What Causes Postconcussion Syndrome?
The causes, diagnosis and outcome of postconcussion syndrome (PCS) remain controversial, especially following mild traumatic brain injury (mTBI) . An article in the August 2007 issue of the Journal of Neurology, Neurosurgery and Psychiatry describes the results of a prospective study examining the role of preexisting psychiatric disorders, demographic factors, injury-related characteristics, neuropsychological and psychological variables in shaping acute PCS. Using a sample of 90 traumatic brain-injured admissions to a Level 1 trauma hospital and 85 non-brain injured trauma controls, participants were given a battery of neuropsychological and psychological tests and a PCS checklist. Statistical analyses were used to predict acute PCS after 5 days postinjury. The results indicated that diagnosis of acute PCS was not specific to mild traumatic brain injury (mTBI 43.3%; controls 43.5%). Pain was found to be a significant factor but the the strongest predictor for acute PCS was previous history of affective or anxiety disorder. Females were 3.33 times more likely than males to experience acute PCS but the role of acute posttraumatic stress and neuropsychological function was relatively small. Higher IQ was also associated with acute PCS. The authors concluded that there is a high rate of acute PCS in both mTBI and non-brain injured trauma patients and that PCS was not found to be specific to mTBI. For this reason, the use of the term PCS may be misleading as it incorrectly suggests that the basis of PCS is a brain injury.
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