Annals of Emergency Medicine
Volume 53, Issue 6 , Pages 796-803.e1 , June 2009

Neurocognitive Function of Emergency Department Patients With Mild Traumatic Brain Injury

  • Shane E. Peterson, BS

      Affiliations

    • Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
    • ,
  • Matthew J. Stull, BS, BA

      Affiliations

    • Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
    • ,
  • Michael W. Collins, PhD

      Affiliations

    • Department of Orthopedic Surgery, Sports Concussion Program, University of Pittsburgh Medical Center, Center for Sports Medicine, Pittsburgh, PA
    • ,
  • Henry E. Wang, MD, MS

      Affiliations

    • Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA
    • Corresponding Author InformationAddress for correspondence: Henry E. Wang, MD, MS, Department of Emergency Medicine, University of Alabama at Birmingham, 619 19th Street South, JTN266, Birmingham, AL 35249

Received 18 February 2008 ,Revised 17 June 2008 ,Accepted 15 October 2008.

References 

  1. Bazarian JJ, McClung J, Cheng YT, et al. Emergency department management of mild traumatic brain injury in the USA. Emerg Med J. 2005;22:473–477
  2. Johnston KM, Ptito A, Chankowsky J, et al. New frontiers in diagnostic imaging in concussive head injury. Clin J Sport Med. 2001;11:166–175
  3. Centers for Disease Control and Prevention. Facts about concussion and brain injury and where to get help. Available at: http://www.cdc.gov/ncipc/tbi/. Accessed February 18, 2008.
  4. Ponsford J, Willmott C, Rothwell A, et al. Impact of early intervention on outcome following mild head injury in adults. J Neurol Neurosurg Psychiatry. 2002;73:330–332
  5. Johnston KM, McCrory P, Mohtadi NG, et al. Evidence-based review of sport-related concussion: clinical science. Clin J Sport Med. 2001;11(3):150–159
  6. Sheedy J, Geffen G, Donnelly J, et al. Emergency department assessment of mild traumatic brain injury and prediction of post-concussion symptoms at one month post injury. J Clin Exp Neuropsychol. 2006;28:755–772
  7. Collins MW, Lovell MR, McKeag DB. Current issues in managing sports-related concussion. JAMA. 1999;282:2283–2285
  8. Moser RS, Schatz P, Jordan BD. Prolonged effects of concussion in high school athletes. Neurosurgery. 2005;57:300–306; discussion 300-306
  9. Lovell MR, Collins MW, Iverson GL, et al. Recovery from mild concussion in high school athletes. J Neurosurg. 2003;98:296–301
  10. Collins MW, Lovell MR, Iverson GL, et al. Cumulative effects of concussion in high school athletes. Neurosurgery. 2002;51:1175–1179; discussion 1180-1181
  11. Delaney JS, Abuzeyad F, Correa JA, et al. Recognition and characteristics of concussions in the emergency department population. J Emerg Med. 2005;29:189–197
  12. Fabbri A, Servadei F, Marchesini G, et al. Early predictors of unfavourable outcome in subjects with moderate head injury in the emergency department. J Neurol Neurosurg Psychiatry. 2008;79:567–573
  13. Cushman JG, Agarwal N, Fabian TC, et al. Practice management guidelines for the management of mild traumatic brain injury: the EAST Practice Management Guidelines Work Group. J Trauma. 2001;51:1016–1026
  14. Davidoff G, Doljanac R, Berent S, et al. Galveston Orientation and Amnesia Test: its utility in the determination of closed head injury in acute spinal cord injury patients. Arch Phys Med Rehabil. 1988;69:432–434
  15. Levin HS, O'Donnell VM, Grossman RG. The Galveston Orientation and Amnesia Test (A practical scale to assess cognition after head injury). J Nerv Ment Dis. 1979;167:675–684
  16. Collins MW, Grindel SH, Lovell MR, et al. Relationship between concussion and neuropsychological performance in college football players. JAMA. 1999;282:964–970
  17. Schatz P, Pardini JE, Lovell MR, et al. Sensitivity and specificity of the ImPACT Test Battery for concussion in athletes. Arch Clin Neuropsychol. 2006;21:91–99
  18. Iverson GL, Lovell MR, Collins MW. Interpreting change on ImPACT following sport concussion. Clin Neuropsychol. 2003;17:460–467
  19. Lovell M. ImPACT 2007 (6.0) Clinical interpretation manual. Available at: http://www.impacttest.com/pdf/ImPACT_Clinical_Interpretation_Manual.pdf. Accessed February 15, 2008.
  20. Altman DG. Practical Statistics for Medical Research. Boca Raton, FL: Chapman & Hall/CRC; 1999;
  21. Macciocchi SN, Barth JT, Alves W, et al. Neuropsychological functioning and recovery after mild head injury in collegiate athletes. Neurosurgery. 1996;39:510–514
  22. Wade DT, King NS, Wenden FJ, et al. Routine follow up after head injury: a second randomised controlled trial. J Neurol Neurosurg Psychiatry. 1998;65:177–183
  23. Bazarian J, Hartman M, Delahunta E. Minor head injury: predicting follow-up after discharge from the emergency department. Brain Inj. 2000;14:285–294
  24. Stewart DP, Kaylor J, Koutanis E. Cognitive deficits in presumed minor head-injured patients. Acad Emerg Med. 1996;3:21–26
  25. Shores EA, Lammel A, Hullick C, et al. The diagnostic accuracy of the Revised Westmead PTA Scale as an adjunct to the Glasgow Coma Scale in the early identification of cognitive impairment in patients with mild traumatic brain injury. J Neurol Neurosurg Psychiatry. 2008;79:1100–1106
  26. Aubry M, Cantu R, Dvorak J, et al. Summary and agreement statement of the First International Conference on Concussion in Sport, Vienna 2001 (Recommendations for the improvement of safety and health of athletes who may suffer concussive injuries). Br J Sports Med. 2002;36:6–10
  27. Elgmark Andersson E, Emanuelson I, Bjorklund R, et al. Mild traumatic brain injuries: the impact of early intervention on late sequelae (A randomized controlled trial). Acta Neurochir (Wein). 2007;149:151–159; discussion 160
  28. Wojtys EM, Hovda D, Landry G, et al. Current concepts (Concussion in sports). Am J Sports Med. 1999;27:676–687
  29. Bazarian JJ, Blyth B, Cimpello L. Bench to bedside: evidence for brain injury after concussion—looking beyond the computed tomography scan. Acad Emerg Med. 2006;13:199–214

 Provide feedback on this article at the journal's Web site, www.annemergmed.com.

 Supervising editor: Robert Silbergleit, MD

 Author contributions: MWC and HEW conceived and designed the study. SEP, MJS, and HEW obtained funding. SEP and MJS carried out data collection. SEP, MJS, and HEW analyzed the data. All authors contributed to drafting and editing the article. HEW takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article, that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. Grant support for this study was provided by the Pittsburgh Emergency Medicine Foundation and the University of Pittsburgh School of Medicine Dean's Summer Research Program. Dr. Wang is supported by Clinical Scientist Development Award K08-HS013628 from the Agency for Healthcare Research and Quality. Dr. Collins is co-developer and co-owner of IMPACT Applications, the company that distributes the IMPACT Concussion Management Software used in this study.

 Dr. Wang is now affiliated with the Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL.

 Publication date: Available online January 24, 2009.

 Reprints not available from the authors.

PII: S0196-0644(08)01899-4

doi: 10.1016/j.annemergmed.2008.10.015

Annals of Emergency Medicine
Volume 53, Issue 6 , Pages 796-803.e1 , June 2009

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