Neuropsychological outcomes in patients with complicated versus uncomplicated mild traumatic brain injury: a 6 months follow-up

Abstract

Objective: To evaluate the extent of persistent neuropsychological impairment in patients with complicated versus uncomplicated mild traumatic brain injury (mTBI). Methods: 61 patients with mTBI (GCS 13 to 15) were prospectively recruited, categorized according to baseline CT findings, and underwent neuropsychological assessment at initial admission (n=61) as well as at 6 month follow-up (n=30). A paired t-test, Cohen's d effect size calculation, and repeated measure ANOVA were used to establish the differences between the groups in terms of their neuropsychological performance. Results: A trend of poorer neuropsychological performance among complicated mTBI patients was observed during admission; however, performance in this group improved over time. The uncomplicated mTBI group in contrast showed slower recovery especially on tasks of memory, visuospatial processing, and executive functions at follow up. Conclusion: Our findings suggest that, despite the broad umbrella designation of mTBI, the current classification schemes of injury severity for mild neurotrauma should be revisited, and they also raise questions about the clinical relevance of both traumatic focal lesions and the absence of visible traumatic lesions on brain imaging studies related to patients with milder forms of head trauma