Incidence, risk factors and prevention of mild traumatic brain injury: results of the who collaborating centre task force on mild traumatic brain injury
J. David Cassidy A1, Linda J. Carroll A1, Paul M. Peloso A4, Jörgen Borg A5, Hans von Holst A6, Lena Holm A3, Jess Kraus A7, Victor G. Coronado A8
A1 Alberta Centre for Injury Control and Research, Department of Public Health Sciences University of Alberta Edmonton Alberta Canada
A2 Department of Medicine University of Alberta Edmonton Alberta Canada
A3 Section for Personal Injury Prevention, Department of Clinical Neurosciences Karolinska Institutet Stockholm Sweden
A4 Department of Internal Medicine University of Iowa Health Center Iowa City Iowa USA
A5 Department of Neuroscience, Rehabilitation Medicine Uppsala University Uppsala Sweden
A6 Department of Neurosurgery Karolinska Institutet Stockholm Sweden
A7 Division of Epidemiology School of Public Health University of California Los Angeles California USA
A8 National Center for Injury Prevention and Control Centers for Disease Control and Prevention Atlanta Georgia USA
Objective: We undertook a best-evidence synthesis on the incidence, risk factors and prevention of mild traumatic brain injury. Methods: Medline, Cinahl, PsycINFO and Embase were searched for relevant articles. After screening 38,806 abstracts, we critically reviewed 169 studies on incidence, risk and prevention, and accepted 121 (72%). Results: The accepted articles show that 70-90% of all treated brain injuries are mild, and the incidence of hospital-treated patients with mild traumatic brain injury is about 100-300/100,000 population. However, much mild traumatic brain injury is not treated at hospitals, and the true population-based rate is probably above 600/100,000. Mild traumatic brain injury is more common in males and in teenagers and young adults. Falls and motor-vehicle collisions are common causes. Conclusion: Strong evidence supports helmet use to prevent mild traumatic brain injury in motorcyclists and bicyclists. The mild traumatic brain injury literature is of varying quality, and the studies are very heterogeneous. Nevertheless, there is evidence that mild traumatic brain injury is an important public health problem, but we need more high-quality research into this area.
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