Post-Concussion Symptoms and Post-Traumatic Amnesia of Patients with Mild Traumatic Brain Injury
Article Sidebar
Main Article Content
Abstract
Objectives: The purpose of this descriptive study was to compare the mean severity of post-concussion symptoms and to investigate post-traumatic amnesia in patients with mild traumatic brain injury in trauma wards at two tertiary care hospitals in Khon Kaen Province. Methods: Specifically, the symptoms in a sample of 166 patients were observed and monitored during specific time intervals, including the first 24 hours, the first week, the second week, and the fourth week after experiencing brain injury. There were three research instruments employed to collect the data, namely 1) a demographic record form, 2) the Rivermead Post-concussion Symptom Questionnaire (RPQ-3, RPQ-13), and 3) the Galveston Orientation and Amnesia Test (GOAT). The collected data were analyzed through descriptive statistics and Repeated Measures ANOVA. Results: The sample group had mean scores for the severity of post-concussion symptoms during the first 24 hours, the first week, the second week, and the fourth-week post traumatic brain injury, based on the RPQ-3 symptom groups had a statistically significant decline in the mean score of the symptom severity (p <.01), while the RPQ-13 symptom groups showed a statistically significant rise in the mean score of the symptom severity (p < .01). Nineteen of the patients, accounting for 11.40 percent, exhibited post-traumatic amnesia during the first 24 hours but did not show such a symptom in the later periods. Conclusion: The results of the study can be built on to plan symptom management, discharge, and information transfer to ensure continuous care, enabling patients with mild traumatic brain injury to return to normal life.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Dewan MC, Rattani A, Gupta S, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg. 2018; 130(4): 1-18. doi: 10.3171/2017.10.JNS17352.
Institute of Neurological Sciences NHS Greater Glasgow and Clyde. Glasgow coma scale [internet]. 2015 [cited 2021 Jul 22]. Available from: https://www.glasgowcomascale.org/downloads/GCS-Assessment-Aid-English.pdf?v=3
Phuenpathom N, Srikijvialikul T, editor. Clinical practice guidelines for traumatic brain injury. 1 st ed. Bangkok: Prosperous plus company limited; 2019. Thai.
Haydel MJ, Preston CA, Mills TJ, et al. Indications for computed tomography in patients with minor head injury. N Engl J Med. 2000; 343(2): 100-5. doi: 10.1056/NEJM200007133430204.
Abdulle AE, de Koning ME, van der Horn HJ, et al. Early predictors for long-term functional outcome after mild traumatic brain injury in frail elderly patients. J Head Trauma Rehabil. 2018; 33(6): E59-E67. doi: 10.1097/HTR.0000000000000368.
Lefevre-Dognin C, Cogné M, Perdrieau V, et al. Definition and epidemiology of mild traumatic brain injury. Neurochirurgie. 2021; 67(3): 218-21. doi: 10.1016/j.neuchi.2020.02.002.
Ponsford J, Nguyen S, Downing M, et al. Factors associated with persistent post-concussion symptoms following mild traumatic brain injury in adults. J Rehabil Med. 2019; 51(1): 32-9. doi: 10.2340/16501977-2492.
Utaisang A. Factors associated with severity level of post-concussion syndrome in patients with mild traumatic brain injury. [dissertation].[Khon Kean]: Khon Kaen University; 2016. 110 p.
Snell D, Macleod A, Anderson T. Post-concussion syndrome after a mild traumatic brain injury: A minefield for clinical practice. J Behav Brain Sci. 2016; 6: 227-32. doi: org/10.4236/jbbs.2016.66023.
Eisenberg MA, Meehan WP 3rd, Mannix R. Duration and course of post-concussive symptoms. Pediatrics. 2014; 133(6): 999-1006. doi: 10.1542/peds.2014-0158.
Tator CH, Davis HS, Dufort PA, et al. Postconcussion syndrome: Demographics and predictors in 221 patients. J Neurosurg. 2016; 125(5): 1206-16. doi: 10.3171/2015.6.JNS15664.
Andelic N, Howe EI, Hellstrøm T, et al. Disability and quality of life 20 years after traumatic brain injury. Brain Behav. 2018; 8(7): 1-10. doi: 10.1002/brb3.1018.
Voormolen DC, Polinder S, von Steinbuechel N, et al. The association between post-concussion symptoms and health-related quality of life in patients with mild traumatic brain injury. Injury. 2019; 50(5): 1068-74. doi: 10.1016/j.injury.2018.12.002.
Marshman LAG, Jakabek D, Hennessy M, et al. Post-traumatic amnesia. J Clin Neurosci. 2013; 20: 1475-81. doi: org/10.1016/j.jocn.2012.11.022.
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(11): 675-84. doi: 10.1097/00005053-197911000-00004.
Fotakopoulos G, Makris D, Tsianaka E, et al. The value of the identification of predisposing factors for post-traumatic amnesia in management of mild traumatic brain injury. Brain Inj. 2018; 32(5): 563-8. doi: 10.1080/02699052.2018.1432075.
Wongsasung J, Jitpanya C, Chuntra K. The effect of integrated reality orientation program on amnesia in adults with head injury. JRTAN. 2011; 12(2): 46-52. Thai.
Lenz ER, Pugh LC, Milligan R, et al. The middle range theory of unpleasant symptoms: An update. ANS Adv Nurs Sci. 1997; 19(3): 14-27. doi: 10.1097/00012272-199703000-00003.
Faul F, Erdfelder E, Lang AG, et al. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007; 39(2): 175-91. doi: 10.3758/bf03193146.
Srisatidnarakul B. Effect size, power analysis, optimal sample size calculations using g*power software. 1 st ed. Bangkok: Chulalongkorn University Press; 2020. Thai.
Emeot Y, Khuwatsamrit K, Chaivaiboontham S. Effects of the self-care agency promoting program on knowledge, self-care ability perceived post concussion symptoms, and recovery from brain injury in patients with mild traumatic brain injury. NJPH. 2020; 30(3): 207-22. Thai.
Eyres S, Carey A, Gilworth G, et al. Construct validity and reliability of the Rivermead Post-Concussion Symptoms Questionnaire. Clin Rehabil. 2005; 19(8): 878-87. doi: 10.1191/0269215505cr905oa.
Premsai T. Follow up study of patient’ adaptation after mild head injury [dissertation].[Bangkok]: Mahidol University; 2003. 71 p. Thai.
Kinklaykan K, Jitpanya C. Relationships among pain, anxiety, social support, and post concussive syndromes. Chula Med Bull. 2019; 1(5): 439-49. Thai.
Nelson LD, Furger RE, Ranson J, et al. Acute clinical predictors of symptom recovery in emergency department patients with uncomplicated mild traumatic brain injury or non-traumatic brain injuries. J Neurotrauma. 2018; 35(2): 249-59. doi: 10.1089/neu.2017.4988.
Vaniyapong T, Patumanond J, Ratanalert S, et al. Clinical indicators for traumatic intracranial findings in mild traumatic brain injury patients. Surg Neurol Int. 2019; 10(64): 1-5. doi: 10.25259/SNI-101-2019.
Paredes I, Navarro B, Lagares A. Sleep disorders in traumatic brain injury. Neurocirugia (Astur: Engl Ed). 2021; 32(4): 178-87. doi: 10.1016/j.neucie.2020.12.001.
Bauer RM, Jaffee MS. Behavioral and Cognitive Aspects of Concussion. Continuum (Minneap Minn). 2021; 27(6): 1646-69. doi: 10.1212/CON.0000000000001057.
Lum P, Harnirattisai T, Tantongtip D. The effects of a continuing care program on the perceived self-efficacy of caregivers and post-concussion syndrome in persons with mild traumatic brain injury. Rama Nurs J. 2019; 25(1): 58-73. Thai.
Sen N. An insight into the vision impairment following traumatic brain injury. Neurochem Int. 2017; 111: 103-7. doi: 10.1016/j.neuint.2017.01.019.