Abstract
BackgroundThe objective of this study was to determine who gets post-concussion syndrome (PCS) after mild traumatic brain injury or head injury.MethodsPatients presented within an hour of mild traumatic brain injury (mTBI). Written informed consent was obtained from all patients, who then provided detailed answers to surveys at the time of injury as well as at 1 week and 1 month follow-up. Statistical analyses were performed using JMP 11.0 for the Macintosh.ResultsThe most commonly reported symptoms of PCS at first follow-up were headache (27%), trouble falling asleep (18%), fatigue (17%), difficulty remembering (16%), and dizziness (16%). Furthermore, only 61% of the cohort was driving at 1 week follow-up, compared to 100% prior to the injury.Linear regression analysis revealed the consumption of alcohol prior to head injury, the mechanism of head injury being a result of motor vehicle collision (MVC) or fall, and the presence of a post-injury headache to be significantly associated with developing PCS at 1 week follow-up, while the occurrence of a seizure post-injury or having an alteration in consciousness post-injury was significantly associated with developing PCS at 1 month follow-up. On multivariate regression analysis, the presence of a headache post-injury was the most robust predictor, retaining statistical significance even after controlling for age, gender, and presence of loss of consciousness (LOC), alteration of consciousness (AOC), post-traumatic amnesia (PTA), seizure, or vomiting.ConclusionsThe results of this prospective study suggest that headache right after the head injury, an alteration of consciousness after the head injury, and alcohol consumption prior to the head injury are significant predictors of developing PCS, which occurs with equal frequency in men and women. Early identification of those who are at risk of developing PCS would diminish the burden of the injury and could potentially reduce the number of missed work and school days.
Highlights
The objective of this study was to determine who gets post-concussion syndrome (PCS) after mild traumatic brain injury or head injury
This was an institutional review board (IRB; The University of Florida Institutional Review Board)-approved prospective observational cohort study of adults presenting to the emergency department (ED) with Mild traumatic brain injury (mTBI), defined as having a Glasgow Coma Score (GCS) of 13 to 15 upon initial presentation to the ED, with head injury having occurred within 24 h of presentation
Almost three quarters of the cohort (71%) came via emergency medical service/ambulance (EMS), while 24% arrived via private vehicle, 4% arrived by air, and 1% walked in
Summary
The objective of this study was to determine who gets post-concussion syndrome (PCS) after mild traumatic brain injury or head injury. Mild traumatic brain injury (mTBI) or concussion is becoming a widespread public health problem [1] and is of especial concern in our youth [2], college athletes [3], and senior citizens [4]. Post-concussion syndrome (PCS) includes a constellation of symptoms that are classified into physical, cognitive, It is not known what causes PCS symptoms to occur and persist or why some people who suffer an mTBI develop PCS while others do not.
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