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Identifying mild traumatic brain injury in the post-acute polytrauma setting: a scoping review of diagnostic
Matthew J Burke1,2, Yomna E Ahmed3, Zoe Li3
1Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Objective:
Mild traumatic brain injury (mTBI) is frequently overlooked in polytrauma patients due to the overshadowing of more severe injuries, a fact that makes its identification in post-acute settings challenging since symptoms overlap with other conditions and no validated diagnostic tools exist. To address this gap, this scoping review explored the literature on mTBI diagnosis in post-acute civilian polytrauma settings.
Methods:
By utilizing the Arksey and O'Malley framework and PRISMA-ScR guidelines, the review focused on studies from 2010 to 2024 related to delayed mTBI diagnosis in adults. Of the 696 studies identified, only six met the inclusion criteria, highlighting the limited research in this area.
Results:
The review assessed various diagnostic tools including the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), neuropsychological tests, advanced imaging, and oculomotor assessments. However, these tools are limited in their ability to confirm whether an mTBI has occurred. The American Congress of Rehabilitation Medicine's updated mTBI criteria may offer the best diagnostic potential but require validation.
Conclusion:
According to the findings, there is a significant gap in validated diagnostic tools for mTBI in post-acute settings, which may negatively affect patient outcomes. Developing and validating effective screening tools for mTBI in the post-acute polytrauma setting should be the priority of future research in this area.
Insights
Diagnosing mild traumatic brain injury (mTBI) in polytrauma patients is difficult due to overlapping symptoms and a lack of validated tools. Future research must prioritize developing effective screening methods for better patient outcomes.
Area of Science:
- Neuroscience
- Trauma Care
- Diagnostic Medicine
Background:
- Mild traumatic brain injury (mTBI) is often missed in polytrauma patients due to more severe injuries.
- mTBI symptoms overlap with other conditions, complicating diagnosis in post-acute settings.
- Currently, no validated diagnostic tools exist for mTBI in this population.
Purpose of the Study:
- To conduct a scoping review of the literature on mTBI diagnosis in post-acute civilian polytrauma settings.
- To identify existing diagnostic tools and assess their limitations.
- To highlight the research gap in this critical area.
Main Methods:
- Utilized the Arksey and O'Malley framework and PRISMA-ScR guidelines.
- Focused on studies published between 2010 and 2024 concerning delayed mTBI diagnosis in adults.
- Screened 696 identified studies, with only six meeting inclusion criteria.
Main Results:
- Reviewed diagnostic tools including the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), neuropsychological tests, advanced imaging, and oculomotor assessments.
- Found existing tools have limited ability to confirm mTBI occurrence.
- The American Congress of Rehabilitation Medicine's updated mTBI criteria show potential but require validation.
Conclusions:
- A significant gap exists in validated diagnostic tools for mTBI in post-acute settings.
- This diagnostic gap may negatively impact patient outcomes.
- Prioritizing the development and validation of effective mTBI screening tools for post-acute polytrauma is crucial for future research.
