A large TRACK-TBI cohort study published in JAMA Network Open finds incomplete recovery at 5 years in 53% of mild traumatic brain injury (mTBI) patients, dictating need for longer term rehabilitation.
A multi-center transforming research and clinical knowledge in TBI (TRACK-TBI) cohort study published March 20, 2023 in JAMA Network Open followed 1196 patients at 18 level 1.0 trauma care centers in the US over five years, including patient with mTBI, patients with moderate-severe brain injury (msTBI) and orthopedic controls. It found persistently elevated rates of incomplete functional outcomes in 53% of mild traumatic brain injury patients and 83% of msTBI patients compared to controls, supporting a need for longer term monitoring and rehabilitation.
A recent study published in JAMA Network Open finds that patients with a history of traumatic brain injury (TBI), including mild TBI (mTBI), are at significantly greater risk of developing chronic cardiovascular, endocrine, neurological and psychiatric disorders. This proved to be true in all age groups, including younger adults (18-40).
This study is important because, as the authors note, “the risks of incident comorbidities in previously healthy patients who sustained mTBI and msTBI (moderate-severe TBI) has not previously been reported.” The most important takeaway of the study is that “patients with TBI in all age groups may benefit from a proactive targeted screening program for chronic multisystem diseases, particularly cardiometabolic diseases.” Read More
As highlighted in prior posts in this blog, TBI research increasingly highlights the importance of providing follow-up care to patients discharged from the ER with a diagnosis of TBI. Put simply, patients with follow up care have better outcomes.
Victims of mild traumatic brain injury (“mTBI”) commonly report psychological distress, which is not surprising given the impact the injury can have on every aspect of everyday life including but not limited to balance, vision, sleeping, physical discomfort including headaches, and perhaps most significantly thinking clearly. Patients often report that they are not the same person and fear that person will never return.
Among the chronic symptoms seen in these children were forgetfulness, memory problems, sensitivity to light and noise, ADHD and even psychological problems. Sadly, many of these children had been misdiagnosed as suffering from unrelated ADHD, sleep disorders, depression, etc. This misdiagnosis, the researchers noted, leads to treatment that is not suited to the problem, thus causing the children prolonged suffering. Read More
A new study published February 16, 2022 by the American Academy of Neurology in the Journal “Neurology” finds that the frequency of clinically meaningful poor cognitive outcomes one year after a concussion are more common than previously thought. The results, says study author Raquel Gardner, MD, of the University of California San Francisco, “highlight the need to better understand the mechanisms underlying poor cognitive outcome, even after relatively mild brain injuries, to improve therapy for recovery.” Read More
So called “mild” traumatic brain injury (“mTBI”) can have long-term, disabling consequences (in both civilian and military populations);
that this injury is heterogeneous in both presentation and clinical outcome (in other words, every injury is different); and
that interventions targeted to the individual presentation of the injury (whether it is predominantly vestibular, cognitive, oculomotor, headache, sleep or mood related, or some combination) can reduce symptoms in otherwise intractable patients.
The message is that ignoring the symptoms and hoping that they will ultimately disappear – the approach often taken in the past – is not wise for either the individual or for society as a whole. Read More
In a peer-reviewed article published in the Journal of Alzheimer’s Disease, 2020;78(2):757-775. doi: 10.3233/JAD-200662, Canadian researcher found that a history of mild traumatic brain injury (mTBI) almost doubled the risk of being diagnosed with dementia and that mTBI was the strongest environmental risk factor for dementia, comparable to health risk factors such as diabetes, hypertension and obesity. Read More
Adding to a growing volume of literature on this topic, Montreal researchers published a study in January, 2021 demonstrating that a single mild traumatic brain injury involving late adulthood patients (ages 50-70) leads to subtle, long-term cognitive consequences.
An article published in April, 2020 by the American College of Emergency Physicians reports on evidence that underdiagnosis of Mild Traumatic Brain Injury (mTBI) “is a pervasive problem in the emergency setting,” and that even patients who receive a diagnosis are unlikely to receive appropriate discharge education and are therefore at risk of missing opportunities for treatment, referral and improvement in outcomes. Koval et. at., Concussion Care in the Emergency Department: A Prospective Operational Brief Report, Annals of Emergency Medicine 2020 Apr;75(4):483-490. Read More