Traumatic brain injury in northern Sweden. Incidence and prevalence of long-standing impairments and disabilities.

Based on a retrospective survey of hospital admissions and autopsies the incidence of traumatic brain injury (TBI) for the age range 16-60 was found to be 24.9/10,000 in the Umeå district of Northern Sweden. In male youngsters aged 16-19 the incidence was remarkably high in comparison with reports from other parts of the western hemisphere. Self-reports on the prevalence of impairments and disabilities 1 1/2-3 years after the injury were obtained by a mailed questionnaire. Among the subjects with brain concussion 1/3 reported impairments and 1/10 disabilities, most commonly leisure-disability. By factor analysis impairments and disabilities could be logically grouped into three factors. Two of these factors clearly circumscribed combinations of impairments and disabilities, one of them being dominated by instrumental ADL, the other by basic self-care ADL. The third factor incorporated the classic post-concussion triad and memory. Taken together the findings indicate that many subjects with an early diagnosis of brain concussion, hospitalized for only one day, experienced losses in pre-injury functions and abilities. It is therefore suggested that not only radiologically and/or operatively confirmed TBIs but also subjects with brain concussion should be followed after discharge in order to minimize losses in social well-being.