Mild traumatic brain injury.

Vos PE, Alekseenko Y, Battistin L, Ehler E, Gerstenbrand F, Muresanu DF, Potapov A, Stepan CA, Traubner P, Vecsei L, von Wild K; European Federation of Neurological Societies.

Source

Radboud University Nijmegen Medical Centre, The Netherlands. p.vos@neuro.umcn.nl

Abstract

Traumatic Brain Injury (TBI) is among the most frequent neurological disorders. Of all TBIs 90% are considered mild with an annual incidence of 100–300/100.000. Intracranial complications of Mild Traumatic Brain Injury (MTBI) are infrequent (10%), requiring neurosurgical intervention in a minority of cases (1%), but potentially life-threatening (case fatality rate 0,1%). Hence, a true health management problem exists because of the need to exclude the small chance of a life threatening complication in large numbers of individual patients. The 2002 EFNS guidelines used a best evidence approach based on the literature until 2001 to guide initial management with respect to indications for CT, hospital admission, observation and follow up of MTBI patients. This updated EFNS guideline version for initial management inMTBI proposes a more selectively strategy for CT when major (dangerous mechanism, GCS<15 2001="" 2="" a="" addition="" age="" agitation="" although="" amnesia="" and="" anterograde="" anticoagulation="" are="" as="" basal="" based="" been="" behavioral="" children="" clinical="" confusion="" consciousness="" contusion="" ct="" decision="" deficit="" deterioration="" disturbances="" evidence.="" evidence="" exist="" factors="" focal="" for="" fracture="" gcs="" have="" high="" hospital="" in="" including="" infection.="" level="" loss="" lower="" minor="" now="" observation="" of="" on="" or="" other="" p="" patient="" persistent="" points="" post="" potential="" present="" prevent="" published="" recommendations="" risk="" rules="" seizure="" signs="" since="" skull="" the="" therapy="" threads="" to="" traumatic="" treat="" vomiting="" well.="" with="">