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Review
Management of mild traumatic brain injury
  1. Anne van Gils1,
  2. Jon Stone2,3,
  3. Killian Welch2,4,
  4. Louise R Davidson2,
  5. Dean Kerslake5,
  6. Dave Caesar5,
  7. Laura McWhirter3,
  8. Alan Carson2,3,4
  1. 1University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands
  2. 2Department of Clinical Neurosciences, Western General Hospital, University of Edinburgh, Edinburgh, UK
  3. 3Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
  4. 4Department of Rehabilitation Medicine, Astley Ainslie Hospital, Edinburgh, UK
  5. 5Department of Emergency Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Professor Alan Carson, Royal Edinburgh Hospital, Edinburgh EH10 5HF, UK; A.Carson{at}ed.ac.uk

Abstract

Mild traumatic brain injury (TBI) is common and associated with a range of diffuse, non-specific symptoms including headache, nausea, dizziness, fatigue, hypersomnolence, attentional difficulties, photosensitivity and phonosensitivity, irritability and depersonalisation. Although these symptoms usually resolve within 3 months, 5%–15% of patients are left with chronic symptoms. We argue that simply labelling such symptoms as ‘postconcussional’ is of little benefit to patients. Instead, we suggest that detailed assessment, including investigation, both of the severity of the ‘mild’ injury and of the individual symptom syndromes, should be used to tailor a rehabilitative approach to symptoms. To complement such an approach, we have developed a self-help website for patients with mild TBI, based on neurorehabilitative and cognitive behavioural therapy principles, offering information, tips and tools to guide recovery: www.headinjurysymptoms.org.

  • head injury
  • neuropsychiatry
  • neurosurgery
  • clinical neurology

https://doi.org/10.1136/practneurol-2018-002087

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    Footnotes

    • Twitter Jon Stone @jonstoneneuro and Alan Carson @alancarson15

    • Contributors AC: conceived the idea. AvG: co-ordinated the development of the website. AC, LMW, LRD, JS: contributed to website content. DC and DK: facilitated testing of website. All authors contributed to writing the manuscript.

    • Funding AvG was on a training fellowship funded by the University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, Groningen, the Netherlands.

    • Competing interests AC, JS and LMW: provided independent testimony in Court on a range of neurological and neuropsychiatric topics including mild brain injury. AC: an associate editor of Journal of Neurology Neurosurgery and Psychiatry.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned. Externally peer reviewed by David Sharp, London, UK, Sallie Baxendale, London, UK, and Colette Griffin, London, UK.

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