Facts about Mild Traumatic Brain Injury
Mild traumatic brain injury (MTBI), commonly known as concussion, is one of the most common neurologic disorders. Physicians can play a key role in helping to reduce the occurrence of MTBI by educating patients and the community about risks and injury prevention.
Physicians can also improve patient outcomes when MTBI is suspected or diagnosed by implementing early treatment and appropriate referral.
MTBI Facts
- Data suggest that as many as 75% of all brain-injured people sustain MTBIs.
- MTBIs cost the nation nearly $17 billion each year.
- An unknown proportion of those who are not hospitalized may experience long-term problems, such as:
- Persistent headache
- Confusion
- Pain
- Cognitive and/or memory problems
- Fatigue
- Changes in sleep patterns
- Mood changes
- Sensory problems such as changes in vision or hearing (postconcussion syndrome)
- In most cases of diagnosed MTBI, the patient recovers fully.
- Some research indicates that up to 15% of patients diagnosed with MTBI may have experienced persistent disabling problems.
Early MTBI symptoms may appear mild, but they can lead to significant, life-long impairment in an individual's ability to function physically, cognitively and psychologically. Although currently there are no standards for treatment and management of MTBI, appropriate diagnosis, referral and patient and family education are critical for helping MTBI patients achieve optimal recovery and to reduce or avoid significant sequelae.
Conceptual Definition of MTBI
Experts from the Centers for Disease Control and Prevention's MTBI Working Group define a case of MTBI as the occurrence of injury to the head arising from blunt trauma or acceleration or deceleration forces with one or more of the following conditions attributable to the head injury.
- Any period of observed or self-reported:
- Transient confusion, disorientation or impaired consciousness
- Dysfunction of memory around the time of injury
- Loss of consciousness lasting less than 30 minutes
- Observed signs of other neurological or neuropsychological dysfunction, such as:
- Seizures acutely following injury to the head
- Irritability, lethargy or vomiting following head injury, especially among infants and very young children
- Headache, dizziness, irritability, fatigue or poor concentration, especially among older children and adults
TBIs may include both concussions and contusions. The term "concussion" is used at times interchangeably with the term "mild TBI." But the category of diagnosed concussions covers a clinical spectrum. Concussion may occur without loss of consciousness. Mild concussion may be present even if there is no external sign of trauma to the head. The Quality Standards Subcommittee of the American Academy of Neurology defines the spectrum of concussions related to sports injuries as follows.
Leading Causes of MTBI
- Motor vehicle crashes
- Falls
- Firearm use
- Sports/recreational activities
Groups Most at Risk for MTBI
- Adolescents and young adults (ages 15 to 24)
- Older adults (ages 65 and older)
Grade 1 Concussion
Transient confusion, no loss of consciousness and duration of mental status abnormalities on examination that resolve in less than 15 minutes.
Grade 2 Concussion
Transient confusion, no loss of consciousness,concussion symptoms or mental status abnormalities on examination that last more than 15 minutes.
Grade 3 Concussion
Any loss of consciousness, either brief (seconds) or prolonged (minutes).