Neurobehavioral outcome following minor head injury: a three-center study

Harvey S. Levin, Steven Mattis, Ronald M. Ruff, Howard M. Eisenberg, Lawrence F. Marshall, Kamran Tabaddor, Walter M. High, Ralph F. Frankowski

Journal of neurosurgery · 1987 · 786 citations · 30 references

Concepts

TL;DR

Minor head injuries account for most hospital head‑trauma admissions, have low mortality, yet the extent of morbidity and long‑term sequelae remains controversial. The study aimed to determine whether patients with minor head injury and no prior neuropsychiatric disorder exhibit subacute cognitive and memory deficits that resolve within 1–3 months. Neurobehavioral performance of 57 patients was assessed within one week of injury and at one month, and compared to 56 matched controls across three medical centers. Baseline deficits in memory, attention, and processing speed largely resolved by three months, and most patients reported no lasting neurobehavioral impairment.

Abstract

✓ The majority of hospital admissions for head trauma are due to minor injuries; that is, no or only transient loss of consciousness without major complications and not requiring intracranial surgery. Despite the low mortality rate following minor head injury, there is controversy surrounding the extent of morbidity and the long-term sequelae. The authors postulated that consecutively admitted patients who fulfilled research diagnostic criteria for minor head injury and who were carefully screened for antecedent neuropsychiatric disorder and prior head injury would exhibit subacute cognitive and memory deficits that would resolve over a period of 1 to 3 months postinjury. To evaluate this hypothesis, the neurobehavioral functioning of 57 patients was compared within 1 week after minor head injury (baseline) and at 1 month postinjury with that of 56 selected control subjects at three medical centers. Quantified tests of memory, attention, and information-processing speed revealed that neurobehavioral impairment demonstrated at baseline by all means of measurement generally resolved during the first 3 months after minor head injury. Although nearly all patients initially reported cognitive problems, somatic complaints, and emotional malaise, these postconcussion symptoms had substantially resolved by the 3-month follow-up examination. The data suggest that a single uncomplicated minor head injury produces no permanent disabling neurobehavioral impairment in the great majority of patients who are free of preexisting neuropsychiatric disorder and substance abuse.

References

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