Department of Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of HUS Medical Imaging Center, Radiology, and Departments of University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
J Neurotrauma. 2021 Sep 1;38(17):2400-2406. doi: 10.1089/neu.2021.0055. Epub 2021 May 26.
The main objective of this prospective cohort study was to evaluate whether traumatic microbleeds (TMBs) are a significant prognostic factor of return to work (RTW), post-traumatic symptoms, and overall recovery in patients with mild traumatic brain injury (mTBI). One hundred and thirteen patients with mTBI were recruited from the Helsinki University Hospital emergency units. All patients underwent multi-contrast 3T magnetic resonance imaging (MRI) 3-17 days after mTBI. Patients were evaluated in the Traumatic Brain Injury Outpatient Clinic of Helsinki University Hospital 1 month after injury. Post-concussion symptoms were assessed with the Post-Concussion Symptom Questionnaire (RPQ) and overall recovery was assessed with the Glasgow Outcome Scale Extended (GOS-E). Their time to RTW was continuously measured up to 1 year after TBI. Median RTW was 9 days (interquartile range [IQR] 4-30) after mTBI and full RTW rate after 1 year was 98%. Patients with TMBs ( = 22) did not have more post-concussion symptoms (median RPQ 10.0 vs. 7.0, = 0.217) or worse overall recovery (58% vs. 56% with GOS-E = 8, = 0.853) than patients without TMBs ( = 91). There was no significant difference in time to RTW (13.5 vs. 7.0 days, = 0.063). In this study, patients with TMBs did not have delayed RTW or more post-concussion symptoms than other patients with mTBI. TMBs in mTBI do not seem to be a significant prognostic factor of RTW.
本前瞻性队列研究的主要目的是评估外伤性微出血（TMB）是否是轻度外伤性脑损伤（mTBI）患者重返工作岗位（RTW）、创伤后症状和整体康复的重要预后因素。113 名 mTBI 患者从赫尔辛基大学医院急诊部招募。所有患者在 mTBI 后 3-17 天进行多对比度 3T 磁共振成像（MRI）检查。患者在 mTBI 后 1 个月在赫尔辛基大学医院创伤性脑损伤门诊进行评估。使用脑震荡后症状问卷（RPQ）评估脑震荡后症状，使用格拉斯哥结局量表扩展版（GOS-E）评估整体康复情况。他们的 RTW 时间在 mTBI 后持续测量长达 1 年。mTBI 后中位 RTW 时间为 9 天（四分位间距 [IQR] 4-30），1 年后完全 RTW 率为 98%。有 TMB（ = 22）的患者没有更多的脑震荡后症状（RPQ 中位数 10.0 比 7.0， = 0.217）或整体康复较差（GOS-E = 8 的 58%比 56%， = 0.853）比没有 TMB（ = 91）的患者。RTW 时间无显著差异（13.5 比 7.0 天， = 0.063）。在这项研究中，有 TMB 的患者与其他 mTBI 患者相比，RTW 时间没有延迟，脑震荡后症状也没有更多。mTBI 中的 TMB 似乎不是 RTW 的重要预后因素。
