Prognostic value of auditory brain-stem responses for late postconcussion symptoms following minor head injury.
ABSTRACT Minor head injury is frequently followed by a subjective postconcussion syndrome. Brain-stem auditory evoked responses (BAER's) were found to be pathological in different small series of patients with a postconcussion syndrome who were examined months after sustaining a slight cranial or cervical trauma; abnormal BAER's have also been reported in larger groups of patients examined early after minor head injury. A relationship between these findings and late subjective symptoms has never been demonstrated. The results of a prospective study into the value of BAER's in the prognosis of a postconcussion syndrome after minor head injury are presented. In 103 patients with minor head injury, BAER's were recorded within 48 hours of the trauma. One year later, the patients were examined for headache, dizziness, depression, anxiety, subjective loss of memory and concentration, and irritability. Eighty percent claimed at least one symptom, most often irritability (54%), memory loss (47%), or depression (39%). Pathological BAER's were found with the same prevalence in patients with and without a postconcussion syndrome. This study confirms the disturbance of brain-stem function in some head-injured patients. However, the lack of correlation with a postconcussion syndrome limits the prognostic value of BAER recordings for postconcussion syndrome. The data suggest that BAER's not be used for medicolegal evaluation of patients with a postconcussion syndrome.
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- "These evoked potentials only qualify outcome in terms of poor or good and not the quality of survival. In mild HI, inconclusive results have been reported from studies with evoked potential testing (Rizzo, Pierelli, Pozzessere , Floris, & Morocutti, 1983; Schoenhuber, Gentilini, & Orlando, 1988). Long latencyevoked potentials, on the other hand, are associated with cognitive processing of a stimulus, the so-called event-related potentials (ERPs; Picton, 1992). "
ABSTRACT: This paper reviews the functional outcome of patients sustaining mild and moderate head injury (HI). Discrepancies across studies in the definition of minor, mild, and moderate HI are discussed in terms of hindering the interpretation of recovery. The predictive value of acute severity indices, neuroimaging findings, and the results of other techniques are summarized. Measurement of outcome based solely on the Glasgow Outcome Scale (GOS) is critiqued, and it is recommended that a differentiated outcome scale involving emotional, behavioral, cognitive, and physical domains should be used.Journal of Clinical and Experimental Neuropsychology 01/2002; 23(6):837-51. DOI:10.1076/jcen.23.6.837.1018 · 2.16 Impact Factor
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ABSTRACT: Forty patients who sustained minor head trauma were investigated by brainstem trigeminal and auditory evoked potentials (BTEP, BAEP) and middle-latency auditory evoked potentials (MLAEP). The patients were evaluated within the first 48 h following their admission and at 3 months after the injury. Outcome was scored at the follow-up examination according to six complaints: failure to resume previous professional activity, headache, memory disorders, dizziness and vertigo, behavioural and emotional disturbances, and other symptoms of a neurological nature. Post-concussion syndrome (PCS) was defined by the presence of four or more of the listed features. All three evoked potential modalities showed significantly increased latencies at the initial assessment, disclosing disseminated axonal damage. Unlike the BTEPs and the BAEPs, the MLAEPs proved to correlate to outcome at 3 months, especially in its psychocognitive aspects. These findings suggest that organic diencephalic-paraventricular primary damage may account for the occurrence of PCS.Brain Injury 07/2009; 9(8):805-13. DOI:10.3109/02699059509008236 · 1.86 Impact Factor
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ABSTRACT: Head trauma in our society is a common occurrence, resulting in significant expenditure of societal resources. Psychiatric consequences following the injury may be the cause of significant disability during the recovery process. While nearly any psychiatric symptom or disorder may occur following head injury, there are a few common complications which are reviewed in this article. Biopsychosocial factors reported to play a role in the etiology of post-traumatic psychiatric dysfunction are reviewed, diagnostic issues are discussed, and new findings regarding treatment are reviewed.The International Journal of Psychiatry in Medicine 02/1990; 20(1):1-35. DOI:10.2190/BE6W-DCY1-V71N-N7J7 · 0.81 Impact Factor