Prognosis for mild traumatic brain injury: results of the who collaborating centre task force on mild traumatic brain injury
Linda J Carroll A1, J. David Cassidy A1, Paul M. Peloso A4, Jörgen Borg A5, Hans von Holst A6, Lena Holm A3, Chris Paniak A7, Michel Pépin 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 Iowa City Iowa USA
A5 Department of Rehabilitation Medicine Uppsala University Uppsala Sweden
A6 Department of Neurosurgery, Karolinska Institutet, Division of Neuronic Engineering Royal Institute of Technology Stockholm Sweden
A7 Glenrose Hospital and the Departments of Psychology and Educational Psychology University of Alberta Edmonton Alberta Canada
A8 Department of Psychology Laval University Quebec Canada
We searched the literature on the epidemiology, diagnosis, prognosis, treatment and costs of mild traumatic brain injury. Of 428 studies related to prognosis after mild traumatic brain injury, 120 (28%) were accepted after critical review. These comprise our best-evidence synthesis on prognosis after mild traumatic brain injury. There was consistent and methodologically sound evidence that children's prognosis after mild traumatic brain injury is good, with quick resolution of symptoms and little evidence of residual cognitive, behavioural or academic deficits. For adults, cognitive deficits and symptoms are common in the acute stage, and the majority of studies report recovery for most within 3-12 months. Where symptoms persist, compensation/litigation is a factor, but there is little consistent evidence for other predictors. The literature on this area is of varying quality and causal inferences are often mistakenly drawn from cross-sectional studies.
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