Faculty Collaboration Database

Identifying neurocognitive deficits in adolescents following concussion. Acad Emerg Med 2011 Mar;18(3):246-54

Date

03/16/2011

Pubmed ID

21401786

Pubmed Central ID

PMC3076718

DOI

10.1111/j.1553-2712.2011.01015.x

Scopus ID

2-s2.0-79952716001 (requires institutional sign-in at Scopus site)   39 Citations

Abstract

OBJECTIVES: This study of concussed adolescents sought to determine if a computer-based neurocognitive assessment (Immediate Postconcussion Assessment and Cognitive Test [ImPACT]) performed on patients who present to the emergency department (ED) immediately following head injury would correlate with assessments performed 3 to 10 days postinjury and if ED neurocognitive testing would detect differences in concussion severity that clinical grading scales could not.

METHODS: A prospective cohort sample of patients 11 to 17 years of age presenting to the ED within 12 hours of a head injury were evaluated using two traditional concussion grading scales and neurocognitive testing. ED neurocognitive scores were compared to follow-up scores obtained at least 3 days postinjury. Postconcussive symptoms, outcomes, and complications were assessed via telephone follow-up for all subjects.

RESULTS: Sixty patients completed phone follow-up. Thirty-six patients (60%) completed follow-up testing a median of 6 days postinjury. Traditional concussion grading did not correlate with neurocognitive deficits detected in the ED or at follow-up. For the neurocognitive domains of verbal memory, processing speed, and reaction time, there was a significant correlation between ED and follow-up scores trending toward clinical improvement. By 2 weeks postinjury, 23 patients (41%) had not returned to normal activity. At 6 weeks, six patients (10%) still had not returned to normal activity.

CONCLUSIONS: Immediate assessment in the ED can predict neurocognitive deficits seen in follow-up and may be potentially useful to individualize management or test therapeutic interventions. Neurocognitive assessment in the ED detected deficits that clinical grading could not and correlated with deficits at follow-up.

Author List

Thomas DG, Collins MW, Saladino RA, Frank V, Raab J, Zuckerbraun NS

Author

Danny G. Thomas MD, MPH Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Analysis of Variance
Brain Concussion
Child
Cognition Disorders
Emergency Service, Hospital
Female
Follow-Up Studies
Glasgow Coma Scale
Humans
Male
Neuropsychological Tests
Predictive Value of Tests
Prospective Studies
Recovery of Function
Severity of Illness Index