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Postconcussion Symptoms in Patients with Injury-Related Chronic Pain

DOI: 10.1155/2012/528265

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Abstract:

Background. Postconcussion symptoms (PCSs)—such as fatigue, headache, irritability, dizziness, and impaired memory—are commonly reported in patients who have mild traumatic brain injuries (MTBIs). Evaluation of PCS after MTBI is proposed to have a diagnostic value although it is unclear whether PCS are specific to MTBI. After whiplash injuries, patients most often complain of headaches and neck pain; the other PCS are not as closely evaluated. In patients with chronic pain because of other injuries, the presence of PCS is unclear. This study aimed to describe the frequency of PCS in patients with injury-related pain and to examine the relationships between PCS, pain, and psychological factors. Methods. This study collected data using questionnaires addressing PCS (Rivermead Postconcussion Questionnaire, RPQ), pain intensity (Visual Analogue Scale), depression, anxiety (Hospital, Anxiety, and Depression Scale), and posttraumatic stress (Impact of Event Scale). Results. Fatigue (90.7%), sleep disturbance (84.9%), headache (73.5%), poor concentration (88.2%), and poor memory (67.1%) were some of the most commonly reported PCS. Significant relationships were found between PCS and posttraumatic stress, depression, and anxiety. Conclusion. To optimize treatment, it is important to assess each patient’s PCS, the mechanism of injury, and factors such as posttraumatic stress and depression. 1. Introduction The great majority (80–90%) of traumatic brain injuries is classified as mild traumatic brain injury (MTBI)/concussion [1, 2]. These injuries are a matter for general concern because of their potential long-term consequences—persistent post-concussion symptoms (PCSs). PCS include headache, fatigue, dizziness, and impaired memory. These symptoms can affect both work and leisure time [3–5]. Although the natural course of recovery after MTBI consists of restitution of many symptoms within three months after injury [6], a significant number of persons report PCSs that last for many months to even years after injury. Evaluation of these symptoms after MTBI can have diagnostic value. For patients with longterm symptoms, a diagnosis of post-concussion syndrome is sometimes used. According to the ICD10 criteria, at least three symptoms, which may include headache, dizziness, fatigue, depression, irritability, difficulty in concentration, and memory problems, are required for a diagnosis of postconcussion syndrome [7]. The DSM IV criteria for postconcussion disorder include evidence of three or more of these symptoms present for at least three months combined with

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