A Primer on Traumatic Brain Injury and Concussions

Rita Hargrave, MD
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Prevention  

The primary prevention strategy for the reduction of the negative sequelae in mild TBI should be aimed at the reduction in the frequency of concussions. Current research suggests that the use of sport-specific helmets and protective head gear among cyclists can reduce frequency and severity of head injuries.41,42,43

Summary

A mild TBI or concussion is secondary to the effects of  blunt force or an acceleration/deceleration head injury and may or may not be associated with a loss of consciousness. The primary symptoms of mild TBI are confusion or amnesia. All patients with mild TBI should undergo a medical examination (including neurological examination and mental status testing) and patients experiencing loss of consciousness or persistent symptoms should be referred to an emergency department for a more comprehensive assessment (including brain CT scan) .

Serious sequelae of TBI include second injury syndrome, chronic traumatic encephalopathy, post-concussion syndrome, headaches, epilepsy, and vertigo. Patients with a history of multiple concussions need to receive a more focused assessment of neurobehavioral symptoms and when appropriate, they should be referred for more comprehensive neurologic and neuropsychological assessments.

Rita Hargrave, MD, is a geriatric psychiatrist at the Martinez VA Outpatient Mental Health Clinic in Martinez, California.

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