Symptom Complaints Following Reports of Blast Versus Non-Blast Mild TBI: Does Mechanism of Injury Matter?

Patients with a reported history of mild traumatic brain injury (mild TBI) due to blast (n = 298) or non-blast (n = 92) mechanisms were asked to complete the Neurobehavioral Symptom Inventory (NSI) and the Post-traumatic Stress Disorder Checklist (PCL). Mechanism of injury did not account for a significant amount of variance in post-concussion symptom reporting overall, nor did severity of mild TBI (i.e., brief loss of consciousness versus only an alteration of consciousness). Symptom reporting was greater in those injured more than 1 month ago compared to those injured less than 1 month ago and in those reporting higher levels versus lower levels of PTSD symptoms. When examining specific symptoms, the only symptom that significantly varied between groups was hearing difficulty (with the blast-injured group reporting more severe difficulty with hearing). Findings suggest that greater symptom reporting is most strongly related to emotional distress.

[1]  Nicholas J. Pastorek,et al.  Postconcussive Symptoms After Blast and Nonblast-Related Mild Traumatic Brain Injuries in Afghanistan and Iraq War Veterans , 2010, Journal of the International Neuropsychological Society.

[2]  N. Elsayed,et al.  Toxicology of blast overpressure. , 1997, Toxicology.

[3]  Charles W Hoge,et al.  Mild traumatic brain injury in U.S. Soldiers returning from Iraq. , 2008, The New England journal of medicine.

[4]  Michael J. Hodgson,et al.  CURRENT CONCEPTS blast injuries , 2005 .

[5]  S. V. Van Dyke,et al.  The utility of the post-concussive symptom questionnaire. , 2010, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[6]  D. Hovda,et al.  Diffuse prolonged depression of cerebral oxidative metabolism following concussive brain injury in the rat: a cytochrome oxidase histochemistry study , 1991, Brain Research.

[7]  E. Blanchard,et al.  Psychometric properties of the PTSD Checklist (PCL). , 1996, Behaviour research and therapy.

[8]  L. Noble-Haeusslein,et al.  Traumatic Brain Injury: An Overview of Pathobiology with Emphasis on Military Populations , 2010, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[9]  J. Borg,et al.  Prognosis for mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. , 2004, Journal of rehabilitation medicine.

[10]  Elisa R Braver,et al.  Understanding sequelae of injury mechanisms and mild traumatic brain injury incurred during the conflicts in Iraq and Afghanistan: persistent postconcussive symptoms and posttraumatic stress disorder. , 2008, American journal of epidemiology.

[11]  Brian J Ivins,et al.  Traumatic Brain Injury, Posttraumatic Stress Disorder, and Postconcussive Symptom Reporting Among Troops Returning From Iraq , 2010, The Journal of head trauma rehabilitation.

[12]  Harvey S. Levin,et al.  Mild head injury classification. , 1990, Neurosurgery.

[13]  W. Anger,et al.  Subjective cognitive complaints, affective distress, and objective cognitive performance in Persian Gulf War veterans. , 1999, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[14]  Louis M French,et al.  Symptom complaints following combat-related traumatic brain injury: Relationship to traumatic brain injury severity and posttraumatic stress disorder , 2009, Journal of the International Neuropsychological Society.

[15]  Mary R. Newsome,et al.  Diffusion tensor imaging of mild to moderate blast-related traumatic brain injury and its sequelae. , 2010, Journal of neurotrauma.

[16]  G. Iverson,et al.  Neuropsychological functioning following complicated vs. uncomplicated mild traumatic brain injury , 2009, Brain injury.

[17]  L. Blackbourne,et al.  Posttraumatic stress disorder in combat casualties with burns sustaining primary blast and concussive injuries. , 2009, The Journal of trauma.

[18]  C. Hoge,et al.  Mild Traumatic Brain Injury (Concussion) During Combat: Lack of Association of Blast Mechanism With Persistent Postconcussive Symptoms , 2010, The Journal of head trauma rehabilitation.

[19]  R. Vanderploeg,et al.  Predictors of postconcussion symptom complex in community dwelling male veterans , 2003, Journal of the International Neuropsychological Society.

[20]  M. Ziejewski,et al.  Biomechanical Assessment of Brain Dynamic Responses Due to Blast Pressure Waves , 2010, Annals of Biomedical Engineering.

[21]  D. Warden,et al.  Traumatic Brain Injury Screening: Preliminary Findings in a US Army Brigade Combat Team , 2009, The Journal of head trauma rehabilitation.

[22]  A. Feinstein,et al.  The effect of major depression on subjective and objective cognitive deficits in mild to moderate traumatic brain injury. , 2006, The Journal of neuropsychiatry and clinical neurosciences.

[23]  Keith D. Cicerone,et al.  Persistent postconcussion syndrome: The structure of subjective complaints after mild traumatic brain injury , 1995 .

[24]  I Cernak,et al.  Cognitive deficits following blast injury-induced neurotrauma: possible involvement of nitric oxide. , 2001, Brain injury.

[25]  E. Ling,et al.  The response of neurons and microglia to blast injury in the rat brain , 1995, Neuropathology and applied neurobiology.

[26]  B. Giordani,et al.  Disability caused by minor head injury. , 1981, Neurosurgery.

[27]  Larry A Tupler,et al.  Cognitive sequelae of blast-related versus other mechanisms of brain trauma , 2009, Journal of the International Neuropsychological Society.

[28]  Robert J. Spencer,et al.  Self-reported cognitive symptoms following mild traumatic brain injury are poorly associated with neuropsychological performance in OIF/OEF veterans. , 2010, Journal of rehabilitation research and development.

[29]  Craig J Bryan,et al.  Comparison of Concussive Symptoms, Cognitive Performance, and Psychological Symptoms Between Acute Blast-Versus Nonblast-Induced Mild Traumatic Brain Injury , 2010, Journal of the International Neuropsychological Society.

[30]  Jeffrey D. Lewis,et al.  Posttraumatic stress symptoms in OIF/OEF service members with blast-related and non-blast-related mild TBI. , 2010, NeuroRehabilitation.

[31]  K. Taber,et al.  Blast-related traumatic brain injury: what is known? , 2006, The Journal of neuropsychiatry and clinical neurosciences.

[32]  Nina A. Sayer,et al.  Characteristics and rehabilitation outcomes among patients with blast and other injuries sustained during the Global War on Terror. , 2008, Archives of physical medicine and rehabilitation.

[33]  Nicholas J. Pastorek,et al.  Postconcussive symptoms in OEF-OIF veterans: factor structure and impact of posttraumatic stress. , 2009, Rehabilitation psychology.

[34]  John F Kragh,et al.  Combat wounds in operation Iraqi Freedom and operation Enduring Freedom. , 2008, The Journal of trauma.

[35]  Michael S. Xydakis,et al.  Tympanic-membrane perforation as a marker of concussive brain injury in Iraq. , 2007, The New England journal of medicine.

[36]  S. Marshall,et al.  Acute effects and recovery time following concussion in collegiate football players: the NCAA Concussion Study. , 2003, JAMA.

[37]  K. Cicerone,et al.  Definition of mild traumatic brain injury , 1993 .

[38]  Glenn Curtiss,et al.  Long-term morbidities following self-reported mild traumatic brain injury , 2007, Journal of clinical and experimental neuropsychology.

[39]  J. Attias,et al.  Otologic and Audiologic Lesions Due to Blast Injury , 2008, Journal of basic and clinical physiology and pharmacology.

[40]  Roberta F. White,et al.  Neuropsychological Performance in Gulf War Era Veterans: Neuropsychological Symptom Reporting , 2003 .

[41]  J. Lewine,et al.  Objective Documentation of Traumatic Brain Injury Subsequent to Mild Head Trauma: Multimodal Brain Imaging With MEG, SPECT, and MRI , 2007, The Journal of head trauma rehabilitation.