Mild traumatic brain injury (mTBI), commonly known as concussion, represents the majority of traumatic brain injury cases seen in emergency departments (ED). However, a significant challenge arises in accurately diagnosing mTBI, particularly in patients who present with other visible injuries following a motor vehicle collision (MVC). This oversight in Mvc Diagnosis can have serious long-term consequences for patient health and recovery.
A retrospective study investigated the frequency of missed mTBI diagnoses in patients treated in the ED after MVCs who subsequently developed chronic pain syndromes. This research, conducted within an interventional pain management clinic, reviewed data from 33 patients referred for chronic pain management after being involved in MVCs. These patients underwent standardized intake assessments, and their medical records from acute care were examined alongside Rivermead Post-Concussion Symptoms Questionnaire (RPQ) scores and patient-reported injury histories to determine the prevalence of missed mTBI and postconcussion syndrome (PCS).
The study revealed a concerningly high prevalence of presumed mTBI in this cohort (69.7%) of MVC patients. Despite this, an mTBI diagnosis was made in acute care in only 39.1% of these cases. Notably, patients who received an mTBI diagnosis during their acute care visit exhibited significantly lower PCS symptom scores compared to those whose mTBI diagnosis was missed (P<0.05). This significant disparity underscores the critical impact of timely and accurate mvc diagnosis on patient outcomes.
The limitations of this study, including potential recall and selection bias and the need for larger sample sizes, are acknowledged. However, the findings strongly suggest that a substantial proportion of patients presenting to the ED following an MVC experience mTBI. Critically, the study highlights that missed mvc diagnosis of mTBI is associated with more severe postconcussion symptoms. All patients in this study, while seeking treatment for chronic pain post-MVC, also developed PCS and subsequent disability. This observation emphasizes the urgent need for improved screening protocols for mTBI in ED settings after MVCs. Identifying individuals at higher risk, particularly those presenting with loss of consciousness, altered mental state, posttraumatic amnesia, or postinjury headache, is paramount to ensure appropriate follow-up care and rehabilitation therapy. Enhanced focus on accurate mvc diagnosis is therefore crucial to mitigate long-term complications and improve the quality of life for individuals affected by mTBI after motor vehicle collisions.
