Journal of the International Neuropsychological Society



Factors influencing outcome following mild traumatic brain injury in adults


JENNIE  PONSFORD a1a5c1, CATHERINE  WILLMOTT a1, ANDREW  ROTHWELL a2, PETER  CAMERON a3, ANN-MAREE  KELLY a4, ROBYN  NELMS a1, CAROLYN  CURRAN a1 and KIM  NG a5
a1 Bethesda Rehabilitation Unit, Epworth Hospital, Melbourne, Australia
a2 Julia Farr Services South Australia, Melbourne, Australia
a3 Royal Melbourne Hospital, Melbourne, Australia
a4 Western Hospital, Melbourne, Australia
a5 Monash University, Melbourne, Australia

Abstract

This study aimed to investigate outcome in adults with mild traumatic brain injury (TBI) at 1 week and 3 months postinjury and to identify factors associated with persisting problems. A total of 84 adults with mild TBI were compared with 53 adults with other minor injuries as controls in terms of postconcussional symptomatology, behavior, and cognitive performance at 1 week and 3 months postinjury. At 1 week postinjury, adults with mild TBI were reporting symptoms, particularly headaches, dizziness, fatigue, visual disturbance, and memory difficulties. They exhibited slowing of information processing on neuropsychological measures, namely the WAIS–R Digit Symbol subtest and the Speed of Comprehension Test. By 3 months postinjury, the symptoms reported at 1 week had largely resolved, and no impairments were evident on neuropsychological measures. However, there was a subgroup of 24% of participants who were still suffering many symptoms, who were highly distressed, and whose lives were still significantly disrupted. These individuals did not have longer posttraumatic amnesia (PTA) duration. They were more likely to have a history of previous head injury, neurological or psychiatric problems, to be students, females, and to have been injured in a motor vehicle accident. The majority were showing significant levels of psychopathology. A range of factors, other than those directly reflecting the severity of injury, appear to be associated with outcome following mild TBI. (JINS, 2000, 6, 568–579.)

(Received January 4 1999)
(Revised September 9 1999)
(Accepted September 14 1999)


Key Words: Mild head injury; Mild traumatic brain injury; Outcome.

Correspondence:
c1 Reprint requests to: Jennie Ponsford, Department of Psychology, Bethesda Rehabilitation Unit, Epworth Hospital, 30 Erin Street, Richmond, Victoria 3121, Australia. E-mail: jennie.ponsford@sci.monash.edu.au