Mild traumatic brain injury - Revision history

Ostermayer: Add mBIG section under Disposition + See also link

2026-04-28T03:57:56Z

Add mBIG section under Disposition + See also link

← Older revision		Revision as of 03:57, 28 April 2026
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	**Standardized Assessment for Concussion		**Standardized Assessment for Concussion
	***Takes 10-15 mins to administer, often not performed in ED		***Takes 10-15 mins to administer, often not performed in ED

			===Modified brain injury guideline (mBIG)===
			For adults with mild TBI (GCS 13–15) and traumatic intracranial hemorrhage on CT, the [[Modified brain injury guideline (mBIG)]] stratifies risk to guide neurosurgical consultation, ICU admission, and safe discharge:

			{{MBig}}

	==Prognosis==		==Prognosis==
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	*[[Head Trauma (Main)]]		*[[Head Trauma (Main)]]
	*[[Severe traumatic brain injury]]		*[[Severe traumatic brain injury]]
			*[[Modified brain injury guideline (mBIG)]]

	==References==		==References==

Danbot: Embed PECARN Calculator on clinical page

2026-03-22T09:56:03Z

Embed PECARN Calculator on clinical page

← Older revision		Revision as of 09:56, 22 March 2026
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	== Calculators ==		== Calculators ==
			{{PECARN Calculator}}
	{{Canadian CT Head Calculator}}		{{Canadian CT Head Calculator}}

Danbot: Embed Canadian CT Head Calculator on clinical page

2026-03-22T09:55:51Z

Embed Canadian CT Head Calculator on clinical page

← Older revision		Revision as of 09:55, 22 March 2026
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	**With treatment for the most common symptoms of [[headache]], difficulty concentrating, and short-term memory difficulties being rest and (in some circumstances) [[NSAIDS]].		**With treatment for the most common symptoms of [[headache]], difficulty concentrating, and short-term memory difficulties being rest and (in some circumstances) [[NSAIDS]].
	*At 1 yr after injury 15% are symptomatic		*At 1 yr after injury 15% are symptomatic

			== Calculators ==
			{{Canadian CT Head Calculator}}

	==See Also==		==See Also==

Beren85: /* Discharge instructions */

2022-06-01T14:15:30Z

Discharge instructions

← Older revision		Revision as of 14:15, 1 June 2022
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	====Discharge instructions====		====Discharge instructions====
	*Given good follow up instructions detailing a graded return-to-activity program and symptoms to anticipate during recovery <ref>Ronsford J, et al. Impact of early intervention on outcome after mild traumatic head in adults. 2002</ref>		*Given good follow up instructions detailing a graded return-to-activity program and symptoms to anticipate during recovery <ref>Ronsford J, et al. Impact of early intervention on outcome after mild traumatic head in adults. 2002</ref>
			*Encourage cognitive rest and avoidance of repetitive head injuries
	*Discharge patient to care of responsible individual		*Discharge patient to care of responsible individual
	*Patients might not understand discharge instructions so repeat them to the individual taking care of the patient		*Patients might not understand discharge instructions so repeat them to the individual taking care of the patient

Beren85: /* Clinical Features */

2022-06-01T14:12:35Z

Clinical Features

← Older revision		Revision as of 14:12, 1 June 2022
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	==Clinical Features==		==Clinical Features==
	*Most consistent abnormality is subtle impairments in cognitive function		*Most consistent abnormality is subtle impairments in cognitive function (concussion symptoms)
	**Attention, concentration, amnesia, memory, processing speed, reaction time, calculation, executive function		**Attention, concentration, amnesia, memory, processing speed, reaction time, calculation, executive function
	*Physical signs/symptoms		*Physical signs/symptoms

Ghwhitcher: /* Discharge instructions */

2020-11-10T03:41:00Z

Discharge instructions

← Older revision		Revision as of 03:41, 10 November 2020
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	*Discharge patient to care of responsible individual		*Discharge patient to care of responsible individual
	*Patients might not understand discharge instructions so repeat them to the individual taking care of the patient		*Patients might not understand discharge instructions so repeat them to the individual taking care of the patient
	*~~Recommend~~ strict rest ~~for 1-2 days with gradual introduction back to regular activity~~<ref>Thomas DG, Apps JN, Hoffmann RG, et al. Benefits of strict rest after acute concussion: a randomized controlled trial. Pediatrics. 2015; 2(135):213-223.</ref>		*In one study of adolescents, strict rest immediately after mild TBI offered no benefit. <ref>Thomas DG, Apps JN, Hoffmann RG, et al. Benefits of strict rest after acute concussion: a randomized controlled trial. Pediatrics. 2015; 2(135):213-223.</ref>
	*Physical activity at any level (light aerobic, moderate, full) within first 7 days compared with no activity associated with lower rates of persistent symptoms at 28 days (29% vs. 40%)<ref>Grool AM et al. Association Between Early Participation in Physical Activity Following Acute Concussion and Persistent Postconcussive Symptoms in Children and Adolescents. JAMA. 2016;316(23):2504-2514.</ref>		*Physical activity at any level (light aerobic, moderate, full) within first 7 days compared with no activity associated with lower rates of persistent symptoms at 28 days (29% vs. 40%)<ref>Grool AM et al. Association Between Early Participation in Physical Activity Following Acute Concussion and Persistent Postconcussive Symptoms in Children and Adolescents. JAMA. 2016;316(23):2504-2514.</ref>
	**Multicohort study - 2400 children, aged 5-18, in the emergency department		**Multicohort study - 2400 children, aged 5-18, in the emergency department

ClaireLewis: /* Background */

2019-10-01T23:47:03Z

Background

← Older revision		Revision as of 23:47, 1 October 2019
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	*Occurs after a blunt force or acceleration-deceleration [[head injury]]		*Occurs after a blunt force or acceleration-deceleration [[head injury]]
	*Likely secondary to metabolic insult ie low oxygen state, ion changes		*Likely secondary to metabolic insult ie low oxygen state, ion changes
	*Structural imaging on MRI or CT might not indicate any injury		*Structural imaging on [[brain MRI\|MRI]] or [[head CT\|CT]] might not indicate any injury
	*Often evidence on microscopic level of injury with histology		*Often evidence on microscopic level of injury with histology
	*Important to not expose the already injured brain to repeated insults which is why there are usually worsening symptoms after a repeat concussion		*Important to not expose the already injured brain to repeated insults which is why there are usually worsening symptoms after a repeat concussion

ClaireLewis at 22:58, 1 October 2019

2019-10-01T22:58:18Z

← Older revision		Revision as of 22:58, 1 October 2019
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	**Attention, concentration, amnesia, memory, processing speed, reaction time, calculation, executive function		**Attention, concentration, amnesia, memory, processing speed, reaction time, calculation, executive function
	*Physical signs/symptoms		*Physical signs/symptoms
	**[[Headache]], dizziness, insomnia, fatigue, uneven gait, nausea/[[vomiting]], blurred vision, [[seizure]]		**[[Headache]], [[dizziness]], [[insomnia]], [[fatigue]], uneven gait, nausea/[[vomiting]], [[blurred vision]], [[seizure]]
	**Postconcussive anosmia (affecting taste as well)		**Postconcussive anosmia (affecting taste as well)
	*Behavioral changes		*Behavioral changes
	**Irritability, depression, anxiety, sleep disturbances, problems related to school/work, emotional lability, loss of initiative, loneliness, and helplessness		**Irritability, [[depression]], [[anxiety]], sleep disturbances, problems related to school/work, emotional lability, loss of initiative, loneliness, and helplessness

	==Differential Diagnosis==		==Differential Diagnosis==
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	*Patient GCS 15 on discharge		*Patient GCS 15 on discharge
	*No [[seizures]]		*No [[seizures]]
	*No anticoagulation or bleeding diathesis		*No [[anticoagulation]] or [[coagulopathy\|bleeding diathesis]]
	*Responsible caregiver at home to discharge to		*Responsible caregiver at home to discharge to

Kxl328: /* Clinical Features */

2018-10-10T21:35:41Z

Clinical Features

← Older revision		Revision as of 21:35, 10 October 2018
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	*Physical signs/symptoms		*Physical signs/symptoms
	**[[Headache]], dizziness, insomnia, fatigue, uneven gait, nausea/[[vomiting]], blurred vision, [[seizure]]		**[[Headache]], dizziness, insomnia, fatigue, uneven gait, nausea/[[vomiting]], blurred vision, [[seizure]]
	**Postconcussive anosmia (affecting taste as well) ~~may be long term or permanently affected~~		**Postconcussive anosmia (affecting taste as well)
	*Behavioral changes		*Behavioral changes
	**Irritability, depression, anxiety, sleep disturbances, problems related to school/work, emotional lability, loss of initiative, loneliness, and helplessness		**Irritability, depression, anxiety, sleep disturbances, problems related to school/work, emotional lability, loss of initiative, loneliness, and helplessness

Kxl328: /* Clinical Features */

2018-10-10T21:35:06Z

Clinical Features

← Older revision		Revision as of 21:35, 10 October 2018
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	*Physical signs/symptoms		*Physical signs/symptoms
	**[[Headache]], dizziness, insomnia, fatigue, uneven gait, nausea/[[vomiting]], blurred vision, [[seizure]]		**[[Headache]], dizziness, insomnia, fatigue, uneven gait, nausea/[[vomiting]], blurred vision, [[seizure]]
			**Postconcussive anosmia (affecting taste as well) may be long term or permanently affected
	*Behavioral changes		*Behavioral changes
	**Irritability, depression, anxiety, sleep disturbances, problems related to school/work, emotional lability, loss of initiative, loneliness, and helplessness		**Irritability, depression, anxiety, sleep disturbances, problems related to school/work, emotional lability, loss of initiative, loneliness, and helplessness