Concussions in Facial Trauma Patients: A Retrospective Study

Background: There is a paucity of literature regarding the incidence of concussions in facial trauma. Prompt identification of concussion is crucial for patient recovery. The purpose of this retrospective study is to evaluate the relationship between facial trauma and concussion symptoms. Methods: We evaluated 74 patients who presented to a facial trauma clinic at a Level 1 trauma center in British Columbia (2019-2021). Patients with facial trauma were evaluated according to injury type, epidemiological, and demographic characteristics in the context of symptoms indicating clinically significant concussions. Results: 95% of patients presenting to a facial trauma clinic at a Level 1 trauma center had a clinically significant concussion symptom that affects quality of life. This was stratified according to mild/moderate/severe concussions. Zygoma/zygomatic arch fractures had the highest mean concussion scores. Surgery cases with general anesthesia had worse mean concussion scores than no surgery or intervention under local anesthesia cases. Male patients were on average younger than female patients. Male patients had on average worse symptoms than female patients. The worst concussion score was for the 20 to 30 age range. Of any symptom, knowing the "irritable" symptom score was the biggest predictor of concussion score, followed by "anxiousness." The more subjective symptoms appear to be more powerful predictors of concussion scores. Conclusions: The severity of concussion scores increased significantly with fractures, particularly with zygoma/zygomatic arch fractures in facial trauma patients. Facial trauma is related to clinically significant concussion symptoms that affect quality of life.