Severe traumatic brain injury (TBI) in older age is associated with high rates of mortality. However, little is known about outcome following mild TBI (mTBI) in older age. We report on a prospective cohort study investigating 3 month outcome in older age patients admitted to hospital-based trauma services. First, 50 mTBI older age patients and 58 orthopedic controls were compared to 123 community control participants to evaluate predisposition and general trauma effects on cognition. Specific brain injury effects were subsequently evaluated by comparing the orthopedic control and mTBI groups. Both trauma groups had significantly lower performances than the community group on prospective memory (d=0.82 to 1.18), attention set-shifting (d=−0.61 to −0.69), and physical quality of life measures (d=0.67 to 0.84). However, there was only a small to moderate but non-significant difference in the orthopedic control and mTBI group performances on the most demanding task of prospective memory (d=0.37). These findings indicate that, at 3 months following mTBI, older adults are at risk of poor cognitive performance but this is substantially accounted for by predisposition to injury or general multi-system trauma. (JINS, 2014, 20, 1–9)

The vast majority of traumatic brain injuries (TBI) in children are of mild severity. Even if only a small proportion of children with mild TBI suffer negative outcomes, then mild TBI is a serious public health problem. This review summarizes the literature regarding the neurobehavioral outcomes associated with mild TBI in children and adolescents, focusing on the longstanding debate regarding postconcussive symptoms and attendant conceptual and methodological issues. The review also discusses future research directions, the long-term goal of which is to develop a comprehensive and integrated biopsychosocial model of outcomes that helps guide clinical management. (JINS, 2010, 16, 953–960.)

This study examined whether memory span was impaired during the acute and post-acute phases following mild traumatic brain injury (mTBI). Twenty-two adults with mTBI were compared with 22 controls on computerized tasks of immediate memory for verbal, spatial, and hand movement sequences under no interference (baseline) and articulatory suppression conditions. Groups were assessed within a month and followed up 3–12 months post-injury. In the acute phase, there were no group differences across tasks under either condition. At follow-up, all spatial and verbal span scores and associated practice effects were equivalent across groups. Yet for the hand movement task, baseline movement span was worse for the mTBI group suggesting that they failed to benefit from practice to the same extent as controls. Furthermore, the fact that this group difference in span scores disappeared when articulatory suppression was imposed indicates that successful hand movement task performance involves verbal recoding. (JINS, 2006, 12, 580–584.)

Recovery of cognitive function after mild head injury (MHI) is thought to be relatively swift and complete. The present study replicates and extends previous work in which university students with self-reported concussion demonstrated reduced P300 amplitude on a set of easy and difficult attention tasks, in addition to performing more poorly than controls on demanding cognitive tasks many years after injury. In the present study, 13 students with self-reported concussion (MHI group: M time since injury 5 8 years) and 10 controls were matched for age, sex, education, and a variety of cognitive, physical and emotional complaints. Controls outperformed the MHI group on the Digit Symbol substitution task and on a difficult dual task involving tone discrimination and visual working memory. Additionally, controls exhibited larger P300 amplitudes on both an easy and a difficult auditory discrimination task. A combination of electrophysiological, neuropsychological and self-report indices predicted group membership (MHI vs. control) with 88% accuracy. The present results, coupled with previous work, offer preliminary evidence that the combination of event-related potentials and demanding behavioral measures might reveal long-lasting, subtle cognitive problems associated with MHI. These findings may challenge existing notions of complete recovery after MHI.

This study aimed to investigate outcome in adults with mild traumatic brain injury (TBI) at 1 week and 3 months postinjury and to identify factors associated with persisting problems. A total of 84 adults with mild TBI were compared with 53 adults with other minor injuries as controls in terms of postconcussional symptomatology, behavior, and cognitive performance at 1 week and 3 months postinjury. At 1 week postinjury, adults with mild TBI were reporting symptoms, particularly headaches, dizziness, fatigue, visual disturbance, and memory difficulties. They exhibited slowing of information processing on neuropsychological measures, namely the WAIS–R Digit Symbol subtest and the Speed of Comprehension Test. By 3 months postinjury, the symptoms reported at 1 week had largely resolved, and no impairments were evident on neuropsychological measures. However, there was a subgroup of 24% of participants who were still suffering many symptoms, who were highly distressed, and whose lives were still significantly disrupted. These individuals did not have longer posttraumatic amnesia (PTA) duration. They were more likely to have a history of previous head injury, neurological or psychiatric problems, to be students, females, and to have been injured in a motor vehicle accident. The majority were showing significant levels of psychopathology. A range of factors, other than those directly reflecting the severity of injury, appear to be associated with outcome following mild TBI. (JINS, 2000, 6, 568–579.)

This article examines the evidence that the effect of head injury on young children may differ from that in adults, in that while in the latter the pattern is of deficits that recover with time since the accident, this is not necessarily the case with very young children. In this group, there may be no evidence of any deficit in the early days or weeks after injury, but the children may fail to develop some skills as quickly as children who have not had a head injury. Results from a series of studies of MHI in preschool children carried out over a more than 10-year period from Auckland Hospital and recently published studies of pediatric MHI from other groups are reviewed. It is concluded from a comparison of these data that there is a need for long-term prospective studies designed within a developmental framework to clarify the issue. (JINS, 1997, 3, 592–597.)