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Minor traumatic brain injury: a primer for the orthopaedic surgeon
Abstract:
Minor traumatic brain injury (mTBI) is a major public health problem. The Centers for Disease Control and Prevention and the National Center for Injury Prevention and Control label it a "silent epidemic." Subtle signs and symptoms of mTBI, including headache, fatigue, and memory loss, are often seen in conjunction with musculoskeletal trauma. Although sometimes evident immediately, mTBI may not manifest until patients return to work and their personal lives. In the patient with acute concurrent mTBI, skeletal management must be based on either a period of observation to rule out evolving neurologic symptoms or, when warranted, the recommendations of a neurosurgeon. Such input is particularly important when mTBI is associated with a prolonged loss of consciousness or posttraumatic amnesia. In the outpatient setting, when concern for mTBI exists weeks after an injury, familiarity with and referral to locally available mTBI specialists and programs can facilitate proper care. Armed with this knowledge, the orthopaedic surgeon has an opportunity to positively influence outcomes and help provide crucial care that extends beyond the management of musculoskeletal injuries.
Insights
Minor traumatic brain injury (mTBI), a silent epidemic, presents subtle symptoms like headache and fatigue, often alongside musculoskeletal injuries. Early recognition and specialist referral are crucial for effective patient management and improved outcomes.
Area of Science:
- Neurology
- Public Health
- Orthopaedic Surgery
Background:
- Minor traumatic brain injury (mTBI) is a significant public health concern, often termed a "silent epidemic."
- mTBI symptoms such as headache, fatigue, and memory loss can co-occur with musculoskeletal trauma.
- Symptoms may not be immediately apparent, manifesting later in work or personal life.
Observation:
- Concurrent mTBI requires careful skeletal management, potentially involving observation or neurosurgical consultation.
- Prolonged loss of consciousness or posttraumatic amnesia necessitates neurosurgical input.
- In outpatient settings, recognizing mTBI weeks post-injury is vital.
Findings:
- Orthopaedic surgeons play a key role in identifying and managing mTBI.
- Referral to mTBI specialists and programs is essential for proper outpatient care.
- Early and appropriate intervention can positively influence patient outcomes.
Implications:
- Orthopaedic surgeons can extend their care beyond musculoskeletal injuries to address mTBI.
- Improved understanding of mTBI facilitates better patient outcomes.
- Integrated care approaches are beneficial for patients with concurrent injuries.
