ABSTRACT

Objective

Post-concussion syndrome (PCS) occurs following mild traumatic brain injury (mTBI). Patients with mTBI are often assessed using self-report instruments that rely on perception of current symptoms compared to how they felt and functioned pre-injury. The objective was to examine reliability of patients’ post-injury reporting of their pre-injury symptoms.

Methods

We included two control groups (trauma patients without brain injury history and healthy controls) who were recruited at an outpatient surgical clinic and among the working and social environment of the researchers, respectively. The Head Injury Symptom Checklist (HISC) was used to assess pre-injury and current symptoms at four time points post injury. We included 836 patients with mTBIs, 191 trauma patients without brain injury history, and 100 healthy controls.

Results

Patients with mTBI reported significantly more pre-injury symptoms than both control groups (p < .001). Forty-five percent of patients with mTBI were inconsistent in their pre-injury ratings across four assessments. Patients with post-injury PCS reported much greater pre-injury symptoms and were more often inconsistent.

Conclusion

Accurately assessing PCS by comparing pre with post-injury complaints is difficult, and may have implications for diagnosis when using self-report instruments. Therefore, post-injury PCS diagnosis should be interpreted with caution and PCS should ideally be examined using clinical examination.

中文翻译：

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轻度颅脑损伤患者随时间推移的损伤前症状评级：重新审视过去的偏见。

摘要

目的

脑震荡后综合征（PCS）发生在轻度脑外伤（mTBI）之后。mTBI患者通常使用自我报告工具进行评估，该工具依赖于对当前症状的感知与受伤前的感觉和功能相比。目的是检查患者损伤后报告其损伤前症状的可靠性。

方法

我们包括两个对照组（无脑损伤史的创伤患者和健康对照组），分别在门诊外科诊所以及研究人员的工作和社交环境中招募。头部受伤症状清单（HISC）用于评估受伤后四个时间点的受伤前症状和当前症状。我们纳入836例mTBI患者，191例无脑损伤史的创伤患者和100例健康对照。

结果

mTBI患者报告的损伤前症状明显高于两个对照组（p <.001）。在四项评估中，有百分之四十五的mTBI患者受伤前评分不一致。损伤后PCS患者报告的损伤前症状要严重得多，而且不一致。

结论

通过比较受伤前和受伤后的投诉来准确评估PCS是困难的，并且在使用自我报告工具时可能会对诊断产生影响。因此，应谨慎解释损伤后PCS的诊断，理想情况下应使用临床检查对PCS进行检查。