Does head CT scan pathology predict outcome after mild traumatic brain injury?
Version of Record online: 19 JUL 2012
© 2012 The Author(s) European Journal of Neurology © 2012 EFNS
European Journal of Neurology
Volume 20, Issue 1, pages 124–129, January 2013
How to Cite
Lannsjö, M., Backheden, M., Johansson, U., af Geijerstam, J. L. and Borg, J. (2013), Does head CT scan pathology predict outcome after mild traumatic brain injury?. European Journal of Neurology, 20: 124–129. doi: 10.1111/j.1468-1331.2012.03813.x
- Issue online: 22 DEC 2012
- Version of Record online: 19 JUL 2012
- Manuscript Accepted: 12 JUN 2012
- Manuscript Received: 3 APR 2012
- brain concussion;
- head CT scan;
- mild traumatic brain injury;
Background and purpose
More evidence is needed to forward our understanding of the key determinants of poor outcome after mild traumatic brain injury (MTBI). A large, prospective, national cohort of patients was studied to analyse the effect of head CT scan pathology on the outcome.
One-thousand two-hundred and sixty-two patients with MTBI (Glasgow Coma Scale score 15) at 39 emergency departments completed a study protocol including acute head CT scan examination and follow-up by the Rivermead Post Concussion Symptoms Questionnaire and the Glasgow Outcome Scale Extended (GOSE) at 3 months after MTBI. Binary logistic regression was used for the assessment of prediction ability.
In 751 men (60%) and 511 women (40%), with a mean age of 30 years (median 21, range 6–94), we observed relevant or suspect relevant pathologic findings on acute CT scan in 52 patients (4%). Patients aged below 30 years reported better outcome both with respect to symptoms and GOSE as compared to patients in older age groups. Men reported better outcome than women as regards symptoms (OR 0.64, CI 0.49–0.85 for ≥3 symptoms) and global function (OR 0.60, CI 0.39–0.92 for GOSE 1–6).
Pathology on acute CT scan examination had no effect on self-reported symptoms or global function at 3 months after MTBI. Female gender and older age predicted a less favourable outcome. The findings support the view that other factors than brain injury deserve attention to minimize long-term complaints after MTBI.