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Brain and Spinal Cord Injuries

7/10/2009
Michael G. Phelan
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New Emergency Room Diagnosis Guidelines for Mild Traumatic Brain Injury

The American College of Emergency Room Physicians (ACEP) in collaboration with the Centers for Disease Control and Prevention (CDC) revised the clinical diagnosis guidelines for mild traumatic brain injury (MTBI).  These guidelines are designed to improve patient outcomes for the more than one million people who visit emergency departments every year for mild traumatic brain injury.

"People with traumatic brain injuries may appear to be normal and their symptoms may be mild, but there can be hidden dangers," said Richard C. Hunt, MD, Director of the Division of Injury Response at the Centers for Disease Control and Prevention.  "TBI's can also lead to significant, life-long impairments that prevent a person's ability to function both physically and mentally.  These revised guidelines can help ensure that patients with even mild TBI's are identified early and receive the care they need."

The real incidence of traumatic brain injury (TBI) is unknown since many patients who sustain an injury never seek medical care. The majority of these injuries are classified as mild, meaning the patient is alert, oriented and functional when they are assessed in the emergency department. It is estimated that 10 percent of patients with a mild TBI have evidence of an intracranial injury on head computed tomography (CT), and that approximately one percent of patients with mild TBI harbor a life-threatening neurosurgical lesion. The challenge for the emergency physician is to identify which patients with a head injury have an acute traumatic intracranial injury, and which patients can be safely sent home.

ACEP and CDC recogize in the revised guidelines that MTBI results from direct trauma to the head or from an acceleration/deceleration stress to the brain, and that MTBI poses a risk for short-term difficulties with symptoms such as headache, difficulty with balance, thinking, concentrating and sleeping. Up to 80 percent of patients report some symptoms related to the injury at three months. If MTBI results in long-term problems, it is often referred to as post-concussive syndrome.

For more information on traumatic brain injury (TBI), visit CDC on the Web at: www.cdc.gov/Injury.




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