Update in mild traumatic brain injury

Med Clin (Barc). 2017 Aug 10;149(3):122-127. doi: 10.1016/j.medcli.2017.05.002. Epub 2017 May 29.
[Article in English, Spanish]

Abstract

There has been concern for many years regarding the identification of patients with mild traumatic brain injury (TBI) at high risk of developing an intracranial lesion (IL) that would require neurosurgical intervention. The small percentage of patients with these characteristics and the exceptional mortality associated with mild TBI with IL have led to the high use of resources such as computerised tomography (CT) being reconsidered. The various protocols developed for the management of mild TBI are based on the identification of risk factors for IL, which ultimately allows more selective indication or discarding both the CT application and the hospital stay for neurological monitoring. Finally, progress in the study of brain injury biomarkers with prognostic utility in different clinical categories of TBI has recently been incorporated by several clinical practice guidelines, which has allowed, together with clinical assessment, a more accurate prognostic approach for these patients to be established.

Keywords: Biomarcadores de lesión cerebral; Brain injury biomarkers; Head computed tomography; Intracranial lesion; Lesión cerebral; Mild traumatic brain injury; Tomografía axial computarizada craneal; Traumatismo craneoencefálico leve.

Publication types

  • Review

MeSH terms

  • Biomarkers / metabolism
  • Brain Concussion / diagnosis*
  • Brain Concussion / physiopathology
  • Brain Concussion / therapy
  • Humans
  • Neuroimaging
  • Neurosurgical Procedures
  • Prognosis
  • Risk Assessment
  • Tomography, X-Ray Computed
  • Trauma Severity Indices

Substances

  • Biomarkers