Examining and comparing the clinical characteristics of adults with persisting post-concussion symptoms presenting for outpatient rehabilitation following a mild traumatic brain injury or a minimal head injury.

Abstract

Objective: First, to describe a clinical sample with persisting post-concussion symptoms after a mild injury to the head. Second, to explore whether patients who sustained a mild traumatic brain injury differed from those with a minimal head injury (no loss of consciousness, no post-traumatic amnesia, no neuroimaging findings).

Design: Cross-sectional clinic-referred sample.

Subjects: 178 adult patients with persisting post-concussion symptoms referred to outpatient rehabilitation.

Methods: Main outcome measures were Rivermead Post-Concussion Symptoms Questionnaire, Glasgow Outcome Scale-Extended, and Return-to-work status.

Results: In the total sample, previous health problems, daily headaches, fatigue, and depressive symptoms were frequent. Most had functional disability on the Glasgow Outcome Scale-Extended and had not returned to full-time work. The mean Rivermead Post-Concussion Symptoms Questionnaire total score was 29. Only 5 patients had intracranial traumatic injuries. Some 45% had sustained a minimal head injury. Patients with minimal head injury and mild traumatic brain injury had different causes of injury and acute care but were comparable regarding symptom burden and functional limitations.

Conclusion: Clinicians treating persisting post-concussion symptoms may need to target physiological, psychological, and social factors. Many had an injury too mild to meet criteria for a traumatic brain injury, but the clinical phenotype was similar, supporting further research on the mildest head injuries.