Mild traumatic brain injury management – consensus statement of the Czech Neurological Society CMS JEP
Authors:
O. Chudomel 1; F. Růžička 2; M. Brázdil 3; P. Marusič 1; E. Růžička 2; E. Ehler 4; J. Bednařík 5
Authors place of work:
Neurologická klinika 2. LF UK a FN Motol, Praha
1; Neurologická klinika 1. LF UK a VFN v Praze
2; 1. neurologická klinika LF MU a FN u sv. Anny, Brno
3; Neurologická klinika FZS UP a Pardubické krajské nemocnice, a. s.
4; Neurologická klinika LF MU a FN Brno
5
Published in the journal:
Cesk Slov Neurol N 2019; 82(1): 106-112
Category:
Doporučené postupy
doi:
https://doi.org/10.14735/amcsnn2019106
Summary
Mild traumatic brain injury (mTBI) is a common medical condition affecting all age groups with the greatest occurrence in young and elderly patients. Research in recent years has proved that mTBI is not as a benign and fully reversible injury as previously thought implying the firmly established term „brain concussion“. Repeated mTBI may result in a broad spectrum of cognitive impairment and even dementia. Some patients with frequent mTBI were described as having a histopathologically well-defined chronic traumatic encephalopathy (CTE). An accumulation of the tau protein was found in the brain tissue of these patients, which is typically present in other neurodegenerative diseases. A small percentage of patients with mTBI suffer from serious intracranial complications which may, if undetected, lead to severe neurological sequelae or even death. Thus, the aim of this consensus statement is to change the attitude toward patients with mTBI. The proposal introduces the extent of the initial neurological examination and lists risk factors indicating performance of a head CT and criteria for inpatient observation including monitored parameters. Furthermore, presented recommendations aim to decrease the long-term sequelae of mTBI and suggest algorithms of care in the Czech Republic.
Key words:
brain concussion – mild traumatic brain injury – neurological examination – neurodegenerative disorder – guidelines
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.
Zdroje
1. Sharp DJ, Jenkins PO. Concussion is confusing us all. Pract Neurol 2015; 15(3): 172– 186. doi: 10.1136/ practneurol-2015-001087.
2. Hou R, Moss-Morris R, Peveler R et al. When a minor head injury results in enduring symptoms: a prospective investigation of risk factors for postconcussional syndrome after mild traumatic brain injury. J Neurol Neurosurg Psychiatry 2012; 83(2): 217– 223. doi: 10.1136/ jnnp-2011-300767.
3. Norrie J, Heitger M, Leathem J et al. Mild traumatic brain injury and fatigue: a prospective longitudinal study. Brain Inj 2010; 24(13– 14): 1528– 1538. doi: 10.3109/ 02699052.2010.531687.
4. Vos PE, Battistin L, Birbamer G et al. EFNS guideline on mild traumatic brain injury: report of an EFNS task force. Eur J Neurol 2002; 9(3): 207– 219.
5. Vos PE, Alekseenko Y, Battistin L et al. Mild traumatic brain injury. Eur J Neurol 2012; 19(2): 191– 198.
6. Stiell IG, Wells GA, Vandemheen K et al. The Canadian CT Head Rule for patients with minor head injury. Lancet 2001; 357: 1391– 1396.
7. 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– 105. doi: 10.1056/ NEJM200007133430204.
8. Cassidy JD, Carroll LJ, Peloso P et al. Incidence, risk factors and prevention of mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med 2004; (43 Suppl): 28– 60.
9. Carroll LJ, Cassidy JD, Holm L et al. Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med 2004; (43 Suppl): 113– 125.
10. National Institute for Health and Care Excellence. Head injury: assessment and early management. [online]. Available from URL: https:/ / www.nice.org.uk/ guidance/ cg176.
11. McCrory P, Meeuwisse WH, Aubry M et al. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Br J Sports Med 2013; 47(5): 250– 258. doi: 10.1136/ bjsports-2013-092313.
12. Peloso PM, Von Holst H, Borg J. Mild traumatic brain injuries presenting to swedish hospitals in 1987-2000. J Rehabil Med 2004; (43 Suppl): 22– 27.
13. Tagliaferri F, Compagnone C, Korsic M et al. A systematic review of brain injury in Europe. Acta Neurochir (Wien) 2006; 148(3): 255– 268. doi: 10.1007/ s00701-005-0651-y.
14. Shivaji T, Lee A, Dougall N et al. The epidemiology of hospital treated traumatic brain injury in Scotland. BMC Neurol 2014; 14: 2– 15. doi: 10.1186/ 1471-2377-14-2.
15. Kristman VL, Borg J, Godbolt AK et al. Methodological issues and research recommendations for prognosis after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehabil 2014; 95 (Suppl 3): S265– S277. doi: 10.1016/ j.apmr.2013.04.026.
16. Voss JD, Connolly J, Schwab KA et al. Update on the epidemiology of concussion/ mild traumatic brain injury. Curr Pain Headache Rep 2015; 19(7): 32. doi: 10.1007/ s11916-015-0506-z.
17. Servadei F, Teasdale G, Merry G. The Neurotraumatology Committee of the World Federation of Neurosurgical Societies. Defining acute mild head injury in adults: a proposal based on prognostic factors, diagnosis, and management. J Neurotrauma 2001; 18(7): 657– 664. doi: 10.1089/ 089771501750357609.
18. McCrory PR, Berkovic SF. Concussion: the history of clinical and pathophysiological concepts and misconceptions. Neurology 2001; 57(12): 2283– 2289.
19. Levin, HS, Diaz-Arrastia RR. Diagnosis, prognosis, and clinical management of mild traumatic brain injury. Lancet Neurol 2015; 14(5): 506– 517. doi: 10.1016/ S1474-4422(15)00002-2.
20. af Geijerstam JL, Britton M. Mild head injury - mortality and complication rate: meta-analysis of findings in a systematic literature review. Acta Neurochir (Wien) 2003; 145(10): 843– 850.
21. Fabbri A, Servadei F, Marchesini G et al. Prospective validation of a proposal for diagnosis and management of patients attending the emergency department for mild head injury. J Neurol Neurosurg Psychiatry 2004; 75(3): 410– 416.
22. Smits M, Dippel DW, de Haan GG et al. Minor head injury: guidelines for the use of CT – a multicenter validation study. Radiology 2007; 245(3): 831– 838. doi: 10.1148/ radiol.2452061509.
23. Melnick ER, Szlezak CM, Bentley SK et al. CT overuse for mild traumatic brain injury. Jt Comm J Qual Patient Saf 2012; 38(11): 483– 489.
24. Mata-Mbemba D, Mugikura S, Nakagawa A et al. Canadian CT head rule and New Orleans Criteria in mild traumatic brain injury: comparison at a tertiary referral hospital in Japan. Springerplus 2016; 5: 176. doi: 10.1186/ s40064-016-1781-9.
25. Papa L, Stiell IG, Clement CM et al. Performance of the Canadian CT Head Rule and the New Orleans Criteria for predicting any traumatic intracranial injury on computed tomography in a United States Level I trauma center. Acad Emerg Med 2012; 19(1): 2– 10. doi: 10.1111/ j.1553-2712.2011.01247.x.
26. Smits M, Dippel DW, de Haan GG et al. Externalvalidation of the Canadian CT Head Rule and the NewOrleans Criteria for CT scanning in patients with minor head injury. JAMA 2005; 294(12): 1519– 1525. doi: 10.1001/ jama.294.12.1519.
27. Stiell IG, Clement CM, Rowe BH et al. Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury. JAMA 2005; 294(12): 1511– 1518. doi: 10.1001/ jama.294.12.1511.
28. Kavalci C, Aksel G, Salt O et al. Comparison of the Canadian CT head rule and the new orleans criteria in patients with minor head injury. World J Emerg Surg 2014; 9: 31.
29. Růžička E, Marusič P. Základní neurologické vyšetření – nastal čas pro změny? Cesk Slov Neurol N 2017; 80/ 113(1): 84– 91. doi: 10.14735/ amcsnn201784.
30. Kleiven S. Why most traumatic brain injuries are not caused by linear acceleration but skull fractures are. Front Bioeng Biotechnol 2013; 1: 15. doi: 10.3389/ fbioe.2013.00015.
31. Hernandez F, Wu LC, Yip MC et al. Six degree-of-freedom measurements of human mild traumatic brain injury. Ann Biomed Eng 2015; 43(8): 1918– 1934. doi: 10.1007/ s10439-014-1212-4.
32. Zhao W, Ford JC, Flashman LA et al. White matter injury susceptibility via fiber strain evaluation using whole-brain tractography. J Neurotrauma 2016; 33(20): 1834– 1847. doi: 10.1089/ neu.2015.4239.
33. Blennow K, Hardy J, Zetterberg H. The neuropathology and neurobiology of traumatic brain injury. Neuron 2012; 76(5): 886– 899. doi: 10.1016/ j.neuron.2012.11.021.
34. Fehily B, Fitzgerald M. Repeated mild traumatic brain injury: potential mechanisms of damage. Cell Transplant 2017; 26(7): 1131– 1155. doi: 10.1177/ 0963689717714092.
35. Bigler ED. Structural neuroimaging in sport-related concussion. Int J Psychophysiol 2017; 132(Pt A): 105– 123. doi: 10.1016/ j.ijpsycho.2017.09.006.
36. Mez J, Daneshvar DH, Kiernan PT et al. Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football. JAMA 2017; 318(4): 360– 370. doi: 10.1001/ jama.2017.8334.
37. Tagge CA, Fisher AM, Minaeva OV et al. Concussion, microvascular injury, and early tauopathy in young athletes after impact head injury and an impact concussion mouse model. Brain 2018; 141(2): 422– 458. doi: 10.1093/ brain/ awx350.
38. Koerte IK, Lin AP, Willems A et al. A review of neuroimaging findings in repetitive brain trauma. Brain Pathol 2015; 25(3): 318– 349. doi: 10.1111/ bpa.12249.
39. Khong E, Odenwald N, Hashim E et al. Diffusion tensor imaging findings in post-concussion syndrome patients after mild traumatic brain injury: a systematic review. Front Neurol 2016; 7: 156. doi: 10.3389/ fneur.2016.00156.
40. Ghajari M, Hellyer PJ, Sharp DJ. Computational modelling of traumatic brain injury predicts the location of chronic traumatic encephalopathy pathology. Brain 2017; 140(2): 333– 343. doi: 10.1093/ brain/ aww317.
41. Sussman D, da Costa L, Chakravarty MM et al. Concussion induces focal and widespread neuromorphological changes. Neurosci Lett 2017; 650: 52– 59. doi: 10.1016/ j.neulet.2017.04.026.
42. Monti JM, Voss MW, Pence A et al. History of mild traumatic brain injury is associated with deficits in relational memory, reduced hippocampal volume, and less neural activity later in life. Front Aging Neurosci 2013; 5: 41. doi: 10.3389/ fnagi.2013.00041.
43. List J, Ott S, Bukowski M et al. Cognitive function and brain structure after recurrent mild traumatic brain injuries in young-to-middle-aged adults. Front Hum Neurosci 2015; 9: 228. doi: 10.3389/ fnhum.2015.00228.
44. Mayer AR, Bellgowan PS, Hanlon FM. Functional magnetic resonance imaging of mild traumatic brain injury. Neurosci Biobehav Rev 2015; 49: 8– 18. doi: 10.1016/ j.neubiorev.2014.11.016.
45. Koerte IK, Ertl-Wagner B, Reiser M et al. White matter integrity in the brains of professional soccer players without a symptomatic concussion. JAMA 2012; 308(18): 1859– 1861. doi: 10.1001/ jama.2012.13735.
46. Koerte IK, Mayinger M, Muehlmann M et al. Cortical thinning in former professional soccer players. Brain Imaging Behav 2016; 10(3): 792– 798. doi: 10.1007/ s11682-015-9442-0.
47. Bazarian JJ, Zhu T, Zhong J et al. Persistent, long-term cerebral white matter changes after sports-related repetitive head impacts. PloS One 2014; 9(4): e94734. doi: 10.1371/ journal.pone.0094734.
48. Rose SC, Fischer AN, Heyer GL. How long is too long? The lack of consensus regarding the post-concussion syndrome diagnosis. Brain Inj 2015; 29(7– 8): 798– 803. doi: 10.3109/ 02699052.2015.1004756.
49. Broshek DK, De Marco AP, Freeman JR. A review of post-concussion syndrome and psychological factors associated with concussion. Brain Inj 2015; 29(2): 228– 237. doi: 10.3109/ 02699052.2014.974674.
50. Boake C, McCauley SR, Levin HS et al. Diagnostic criteria for postconcussional syndrome after mild to moderate traumatic brain injury. J Neuropsychiatry Clin Neurosci 2005; 17(3): 350– 356. doi: 10.1176/ jnp.17.3.350.
51. Simpson JR. DSM-5 and neurocognitive disorders. J Am Acad Psychiatry Law 2014; 42(2): 159– 164.
52. McMahon PJ, Hricik A, Yue JK et al. Symptomatology and functional outcome in mild traumatic brain injury: results from the prospective TRACK-TBI study. J Neurotrauma 2014; 31(1): 26– 33. doi: 10.1089/ neu.2013.2984.
53. Hiploylee C, Dufort PA, Davis HS et al. Longitudinal study of postconcussion syndrome: not everyone recovers. J Neurotrauma 2017; 34(8): 1511– 1523. doi: 10.1089/ neu.2016.4677.
54. McInnes K, Friesen CL, MacKenzie DE et al. Mild Traumatic Brain Injury (mTBI) and chronic cognitive impairment: a scoping review. PloS One 2017; 12(4): e0174847. doi: 10.1371/ journal.pone.0174847.
55. de Koning ME, Scheenen ME, van der Horn HJ et al. Prediction of work resumption and sustainability up to 1 year after mild traumatic brain injury. Neurology 2017; 89(18): 1908– 1914. doi: 10.1212/ WNL.0000000000004604.
56. McKee AC, Daneshvar DH. The neuropathology of traumatic brain injury. Handbook of clinical neurology 127. Amsterdam: Elsevier 2015: 45– 66.
57. McKee AC, Stein TD, Nowinski CJ et al. The spectrum of disease in chronic traumatic encephalopathy. Brain 2013; 136(Pt 1): 43– 64. doi: 10.1093/ brain/ aws307.
58. Stern RA, Daneshvar DH, Baugh CM et al. Clinical presentation of chronic traumatic encephalopathy. Neurology 2013; 81(13): 1122– 1129. doi: 10.1212/ WNL.0b013e3182a55f7f.
59. Crane PK, Gibbons LE, Dams-O’Connor K et al. Association of traumatic brain injury with late-life neurodegenerative conditions and neuropathologic findings. JAMA Neurol 2016; 73(9): 1062– 1069. doi: 10.1001/ jamaneurol.2016.1948.
60. Jafari S, Etminan M, Aminzadeh F et al. Head injury and risk of Parkinson disease: A systematic review and meta-analysis. Mov Disord 2013; 28(9): 1222– 1229. doi: 10.1002/ mds.25458.
61. Irwin DJ, Trojanowski JQ. Many roads to Parkinson‘s disease neurodegeneration: head trauma – a road more traveled than we know? Mov Disord 2013; 28(9): 1167– 1170. doi: 10.1002/ mds.25551.
62. Silverberg ND, Iverson GL. Is rest after concussion “the best medicine?”: recommendations for activity resumption following concussion in athletes, civilians, and military service members. J Head Trauma Rehabil2013; 28(4): 250– 259. doi: 10.1097/ HTR.0b013e31825ad658.
63. Schneider KJ, Leddy JJ, Guskiewicz KM et al. Rest and treatment/ rehabilitation following sport-related concussion: a systematic review. Br J Sports Med 2017; 51(12): 930– 934. doi: 10.1136/ bjsports-2016-097475.
64. King D, Brughelli M, Hume P et al. Assessment, management and knowledge of sport-related concussion: systematic review. Sports Med 2014; 44(4): 449– 471. doi: 10.1007/ s40279-013-0134-x.
65. Levin HS, Diaz-Arrastia RR. Diagnosis, prognosis, and clinical management of mild traumatic brain injury. Lancet Neurol 2015; 14(5): 506– 517. doi: 10.1016/ S1474-4422(15)00002-2.
66. Hadanny A, Efrati S. Treatment of persistent post-concussion syndrome due to mild traumatic brain injury: current status and future directions. Expert RevNeurother 2016; 16(8): 875– 887. doi: 10.1080/ 14737175.2016.1205487.
67. Makdissi M, Schneider KJ, Feddermann-Demont Net al. Approach to investigation and treatment of persistent symptoms following sport-related concussion: a systematic review. Br J Sports Med 2017; 51(12): 958– 968. doi: 10.1136/ bjsports-2016-097470.
68. Davis-Hayes C, Baker DR, Bottiglieri TS et al. Medical retirement from sport after concussions: a practical guide for a difficult discussion. Neurol Clin Pract 2018; 8(1): 40– 47. doi: 10.1212/ CPJ.0000000000000424.
Štítky
Detská neurológia Neurochirurgia NeurológiaČlánok vyšiel v časopise
Česká a slovenská neurologie a neurochirurgie
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