGoogle Scholar
  7. 7.
    Pearce JMS. Observations on concussion: a review. Eur Neurol. 2008;58:113–9.CrossRefGoogle Scholar
  8. 8.
    Cantu RC. Return to play guidelines after a head injury. Clin Sports Med. 1998;17:45–60.CrossRefGoogle Scholar
  9. 9.
    Colorado Medical Society School and Sports Medicine Committee. Guidelines for the management of concussion in sports. Colo Med. 1900;87:4.Google Scholar
  10. 10.
    Reports of the Quality Standards Subcommittee. Practice parameter: the management of concussion in sports (summary statement). Neurology. 1997;48:581–5.CrossRefGoogle Scholar
  11. 11.
    Mullally WJ. Concussion. Am J Med. 2017; pii: S0002-9343(17)30482-5.  https://doi.org/10.1016/j.amjmed.2017.04.016.CrossRefGoogle Scholar
  12. 12.
    McCrory P, Meeuwisse WH, Aubry M, Cantu RC, Dvorak J, Echemendia RJ, Engebretsen RJ, Johnston K, Kutcher JS, Raftery M, et al. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport, Zurich, November 2012. J Athl Train. 2013;48(4):554–75.CrossRefGoogle Scholar
  13. 13.
    McIntyre A, Mehta S, Aubut J, Dijkers M, Teasell RW. Mortality among older adults after a traumatic brain injury: a meta-analysis. Brain Inj. 2013;27(1):31–40.CrossRefGoogle Scholar
  14. 14.
    Cheng PL, Lin HY, Lee YK, Hsu CY, Lee CC, Su YC. Higher mortality rates among the elderly with mild traumatic brain injury: a nationwide cohort study. Scand J Trauma Resusc Emerg Med. 2014 Jan 28;22:7.  https://doi.org/10.1186/1757-7241-22-7.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Thurman DJ, Alverson C, Dunn KA, Guerrero J, Sniezek JE. Traumatic brain injury in the United States: a public health perspective. J Head Trauma Rehabil. 1999;14(6):602–15.CrossRefGoogle Scholar
  16. 16.
    Gururaj G. An epidemiological approach to prevention – pre-hospital care and rehabilitation in neurotrauma. Neurol India. 1995;43(3):95–105.Google Scholar
  17. 17.
    Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Report to Congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Atlanta (GA): Centers for Disease Control and Prevention; 2003.Google Scholar
  18. 18.
    WHO (World Health Organization). International statistical classification of diseases and related health problems. 2010. [January 30, 2016]. (10th Revision. [Online version.]). http://apps​.who.int/classifications​/icd10/browse/2010/en.Google Scholar
  19. 19.
    Ahman S, Saverman BI, Styrke J, Bjornstig U, Stalnacke BM. Long term follow up of patients with mild traumatic brain injury: a mixed-methods study. J Rehabil Med. 2013;45:758–64.CrossRefGoogle Scholar
  20. 20.
    Ponsford J, Willmott C, Rothwell A, et al. Factors influencing outcome following mild traumatic brain injury in adults. J Inte Neuropsychol Soc. 2000;6:568–79.CrossRefGoogle Scholar
  21. 21.
    Rogers JM, Read CA. Psychiatric comorbidity following traumatic brain injury. Brain Inj. 2007;21:1321–33.CrossRefGoogle Scholar
  22. 22.
    Pagulayan KF, Hoffman JM, Temkin NR, Machamer JE, Dikmen SS. A longitudinal study of health-related quality of life after traumatic brain injury. Arch Phys Med Rehabil. 2006;87:611–8.CrossRefGoogle Scholar
  23. 23.
    U.S. National Institutes of Health. Rehabilitation of persons with traumatic brain injury: NIH consensus statement. JAMA. 1999;282(10):974–83.CrossRefGoogle Scholar
  24. 24.
    Marshall S, Bayley M, McCullagh S, Velikonja D, Berrigan L. Clinical practice guidelines for mild traumatic brain injury and persistent symptoms. Can Fam Physician. 2012;58:257–67.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Marcia Mitie Nagumo
    • 1
  • Daniele Vieira da Silva
    • 2
  • Robson Luis Oliveira de Amorim
    • 1
    • 3
  1. 1.Department of Neurology – Neurosurgery – Clinics Hospital – School of Medicine– University of São PauloSão PauloBrazil
  2. 2.Nursing School – University of São PauloSão PauloBrazil
  3. 3.Department of Neurology – Neurosurgery – Amazonas State UniversityAmazonasBrazil

Personalised recommendations