Classification, Diagnosis, and Management of Mild Traumatic Brain Injury: A Major Problem Presenting in a Minor Way

 

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ABSTRACT

Concussion and mild traumatic brain injury (TBI) account for the majority of TBIs treated. Traditional management of these injuries involves diagnosis and classification, computed tomography to identify traumatic lesions, and neuropsychological studies in those with persistent symptoms. Long-term treatment involves management of postconcussive symptoms with the goal of resuming normal cognitive and physical activities. This review summarizes the diagnosis and management of this disease.

REFERENCES

• 1 Hugenholtz H, Stuss D T, Stethem L L, Richard M T. How long does it take to recover from a mild concussion?.  Neurosurgery . 1988;  22 853-858
  PubMedGoogle Scholar
• 2 Oppenheimer D R. Microscopic lesions in the brain following head injury.  J Neurol Neurosurg Psychiatry . 1968;  31 299-306
  CrossrefPubMedGoogle Scholar
• 3 Cushman J G, Agarwal N, Fabian T C. et al . Practice management guidelines for the management of mild traumatic brain injury: the EAST practice management guidelines work group.  J Trauma . 2001;  51 1016-1026
  CrossrefPubMedGoogle Scholar
• 4 Alexander M P. Mild traumatic brain injury: pathophysiology, natural history, and clinical management.  Neurology . 1995;  45 1253-1260
  CrossrefPubMedGoogle Scholar
• 5 Practice parameter: the management of concussion in sports (summary statement): Report of the Quality Standards Subcommittee.   Neurology . 1997;  48 581-585
  PubMedGoogle Scholar
• 6 Williams D H, Levin H S, Eisenberg H M. Mild head injury classification.  Neurosurgery . 1990;  27 422-428
  CrossrefPubMedGoogle Scholar
• 7 Shackford S R, Wald S L, Ross S E. et al . The clinical utility of computed tomographic scanning and neurologic examination in the management of patients with minor head injuries.  J Trauma . 1992;  33 385-394
  CrossrefPubMedGoogle Scholar
• 8 Stein S C, Ross S E. Mild head injury: a plea for routine early CT scanning.  J Trauma . 1992;  33 11-13
  PubMedGoogle Scholar
• 9 Miller E C, Derlet R W, Kinser D. Minor head trauma: is computed tomography always necessary?.  Ann Emerg Med . 1996;  27 290-294
  CrossrefPubMedGoogle Scholar
• 10 Jeret J S, Mandell M, Anziska B. et al . Clinical predictors of abnormality disclosed by computed tomography after mild head trauma.  Neurosurgery . 1993;  32 9-15
  CrossrefPubMedGoogle Scholar
• 11 Bassett S S, Slater E J. Neuropsychological function in adolescents sustaining mild closed head injury.  J Pediatr Psychol . 1990;  15 225-236
  PubMedGoogle Scholar
• 12 Rimel R W, Giordani B, Barth J T, Boll T J, Jane J A. Disability caused by minor head injury.  Neurosurgery . 1981;  9 221-228
  CrossrefPubMedGoogle Scholar
• 13 Bohnen N, Jolles J, Twijnstra A. Neuropsychological deficits in patients with persistent symptoms six months after mild head injury.  Neurosurgery . 1992;  30 692-695
  PubMedGoogle Scholar
• 14 Kreutzer J S, Marwitz J H, Seel R, Serio C D. Validation of a neurobehavioral functioning inventory for adults with traumatic brain injury.  Arch Phys Med Rehabil . 1996;  77 116-124
  CrossrefPubMedGoogle Scholar
• 15 Klauber M R, Marshall L F, Luerssen T G, Frankowski R, Tabaddor K, Eisenberg H M. Determinants of head injury mortality: importance of the low risk patient.  Neurosurgery . 1989;  24 31-36
  PubMedGoogle Scholar
• 16 Marshall L F, Toole B M, Bowers S A. The National Traumatic Coma Data Bank. Part 2: Patients who talk and deteriorate: implications for treatment.  J Neurosurg . 1983;  59 285-288
  CrossrefPubMedGoogle Scholar
• 17 Dacey Jr G R, Alves W M, Rimel R W, Winn H R, Jane J A. Neurosurgical complications after apparently minor head injury. Assessment of risk in a series of 610 patients.  J Neurosurg . 1986;  65 203-210
  PubMedGoogle Scholar
• 18 Alves W M, Coloban A R, O'Leary T J, Rimel R W, Jane J A. Understanding posttraumatic symptoms after minor head injury.  J Head Trauma Rehabil . 1986;  1 1-12
  PubMedGoogle Scholar
• 19 Watson M R, Fenton G W, McClelland R J, Lumsden J, Headley M, Rutherford W H. The post-concussional state: neurophysiological aspects.  Br J Psychiatry . 1995;  167 514-521
  PubMedGoogle Scholar
• 20 Collins M W, Lovell M R, Iverson G L, Cantu R C, Maroon J C, Field M. Cumulative effects of concussion in high school athletes.  Neurosurgery . 2002;  51 1175-1179
  CrossrefPubMedGoogle Scholar
• 21 Cantu R C. Return to play guidelines after a head injury.  Clin Sports Med . 1998;  17 45-60
  PubMedGoogle Scholar