Artikel
Short- and long-term consequences of mild traumatic brain injury (TBI) : a prospective study
Kurz- und Langzeitfolgen des leichten Schädelhirntraumas: eine prospektive Studie
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
Patients after mild head injury often complain prolonged headache, dizziness or lack of concentration often resulting in a sick leave for several days after trauma. The present study was designed to identify parameters after mild TBI predictive for the severity and length of posttraumatic complaints.
Methods
In a prospective study we included patients from 18 to 70 years admitted to our hospital with a Glasgow Coma Score of 13 – 15 and a CCT scan on admission. Chronic alcohol abuse was a exclusion criteria. Various parameters were obtained on day 1, 3, 14 and after 3, 6 and 12 month. These included subjective complaints like headache, dizziness or nausea (all follow-up's), biochemical markers (S-100B and neurone specific enolase) on day 1 and after 2 weeks, MRI scan and an electroencephalography on day 14 and measuring of the cognitive functions with the “Syndromkurztest” (day 3, 14 and after 3, 6 and 12 month).
Results
Up to now 45 patients have been included. 13 patients had additional injury in the midface and 8 elsewhere (extremity fractures, splenic rupture, e.g.). Increased biochemical markers were found in 20 patients. Traumaspecific lesions were detected in 8 patients both in MRI and CCT scan. Additional findings in MRI were microangiopathic changes in 3 and an asymptomatic aneurysm in one patient. In 4 patients we found an acute brain syndrome requiring medical treatment during the first days. All patients showed good results in the neuropsychological testing on day 14 even if they had poor results on day 3. Except those patients who were sick leave due to extracranial causes all of our patients were able to return to work after one week. Only one patient was ill posted due to persisting headache after having returned to work.
Conclusions
In this on-going study we found only one patient who was sick leave for more than one week due to TBI. The only complaints of our patients belonged to associated injuries like splenic rupture, thoracic contusion or extremity fractures. Initial headache, dizziness or nausea had no influence on the clinical outcome. Even the elevated levels of biochemical markers on day 1 were not associated with a negative posthospitalisation course.