History Of Mild Head Injury Research Articles

Infant with large arachnoid cyst presented with repetitive vomiting after minor fall

A 12 month old boy, previously healthy, presented to our Emergency Department (ED) with 7 episodes non bilious vomiting, parents gave history of mild head injury the night before. Clinical examination was unremarkable.

Moral decision-making in university students with self-reported mild head injury

ABSTRACTConverging evidence shows that the prefrontal cortex is involved in moral decision-making. Individuals who have suffered injury to the ventromedial prefrontal cortex are more willing to endorse personal moral transgressions (e.g., make their decisions faster, and have attenuated sympathetic responses to those violations). We examined whether university students who have experienced a mild head injury (MHI), and are asymptomatic, present with a similar pattern of responding to moral dilemmas. Students reporting a history of MHI responded more quickly when making moral choices and exhibited less reticence toward the endorsement of personal moral transgressions than their non-MHI counterparts. Our results are consistent with studies involving persons with more serious, and evident, neuronal injury, and emphasize the important relationship between head injury and moral decision-making.

Susceptibility of the MMPI-2-RF Neurological Complaints and Cognitive Complaints Scales to Over-reporting in Simulated Head Injury

We examined the effect of simulated head injury on scores on the Neurological Complaints (NUC) and Cognitive Complaints (COG) scales of the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). Young adults with a history of mild head injury were randomly assigned to simulate head injury or give their best effort on a battery of neuropsychological tests, including the MMPI-2-RF. Simulators who also showed poor effort on performance validity tests (PVTs) were compared with controls who showed valid performance on PVTs. Results showed that both scales, but especially NUC, are elevated in individuals simulating head injury, with medium to large effect sizes. Although both scales were highly correlated with all MMPI-2-RF over-reporting validity scales, the relationship of Response Bias Scale to both NUC and COG was much stronger in the simulators than controls. Even accounting for over-reporting on the MMPI-2-RF, NUC was related to general somatic complaints regardless of group membership, whereas COG was related to both psychological distress and somatic complaints in the control group only. Neither scale was related to actual neuropsychological performance, regardless of group membership. Overall, results provide further evidence that self-reported cognitive symptoms can be due to many causes, not necessarily cognitive impairment, and can be exaggerated in a non-credible manner.

Parent-reported mild head injury history and behavioural performance in children at 6 years

Objective: Mild head and brain injuries have gained increasing attention from health professionals and researchers. Little is known about mild injuries, which may not always be diagnosed or brought to medical attention. This study examines the associations between parent-reported history of mild head injury and behavioural problems in a large community-based sample of Chinese children.Method: Subjects included 725 children from China. Parents reported on children’s head injury history and behaviour at age 6 years using the Chinese version of the Child Behavior Checklist. Mild head injury was defined as injury without loss of consciousness or hospitalization. Standardized T-scores were compared for each of the seven clinical sub-scales and three summary behavioural measures, adjusting for confounders. Logistic models were used to calculate odds ratios (ORs) between head injury and behavioural problems.Results: Parents reported that 97 children (14%) had a single injury and 70 (10%) had multiple injuries. Compared to the controls, head-injured children had worse behavioural outcomes and a higher prevalence of behavioural problems. Multiple injuries were associated with higher risk of certain internalizing and externalizing problems.Conclusion: Mild head injuries, especially incurred repeatedly, may still be a significant risk for adverse behaviours in children.

Exploration of Malingering Indices in the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span Subtest

Prior research shows that Digit Span is a useful embedded measure of malingering. However, the Wechsler Adult Intelligence Scale-IV (Wechsler, 2008) altered Digit Span in meaningful ways, necessitating another look at Digit Span as an embedded measure of malingering. Using a simulated malingerer design, we examined the predictive accuracy of existing Digit Span validity indices and explored whether patterns of performance utilizing the new version would provide additional evidence for malingering. Undergraduates with a history of mild head injury performed with best effort or simulated impaired cognition and were also compared with a large sample of non-head-injured controls. Previously established cutoffs for the age-corrected scaled score and Reliable Digit Span (RDS) performed similarly in the present samples. Patterns of RDS length using all three subscales of the new scale were different in malingerers when compared with both head-injured and non-head-injured controls. Two potential alternative RDS scores were introduced, which showed better sensitivity than the traditional RDS, while retaining specificity to malingering.

Mild head injury and sympathetic arousal: Investigating relationships with decision-making and neuropsychological performance in university students

Summary: The purpose of this study was to examine the relationships between neuropsychological performance, physiological arousal and decision-making in university students who have or have not reported a history of mild head injury (MHI).Methods: Forty-four students, 18 (41%) reporting a history of MHI, performed a design fluency task and the Iowa Gambling Task (IGT) while electrodermal activity (EDA) was recorded.Results: General cognitive ability and overall choice outcomes did not differ between groups. However, self-reported MHI severity predicted decision-making performance such that the greater the neural indices of trauma, the more disadvantageous the choices made by participants. As expected, both groups exhibited similar base levels of autonomic arousal and physiological responses to reward and punishment outcomes; however, those reporting MHI produced significantly lower levels of EDA during the anticipatory stages of decision-making.Conclusions: Overall, these findings encourage the acceptance of head injury as being on a continuum of brain injury severity, as MHI can emulate neurophysiological and neuropsychological features of more traumatic cases and may be impacting mechanisms which sustain adaptive social decision-making.

Chronic Subdural Hematoma Associated with Arachnoid Cyst in Young Adults: A Case Report

Intracranial arachnoid cysts are believed to be congenital; they can become symptomatic in pediatric patients. Chronic subdural hematomas tend to occur in elderly patients with a history of mild head injury a few months prior to the onset of symptoms. However, these two distinct clinical entities sporadically occur together in relatively young patients. We report a 29-year-old man who presented with headache and dizziness of 2 months' duration. Brain computed tomography revealed a huge chronic subdural hematoma over the left frontoparietal lobe, with an incidental finding of an arachnoid cyst over the left sylvian fissure. In light of a literature review, we discuss arachnoid cysts as a possible risk factor for subdural hematoma, especially in young adults.

“Diagnosis Threat”: The Effect of Negative Expectations on Cognitive Performance in Head Injury

The present study examined the effect of negative expectations on neuropsychological test performance. It was hypothesized that having attention called to a history of prior head injury and the potential effects of head injury on cognition would result in diminished neuropsychological test performance relative to individuals with a similar head injury history but who did not have their attention called to their head injury history (‘diagnosis threat’). Of 36 participants with a history of mild head injury, 17 were randomly assigned to diagnosis threat and 19 to neutral test directions. The diagnosis threat group performed significantly worse on tests measuring general intellect and memory, but were not different from the neutral group in basic attention or psychomotor speed. The diagnosis threat group rated themselves as putting forth less effort on the neuropsychological battery, and self-rated effort correlated with test performance in that group. Overall, results serve as a reminder that neuropsychological tests are measures of behavior, and thus can be influenced by nonneurological factors.

Cross-validation of indicators of malingering: a comparison of nine neuropsychological tests, four tests of malingering, and behavioral observations

Few studies to date have cross-validated indicators of malingering that have been suggested on various neuropsychological tests. This study presents data cross-validating several indicators of malingering on neuropsychological tests, as well as on tests of malingering and via behavioral observations. It incorporates methodological recommendations by Rogers [Researching dissimulation. In: R. Rogers (Ed.), Clinical assessment of malingering and deception (pp. 309–327). New York: Guilford Press.] resulting in an ecologically valid design utilizing college students with a history of mild head injury as analog malingerers. Results indicated that the Letter Memory Test (LMT) and the Digit Memory Test (DMT) attained the highest hit rates for the detection of malingering, while the sensitivity of many other measures declined on cross-validation.

Cross-validation of indicators of malingering: a comparison of nine neuropsychological tests, four tests of malingering, and behavioral observations

Few studies to date have cross-validated indicators of malingering that have been suggested on various neuropsychological tests. This study presents data cross-validating several indicators of malingering on neuropsychological tests, as well as on tests of malingering and via behavioral observations. It incorporates methodological recommendations by Rogers [Researching dissimulation. In: R. Rogers (Ed.), Clinical assessment of malingering and deception (pp. 309-327). New York: Guilford Press.] resulting in an ecologically valid design utilizing college students with a history of mild head injury as analog malingerers. Results indicated that the Letter Memory Test (LMT) and the Digit Memory Test (DMT) attained the highest hit rates for the detection of malingering, while the sensitivity of many other measures declined on cross-validation.

Stability of postconcussion symptomatology differs between high and low responders and by gender but not by mild head injury status.

A large sample of undergraduates (N = 2,326) were screened for general health. The screen discretely included items assessing postconcussion symptomatology and neurologic history. A subsample of experiment-blind participants whose self-reported postconcussion symptom levels were >0.5 SD below the screening sample mean (low symptomatic; n = 45) or >0.5 SD above the screening sample mean (high symptomatic; n = 53) were re-evaluated for postconcussion symptomatology 3 to 90 days later. The sample included 50 participants who reported history of mild head injury (MHI) and 48 controls. MHI was defined as loss of consciousness of < or =20 minutes within the past 10 years, but no more recent than 3 months. Persons with history of >1 head injury or with other neurologic history were not included in the study. The stability of postconcussion symptoms differed by high symptomatic versus low symptomatic presentation (high symptomatic presentation was more variable) and by gender (females were more variable), but not by actual history of MHI. Sex differences in self-reported postconcussion symptomatology are consistent with gender-related differences in reporting of other physical and psychological symptoms. In addition to demonstrating differences in the stability of self-reported postconcussion symptomatology, the current study provides normative test-retest data for the Postconcussion Symptom Checklist for extreme responders by gender and MHI status.

Inhibitory Control Differences Following Mild Head Injury

Complex inhibitory control, defined as the ability to inhibit a planned or ongoing action, was assessed in a sample of individuals with a history of mild head injury, case-matched with normal control subjects for age and gender. This central act of control was assessed using a modification of the stop-signal paradigm. The group with mild head injury took longer to inhibit their on going action and reported more accidents than the normal control subjects. The group that reported having had a mild head injury did not differ in terms of their go reaction time, number of correct responses, handedness, education level, or reported learning disabilities. Limitations of this design and directions for future research are discussed.

Mild Head Injury, Significant Impairment on Neuropsychological Test Scores, and Psychiatric Disability

Typically there is a positive correlation between severity of known brain injury and level of performance on neuropsychological tests, particularly tests of memory and speed of information processing. This paper will discuss in detail nine individuals who had a history of mild head injury, but who presented with significant neuropsychological deficits on testing. In each case, evidence of significant psychiatric disability and/or malingering was present and seemed to better explain the poor neuropsychological test findings than did the trauma. All nine patients showed evidence of significant premorbid stressors, an ''atypical'' response style on neuropsychological tests, and vague and unusual somatic complaints. The importance of interpreting test findings within the context of an adequate history via record review and a thorough clinical interview is stressed.

Neuropsychological differences between college students with learning disabilities and those with mild head injury.

College students with learning disabilities (LD) and those with a history of mild head injury (MHI) are two groups whose learning problems are not adequately addressed. We administered a comprehensive battery of neuropsychological, psychological, and academic achievement tests to college students with learning problems (LD, n = 35; MHI, n = 25) and a control group (n = 22), and completed a series of discriminant function analyses. A combination of six neuropsychological and psychoeducational test variables produced statistically significant differences among the three groups. The instruments were sensitive to LD, MHI, and the differences between them. The students with LD performed poorly on linguistically oriented psychoeducational tests, whereas the students with MHI showed cognitive deficits in visual-spatial skills and in the areas of attention, memory, and novel problem solving. Differential interventions addressing these deficits appear to be indicated.