Understand mild traumatic brain injury and concussion, including the definitions and common symptoms.
A mild traumatic brain injury is diagnosed when a patient presents:
- following an impact or force applied to the head or body that results in neurological dysfunction
- with an initial Glasgow Coma Scale (GCS) (PDF) score of 13–15 upon arrival at a healthcare facility.
Neurological dysfunction can include a number of signs and symptoms with or without trauma-related changes on brain imaging.
Patients with an initial GCS of 13 have higher rates of intracranial injury and may require more surgical intervention. They also perform more poorly on neuropsychological assessments, with outcomes more closely aligned to patients with moderate traumatic brain injury.
Concussion
There is not a universally agreed definition in the literature for concussion. The terms mild traumatic brain injury and concussion are used interchangeably. For the purpose of this guide, concussion is a subset of mild traumatic brain injury. Concussion includes physical, cognitive and behavioural symptoms (see below) after an injury, without evidence of a structural lesion on imaging.
Symptoms
Common symptoms after mild traumatic brain injury or concussion include:
- headache
- confusion
- nausea
- vision changes, e.g. double vision
- sleep disturbances
- memory loss
- dizziness and light-headedness
- balance issues
- cognitive, behavioural or emotional changes
- anxiety
- depression
- irritability
- fatigue
- ringing in the ears
- disturbance in taste, e.g. bad taste in the mouth
- sensitivity to light or sound
- poor concentration, difficulty maintaining attention or thinking.
Symptom duration can vary. For most people, symptoms resolve within days of injury. The majority of people recover fully within 3 months.
Assessment
Assessment of a patient with a mild traumatic brain injury.
Imaging
How to identify patients for a CT scan based on assessment of the clinical findings.
Complications and risk factors
Complications and risk factors where a patient may require hospitalisation, monitoring or neurosurgical consultation and/or intervention.
Managing a deteriorating patient in a non-neurosurgical facility
Action to support a patient who is deteriorating and may require transfer if the facility does not have neurosurgical capability.
Discharge
Criteria to safely discharge patients; when to refer patients for ongoing treatment; and information to provide at discharge.