Loss of consciousness and pre-existing psychological disorders are associated with persistent post-concussion symptoms after traumatic brain injury

brain scans

Millions of people worldwide sustain traumatic brain injury (TBI) each year. Most of these injuries are classified as mild TBI, or concussion, and commonly result in post-concussive symptoms (PCS) that may persist for hours, days, or weeks after the initial injury. Although the majority of individuals with concussion experience a full recovery within one to three months post-TBI, about one-quarter of individuals experience persistent PCS, which lasts more than three months after injury. Currently, clinicians disagree about the causes and mechanisms underlying persistent PCS in this small proportion of concussion cases.

A recent Australian study addressed this research gap by conducting a study of 343 individuals with mild TBI. The participants completed a series of assessments designed to determine the severity of their PCS, their experiences with anxiety and depression, and their overall quality of life. Overall, about 20% of participants reported three or more post-concussive symptoms, typically fatigue and forgetfulness. Nearly 13% of participants also reported experiencing anxiety, which was a significant predictor of reporting other post-concussive symptoms. Participants were more likely to report PCS if they had also experienced loss of consciousness, reported pre-existing psychological disorders, or received no official information about TBI recovery in the emergency department.

Individuals who experience loss of consciousness and report pre-injury mental disorders are more likely to suffer from persistent symptoms after sustaining a concussion. Importantly, those who didn’t receive injury information during their stay in the emergency department were also more likely to experience persistent PCS, indicating that adequate education about TBI recovery can improve post-injury outcomes. Emergency departments are encouraged to provide patients with information about at-home injury care to ensure that patients make a full recovery after hospital discharge.

Ponsford J, Nguyen S, Downing M, et al. Factors associated with persistent post-concussion symptoms following mild traumatic brain injury in adults. Journal of Rehabilitation Medicine. (November 2018).

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