Post-concussion syndrome due to minor head injury

Minor head injury is a poorly defined and misunderstood health problem. These injuries may result in long-term symptoms that affect the quality of a person's life in profound ways. This manuscript-based thesis examines rates of minor head injury in an inception cohort, patterns of associated medical symptoms, and associations between the directional components of forces leading to injury and these symptoms. The results of this thesis identify subgroups of patients at higher risk for long-term morbidity following a minor head injury.;The objective of the second manuscript was to assess whether symptoms experienced by patients who sustained minor head injuries due to rotational forces translated during the injury event differed significantly from patients who experienced focal forces only during the injury event. The outcomes under study were Post-concussion Syndrome (PCS) and associated symptoms. The same patient cohort was used. An existing questionnaire, the Rivermead Post-concussion Symptoms Questionnaire (RPQ), was used to identify individual post-concussive symptoms. Associations between rotational versus focal injuries and the occurrence of PCS were explored using multiple logistic regression analyses. Elevated risks for PCS were associated with rotational forces at the follow-up interview (overall adjusted OR: 2.8 95% C.I. 1.1--6.8), and for cognitive PCS symptoms at follow-up (overall adjusted OR: 6.195% C.I. 1.5--21.6).;This study suggests that minor head injury is a serious public health issue on a population basis and that rotational forces experienced during a minor head injury are associated with a greater risk for PCS up to 4-weeks post-injury. The clinical management of these injuries needs to recognize these findings.;The first manuscript describes characteristics of minor head injury patients, explores external causes leading to these injuries and quantifies the occurrence of associated medical symptoms over time. Analyses were based on 113 minor head injury patients aged 5 to 75 who presented to the emergency departments of two Kingston, Ontario hospitals. Chart abstraction and patient interviews at baseline (1-week post-injury) and follow-up (4-weeks post-injury) provided the basis for analyses. Sports and recreational activities accounted for the majority of reported activities at time of injury. Headache, fatigue and dizziness were the most prevalent individual symptoms at follow-up. The prevalence of somatic, emotional and cognitive symptoms persisted in a substantial proportion (32--55%) of patients up to 4-weeks post-injury.