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Traumatic Microbleeds in Mild Traumatic Brain Injury Are Not Associated with Delayed Return to Work or Persisting
Antti Huovinen1, Ivan Marinkovic1, Harri Isokuortti1
1Department of Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Abstract:
The main objective of this prospective cohort study was to evaluate whether traumatic microbleeds (TMBs) are a significant prognostic factor of return to work (RTW), post-traumatic symptoms, and overall recovery in patients with mild traumatic brain injury (mTBI). One hundred and thirteen patients with mTBI were recruited from the Helsinki University Hospital emergency units. All patients underwent multi-contrast 3T magnetic resonance imaging (MRI) 3-17 days after mTBI. Patients were evaluated in the Traumatic Brain Injury Outpatient Clinic of Helsinki University Hospital 1 month after injury. Post-concussion symptoms were assessed with the Post-Concussion Symptom Questionnaire (RPQ) and overall recovery was assessed with the Glasgow Outcome Scale Extended (GOS-E). Their time to RTW was continuously measured up to 1 year after TBI. Median RTW was 9 days (interquartile range [IQR] 4-30) after mTBI and full RTW rate after 1 year was 98%. Patients with TMBs (n = 22) did not have more post-concussion symptoms (median RPQ 10.0 vs. 7.0, p = 0.217) or worse overall recovery (58% vs. 56% with GOS-E = 8, p = 0.853) than patients without TMBs (n = 91). There was no significant difference in time to RTW (13.5 vs. 7.0 days, p = 0.063). In this study, patients with TMBs did not have delayed RTW or more post-concussion symptoms than other patients with mTBI. TMBs in mTBI do not seem to be a significant prognostic factor of RTW.
Insights
Traumatic microbleeds (TMBs) in mild traumatic brain injury (mTBI) do not predict delayed return to work or increased post-concussion symptoms. This finding suggests TMBs are not a significant prognostic factor for mTBI recovery.
Area of Science:
- Neuroscience
- Radiology
- Clinical Neurology
Background:
- Mild traumatic brain injury (mTBI) is a common condition with varied recovery trajectories.
- Traumatic microbleeds (TMBs) are often detected via MRI after head injury.
- The prognostic significance of TMBs in mTBI remains incompletely understood.
Purpose of the Study:
- To investigate if traumatic microbleeds (TMBs) are a significant prognostic factor for return to work (RTW), post-traumatic symptoms, and overall recovery in patients with mild traumatic brain injury (mTBI).
Main Methods:
- Prospective cohort study of 113 mTBI patients.
- Multi-contrast 3T MRI performed 3-17 days post-injury.
- Assessment of post-concussion symptoms (RPQ) and overall recovery (GOS-E) at 1 month.
- Continuous measurement of time to RTW up to 1 year.
Main Results:
- Median RTW was 9 days; 98% achieved full RTW within 1 year.
- Patients with TMBs (n=22) showed no significant difference in post-concussion symptoms (RPQ scores) compared to those without TMBs (n=91).
- No significant differences were observed in overall recovery (GOS-E) or time to RTW between groups with and without TMBs.
Conclusions:
- Traumatic microbleeds (TMBs) detected by MRI do not appear to be a significant prognostic factor for delayed return to work or increased symptom burden in patients with mild traumatic brain injury (mTBI).
- These findings suggest TMBs may not negatively impact short-term recovery outcomes following mTBI.
