Department of Psychology, University of Kentucky , Lexington, KY, USA.
Department of Physical Medicine and Rehabilitation, Harvard Medical School , Boston, MA, USA.
J Clin Exp Neuropsychol. 2020 Dec;42(10):1049-1058. doi: 10.1080/13803395.2020.1841118. Epub 2020 Nov 9.
A complicated mild traumatic brain injury (MTBI) is defined as mild by all clinical severity indicators but is complicated due to a traumatic intracranial abnormality visible on neuroimaging. Researchers have reported mixed findings regarding whether neuropsychological and functional outcomes following complicated MTBI are worse than, or similar to, outcomes following uncomplicated MTBI. This study examined patients referred from a Taiwanese emergency department to a neurosurgical outpatient clinic. Participants with complicated MTBI, uncomplicated MTBI, and those who did not undergo head computed tomography (CT) were compared on psychological, neuropsychological, and post-concussion symptom outcomes within 21 days of injury.
Participants with complicated MTBI ( = 42), uncomplicated MTBI ( = 77), and no head CT ( = 172) completed the Paced Auditory Serial Attention Test, Taiwanese Word Sequence Learning Test, a semantic Verbal Fluency Test, the Checklist of Post-Concussion Symptoms, and the Beck Depression and Anxiety Inventories.
No significant differences were observed between groups on any measure. For individual post-concussion symptoms, dizziness, anxiety, and attention difficulty were endorsed more often after uncomplicated MTBIs, but these group differences were not significant after controlling for multiple comparisons.
Participants with complicated MTBIs did not have worse acute or subacute outcomes than participants with uncomplicated MTBIs or no head CT. These results are consistent with many studies finding comparable outcomes between those with complicated and uncomplicated MTBIs. This study is limited by small sample size and minimal information on intracranial abnormalities, broadly categorizing groups based on positive or negative neuroimaging as opposed to specific lesion types and locations.
复杂轻度创伤性脑损伤（MTBI）在所有临床严重程度指标上均表现为轻度，但由于神经影像学上可见外伤性颅内异常而变得复杂。研究人员报告称，复杂 MTBI 后的神经心理学和功能结果是否比单纯性 MTBI 更差或相似，结果存在差异。本研究对从台湾急诊室转介到神经外科门诊的患者进行了研究。在受伤后 21 天内，对复杂 MTBI 患者、单纯性 MTBI 患者和未进行头部 CT 检查的患者进行了心理、神经心理学和脑震荡后症状结果的比较。
复杂 MTBI 患者（n=42）、单纯性 MTBI 患者（n=77）和未行头部 CT 检查的患者（n=172）完成了听觉连续注意力测试、台湾语序列学习测试、语义流畅性测试、脑震荡后症状检查表和贝克抑郁和焦虑量表。
在任何测量指标上，各组之间均无显著差异。对于个别脑震荡后症状，单纯性 MTBI 后更常出现头晕、焦虑和注意力困难，但在进行多次比较校正后，这些组间差异无统计学意义。
复杂 MTBI 患者的急性或亚急性结果并不比单纯性 MTBI 患者或无头部 CT 检查患者更差。这些结果与许多研究结果一致，即复杂性和单纯性 MTBI 患者的结果相当。本研究的局限性在于样本量小，以及关于颅内异常的信息有限，只是基于神经影像学的阳性或阴性结果对组进行了广泛分类，而没有考虑到特定的病变类型和位置。
