Article
Which factors are predictive for long-term complaints after mild traumatic brain injuries? Results of a prospective study with a 6-month follow-up
Welche Faktoren können Langzeitbeschwerden beim leichten Schädel-Hirn-Trauma vorhersagen? Ergebnisse einer prospektiven Studie mit einem 6-Monats-Follow-up
Search Medline for
Authors
-
M. Schütze
- Abteilung für Neurochirurgie, Chirurgische Universitätsklinik Rostock (AöR)
-
K. Buchholz
- Abteilung für Neurochirurgie, Chirurgische Universitätsklinik Rostock (AöR)
-
J. Piek
- Abteilung für Neurochirurgie, Chirurgische Universitätsklinik Rostock (AöR)
| Published: | April 11, 2007 |
|---|
Outline
Text
Objective: Patients with mild head injuries (HI) often complain of prolonged headache, dizziness or lack of concentration leading to a sick leave for several days or even for weeks or months.
In the present study we wanted to identify parameters (neuropsychological, biochemical, CT, MRI) after mild traumatic brain injury which are predictive of the severity of posttraumatic complaints.
Methods: Prospective data collection was performed in patients from 18 to 70 years admitted to our hospital for a mild HI (GCS 13 – 15) and a CCT scan on admission.
All patients were asked for subjective complaints (headache, dizziness, nausea). Blood samples for biochemical markers (S-100B, NSE) were drawn on day 1 and 14. MRI scan and an EEG were performed on day 14. To measure the cognitive functions, we performed a neuropsychological test (“Syndromkurztest” nach Erzigkeit) on day 3, 14 and after 3 and 6 months. Patients with a history of addiction were not included. Sensivity, specifity, and predictive values were tested for all parameters.
Results: 36 patients were included. CT and MRI scans showed pathological lesions in about 50% of the patients. CT (day 1) and MRI (day 14) were highly specific (78% CT, 90,9% MRI) but had little negative predictive values (<35%). S-100B (70%) and NSE (50%) also had little positive predictive values and were less specific. Neuropsychological testing, however, had the highest specificity (94.1% day 1, 96.7% after 3 months), positive predictive (66.7%) and negative predictive (93.5%) value which persisted even after 6 months.
Conclusions: EEG as well as the determination of biochemical markers are not predictive of posttraumatic complaints after mild HI. CTs and MRIs may show the acute lesions but can also not predict the long-term outcome.
