PubMed · 7887348
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J W McNabb. 1995. Head concussion guidelines.. https://pubmed.ncbi.nlm.nih.gov/7887348/
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The term 'concussion' has been applied to head injuries of varying severity. Most studies have examined subjects suffering concussion of a severity requiring hospital observation, usually as a consequence of motor vehicle accidents. Milder concussive injuries such as those resulting from contact sport are often not reported in hospital-based studies. In this study, subjects with mild concussive injuries were studied with the aim of determining if neuropsychological sequelae are detectable. The subjects received their injuries while playing Australian Rules Football. Baseline (pre-injury) measures on the Paced Auditory Serial Addition Test (PASAT), Digit Symbol Substitution Test (DSST) and Four-Choice Reaction time, involving measures of decision time (DT) and movement time (MT), were obtained in a sample of 130 players. Ten players subsequently concussed were re-tested at 5 days post-injury. A control group of age-matched umpires were assessed on two corresponding occasions. Analyses of covariance showed poorer performances following concussion on the DSST and DT measures. The results suggested that neuropsychological deficits are detectable after resolution of neurological symptoms in the early stages following mild concussive injury.
OBJECTIVE: The authors evaluated the impact of financial incentives on disability, symptoms, and objective findings after closed-head injury. METHOD: Meta-analysis was used to review the literature. Seventeen reports, covering 18 study groups and a total of 2,353 subjects, contained data from which effect sizes could be calculated. Effect sizes were aggregated after weighting for group size. After discussion, there was 100% agreement between the authors on all calculations. RESULTS: A moderate overall effect size, 0.47, was found. The effect was particularly strong for mild head trauma. The data showed more abnormality and disability in patients with financial incentives despite less severe injuries. CONCLUSIONS: Clinical evaluation of patients after closed-head injury, particularly mild head trauma, must include consideration of the effect of financial incentives on symptoms and disability.
The history of the identification of the so-called (fronto-)temporal lobe contusion is reviewed. Treatment of minor head injuries actually starts with the right diagnosis. Injuries of the temporal lobe, characterized by a comparatively long period of post-traumatic amnesia should be distinguished from minor head injuries (cerebral concussion). Treatment of minor head injuries should include good information and explanation of the medical aspects of minor head injuries to prevent the so called post-concussional syndrome, with long lasting sequelae. Changes of neurotransmitter metabolism in various kinds of head injuries have been known for many years. Treatment with precursors of neurotransmitters (particularly physostigmine and L-DOPA) can be useful in unconsciousness and amnestic syndromes.