Jörgen Borg ^A1, Lena Holm ^A2, Paul M. Peloso ^A3, J. David Cassidy ^A2, Linda J. Carroll ^A4, Hans von Holst ^A6, Chris Paniak ^A7, David Yates ^A8
A1 Department of Neuroscience Rehabilitation Medicine Uppsala University Hospital Uppsala Sweden
^A2 Section for Personal Injury Prevention, Department of Clinical Neurosciences Karolinska Institutet Stockholm Sweden
^A3 Department of Internal Medicine University of Iowa Health Center Iowa City Iowa USA
^A4 Alberta Center for Injury Control and Research, Department of Public Health Sciences University of Alberta Edmonton Alberta Canada
^A5 Department of Medicine University of Alberta Edmonton Alberta Canada
^A6 Department of Neurosurgery Karolinska Institutet Stockholm Sweden
^A7 Glenrose Rehabilitation Hospital and University of Alberta Canada
^A8 Emergency Department Hope Hospital University of Manchester UK

DOI: 10.1080/16501960410023840

We examined the evidence for non-surgical interventions and for economic costs for mild traumatic brain injury patients by a systematic search of the literature and a best-evidence synthesis. After screening 38,806 abstracts, we critically reviewed 45 articles on intervention and accepted 16 (36%). We reviewed 16 articles on economic costs and accepted 7 (44%). We found some evidence that early educational information can reduce long-term complaints and that this early intervention need not be intensive. Most cost studies were performed more than a decade ago. Indirect costs are probably higher than direct costs. Studies comparing costs for routine hospitalized observation vs the use of computerized tomography scan examination for selective hospital admission indicate that the latter policy reduces costs, but comparable clinical outcome of these policies has not been demonstrated. The sparse scientific literature in these areas reflects both conceptual confusion and limited knowledge of the natural history of mild traumatic brain injury.