Uraz głowy i wstrząśnienie mózgu
Epidemiologia

Urazy głowy, w tym łagodne urazy traumatyczne mózgu (mTBI) i wstrząśnienia mózgu, stanowią istotny problem zdrowia publicznego o globalnym zasięgu, z około 42 milionami przypadków mTBI rocznie na świecie. Częstość występowania TBI wynosi około 939/100 000 osób, co przekłada się na 5,48 miliona ciężkich TBI rocznie. W USA w 2014 roku odnotowano 2,87 miliona wizyt związanych z TBI, jednak dane te mogą być zaniżone z powodu niezgłaszania łagodnych urazów. Szczególnie narażone są grupy młodych osób (15-30 lat), mężczyźni oraz dzieci i młodzież, u których 12-miesięczna częstość wstrząśnień wynosi do 12%, a wśród dzieci związanych ze sportem 7-15%. Najczęstsze przyczyny to wypadki komunikacyjne, upadki oraz urazy sportowe, z istotnym udziałem broni palnej w grupie 25-34 lat. Wstrząśnienia mózgu wiążą się z wysokimi kosztami ekonomicznymi (w USA 76,5 mld USD w 2010 r.) oraz znacznym obciążeniem systemu opieki zdrowotnej, z ponad 214 tysiącami hospitalizacji i 69 tysiącami zgonów rocznie.

  1. Epidemiologia urazów głowy i wstrząśnień mózgu
    1. Statystyki dotyczące występowania wstrząśnień mózgu
    2. Czynniki ryzyka i grupy szczególnie narażone
    3. Najczęstsze przyczyny urazów głowy i wstrząśnień mózgu
  2. Nadzór i monitorowanie urazów głowy
    1. Krajowe systemy nadzoru nad wstrząśnieniami mózgu
    2. Wyzwania związane z monitorowaniem wstrząśnień mózgu
    3. Znaczenie danych epidemiologicznych dla zdrowia publicznego
  3. Koszty społeczne i ekonomiczne
    1. Wpływ na system opieki zdrowotnej
    2. Wpływ na edukację i rozwój dzieci
  4. Inicjatywy w zakresie zapobiegania i polityki publicznej
    1. Programy zapobiegania wstrząśnieniom mózgu
    2. Polityka powrotu do gry i powrotu do nauki
    3. Zmiany w przepisach sportowych
  5. Wyzwania i perspektywy w nadzorze nad wstrząśnieniami mózgu
    1. Potrzeba standaryzacji metod zbierania danych
    2. Potrzeba dalszych badań epidemiologicznych
    3. Wyzwania w rozpoznawaniu i leczeniu wstrząśnień mózgu
    4. Kolejne rozdziały

Epidemiologia urazów głowy i wstrząśnień mózgu

Uraz głowy i wstrząśnienie mózgu stanowią poważny problem zdrowia publicznego o globalnym zasięgu. Według Światowej Organizacji Zdrowia (WHO), co roku na świecie dochodzi do około 42 milionów przypadków łagodnych urazów traumatycznych mózgu (mTBI), wśród których przeważającą większość stanowią wstrząśnienia mózgu 12. Szacuje się, że globalna częstość występowania urazów traumatycznych mózgu (TBI) wynosi około 939 przypadków na 100 000 osób, co przekłada się na około 5,48 miliona osób rocznie doświadczających ciężkich TBI 34.

W Stanach Zjednoczonych, według Centrów Kontroli i Zapobiegania Chorobom (CDC), w 2014 roku odnotowano około 2,87 miliona wizyt w oddziałach ratunkowych, hospitalizacji i zgonów związanych z TBI 5. Wskaźniki te prawdopodobnie zaniżają rzeczywistą skalę problemu, ponieważ wiele osób z łagodnymi urazami głowy nie zgłasza się po pomoc medyczną. Szacuje się, że co najmniej 25% osób z mTBI nie otrzymuje oceny stanu zdrowia przez personel medyczny 6.

Statystyki dotyczące występowania wstrząśnień mózgu

Przeprowadzone przez CDC badania pilotażowe dotyczące Krajowego Systemu Nadzoru nad Wstrząśnieniami Mózgu (National Concussion Surveillance System, NCSS) wykazały, że 12-miesięczna częstość występowania wstrząśnień/TBI wśród dorosłych waha się od 2% do 12%, natomiast częstość występowania w ciągu całego życia wynosi od 19% do 29% 78. W przypadku dzieci i młodzieży, 12-miesięczna częstość występowania wstrząśnień/TBI wynosi około 10%, a częstość występowania związana ze sportem i rekreacją waha się od 7% do 15% 9.

Według CDC, około 6,8% dzieci w wieku do 17 lat doświadczyło objawów wstrząśnienia mózgu lub urazu mózgu w pewnym momencie swojego życia, a 3,9% dzieci w tej grupie wiekowej otrzymało formalną diagnozę wstrząśnienia mózgu lub urazu mózgu od pracownika służby zdrowia 10. Badania wskazują również, że częstość występowania wstrząśnień mózgu jest wyższa wśród chłopców (4,7%) i dzieci rasy białej nie-latynoskiej (5,2%) w porównaniu do ich rówieśników 11.

W Kanadzie szacuje się, że każdego roku dochodzi do około 200 000 wstrząśnień mózgu, a dzieci i młodzież stanowią główną grupę dotkniętą tym problemem 12. Badanie przeprowadzone w 2019 roku wykazało, że około 1,6% Kanadyjczyków w wieku 12 lat i starszych zgłosiło co najmniej jedno wstrząśnienie mózgu 13.

Czynniki ryzyka i grupy szczególnie narażone

Istnieją określone grupy demograficzne, które są szczególnie narażone na ryzyko wstrząśnień mózgu. Młodzi ludzie, zwłaszcza w wieku 15-30 lat, stanowią grupę najwyższego ryzyka 14. Najwyższy wskaźnik śmiertelności związanej z TBI (32,8 przypadków na 100 000 osób) występuje wśród osób w wieku 15-24 lat 15.

Mężczyźni są około dwukrotnie bardziej narażeni na doznanie TBI niż kobiety 1617. Jednak w przypadku porównywalnych dyscyplin sportowych, u kobiet występuje 1,5 do 2,1 razy większe ryzyko wstrząśnienia mózgu niż u ich męskich rówieśników 18. Badanie przeprowadzone na dużej grupie uczniów szkół średnich wykazało, że dziewczęta miały konsekwentnie wyższe wskaźniki wstrząśnienia mózgu w porównaniu do chłopców w takich sportach jak baseball/softball, koszykówka i piłka nożna 19.

Wcześniejsze wstrząśnienie mózgu jest jednym z najsilniejszych czynników prognostycznych zwiększonego ryzyka kolejnego wstrząśnienia. Osoby, które doświadczyły wstrząśnienia mózgu, mają 1,98 (95% CI: 1,65-2,37) razy większe ryzyko wystąpienia każdego kolejnego wstrząśnienia, a wartość ta jest względnie stabilna we wszystkich okolicznościach urazów (OR: 1,73 do 2,01) 20.

Status społeczno-ekonomiczny również wpływa na ryzyko urazu głowy. Badanie przeprowadzone w Wielkiej Brytanii wykazało istotny związek między urazami głowy a deprywacją społeczną: 39,7/100 000 (95% CI 37,0 do 42,6) w najniższym pierwszym kwintylu deprywacji w porównaniu do 55,1 (95% CI 52,1 do 58,2) w najbardziej dotkniętym piątym kwintylu (p<0,01) 21.

Najczęstsze przyczyny urazów głowy i wstrząśnień mózgu

Przyczyny urazów głowy i wstrząśnień mózgu różnią się w zależności od wieku i innych czynników demograficznych. Do najczęstszych przyczyn należą:

  • Wypadki komunikacyjne – są wiodącą przyczyną TBI w populacji ogólnej, szczególnie wśród osób rasy białej w Stanach Zjednoczonych 22.
  • Upadki – stanowią drugą najczęstszą przyczynę TBI i są szczególnie powszechne wśród osób starszych oraz małych dzieci 2324.
  • Urazy związane ze sportem i rekreacją – odpowiadają za około 21% wszystkich urazów traumatycznych mózgu wśród amerykańskich dzieci i młodzieży 25. Szacuje się, że do 5% wszystkich urazów sportowych stanowią wstrząśnienia mózgu 26.
  • Broń palna – stanowi trzecią najczęstszą przyczynę TBI (12% wszystkich TBI) i jest wiodącą przyczyną TBI wśród osób w wieku 25-34 lat 27.

W przypadku dzieci, do najczęstszych przyczyn wstrząśnień mózgu należą upadki (51%) i aktywność sportowa (25%) 28. Badanie przeprowadzone wśród 1 233 dzieci w wieku szkolnym wykazało, że najczęstszym mechanizmem urazu były upadki (64,6%), a 22,5% dzieci miało objawy wstrząśnienia mózgu 29.

Nadzór i monitorowanie urazów głowy

Tradycyjne metody nadzoru nad urazami traumatycznymi mózgu (TBI) w Stanach Zjednoczonych opierały się głównie na zbiorach danych szpitalnych. Jednak te metody zaniżają rzeczywistą liczbę TBI, ponieważ nie uwzględniają przypadków leczonych w warunkach ambulatoryjnych oraz tych, które pozostają nieleczone i niezdiagnozowane 3031.

W odpowiedzi na te ograniczenia, CDC opracowało Krajowy System Nadzoru nad Wstrząśnieniami Mózgu (National Concussion Surveillance System, NCSS), który wykorzystuje ankiety telefoniczne z losowym wybieraniem numerów do zbierania informacji na temat wstrząśnień mózgu i innych TBI 32. System ten jest zaprojektowany tak, aby dokładnie określić, ile osób w Stanach Zjednoczonych (zarówno dzieci, jak i dorosłych) doznaje wstrząśnienia mózgu każdego roku oraz ustalić przyczyny 33.

Krajowe systemy nadzoru nad wstrząśnieniami mózgu

NCSS został zaprojektowany jako nowoczesny system zbierania danych, który ma na celu uzyskanie informacji o liczbie Amerykanów (dzieci i dorosłych) doznających wstrząśnienia mózgu każdego roku oraz o głównych przyczynach tych urazów 34. Wyniki pilotażu NCSS pomagają dopracować plany pełnowymiarowego systemu nadzoru 35.

Pełnowymiarowy NCSS będzie w stanie:

  • Stworzyć po raz pierwszy prawdziwe krajowe szacunki dotyczące liczby osób żyjących z niepełnosprawnością spowodowaną urazem mózgu 36.
  • Dostarczyć pierwsze krajowe szacunki dotyczące wstrząśnień mózgu związanych ze sportem wśród młodzieży, które występują zarówno w ramach zorganizowanych zajęć sportowych, jak i poza nimi 37.
  • Dostarczyć informacji o najczęstszych przyczynach wstrząśnień mózgu, w tym wypadkach samochodowych, upadkach i samookaleczeniach 38.
  • Monitorować trendy, aby zrozumieć, czy liczba wstrząśnień mózgu rośnie czy maleje, oraz ocenić, czy działania prewencyjne są skuteczne 39.
  • Dostarczyć pracownikom służby zdrowia i szpitalom informacji o tym, gdzie pacjenci szukają pomocy w przypadku wstrząśnienia mózgu i jakie są ich potrzeby w zakresie powrotu do zdrowia 40.

W wojsku amerykańskim, Centrum Doskonałości ds. Urazów Traumatycznych Mózgu (TBICoE) jest odpowiedzialne za śledzenie danych dotyczących TBI w siłach zbrojnych USA 41. TBICoE zostało oficjalnie wyznaczone jako odpowiedzialne za tworzenie i utrzymywanie bazy danych nadzoru nad TBI 42.

Wyzwania związane z monitorowaniem wstrząśnień mózgu

Monitorowanie wstrząśnień mózgu napotyka na szereg wyzwań, które wpływają na dokładność danych epidemiologicznych. Jednym z głównych problemów jest niedostateczne zgłaszanie urazów. Szacuje się, że wiele wstrząśnień mózgu nie jest zgłaszanych ze względu na ich rzekomo łagodny charakter; łagodne wstrząśnienia mogą pozostać niezauważone przez kolegów z drużyny, trenerów, a nawet samych sportowców 43. Strach przed dyskwalifikacją medyczną może również prowadzić do zaniżonej liczby zgłoszeń 44.

Innym wyzwaniem jest brak spójnej definicji i klasyfikacji TBI, co utrudnia dokładne opisanie epidemiologii 45. Badania wykazały, że sposób formułowania pytań i używana terminologia mogą znacząco wpływać na obserwowane szacunki 4647.

Ponadto, tradycyjne metody nadzoru oparte na danych z opieki zdrowotnej nie uwzględniają wstrząśnień mózgu, które są leczone poza szpitalami, co prowadzi do zaniżenia rzeczywistej liczby przypadków 48. Nawet w porównaniu do najniższych 12-miesięcznych szacunków TBI (2%), nadzór oparty na opiece zdrowotnej prawdopodobnie pomija dużą część osób z podejrzeniem TBI 49.

Znaczenie danych epidemiologicznych dla zdrowia publicznego

Dokładne dane epidemiologiczne dotyczące urazów głowy i wstrząśnień mózgu mają kluczowe znaczenie dla zdrowia publicznego. Bieżące monitorowanie wstrząśnień mózgu wśród populacji krajowej jest ważnym działaniem w zakresie nadzoru nad urazami, ponieważ może pomóc ocenić skuteczność interwencji zapobiegawczych i lepiej zrozumieć luki w wiedzy oraz obciążenie związane z tym urazem 50.

Dane epidemiologiczne mogą również informować liderów społeczności i stanów o faktycznym obciążeniu związanym z wstrząśnieniami mózgu, co umożliwia im opracowywanie ukierunkowanych strategii zapobiegania 51. Ponadto, dane te mogą pomóc pracownikom służby zdrowia i szpitalom zrozumieć, gdzie pacjenci szukają pomocy w przypadku wstrząśnienia mózgu i jakie są ich potrzeby w zakresie powrotu do zdrowia 52.

Dane z badań epidemiologicznych dotyczących wstrząśnień mózgu mogą również pomóc zrozumieć potencjalny wpływ interwencji mających na celu zapobieganie lub zmniejszanie liczby wstrząśnień mózgu związanych ze sportem 53. Na przykład, zrozumienie epidemiologii wstrząśnień mózgu wśród młodzieży i sportowców jest niezbędne do opracowania skutecznych, ukierunkowanych inicjatyw prewencji pierwotnej w tej populacji 54.

Koszty społeczne i ekonomiczne

Urazy głowy i wstrząśnienia mózgu wiążą się z ogromnymi kosztami społecznymi i ekonomicznymi. W 2010 roku ekonomiczne skutki TBI w Stanach Zjednoczonych szacowano na 76,5 miliarda dolarów w kosztach bezpośrednich i pośrednich 55. Szacuje się, że niepełnosprawność wynikająca z wstrząśnienia mózgu kosztuje USA prawie 17 miliardów dolarów rocznie 56.

W Connecticut, w latach 2007-2013, odnotowano 22 047 hospitalizacji związanych z TBI i około 40 096 wizyt w oddziałach ratunkowych. Koszty związane z oddziałami ratunkowymi wyniosły ponad 138 milionów dolarów 57.

Wpływ na system opieki zdrowotnej

Urazy głowy i wstrząśnienia mózgu mają znaczący wpływ na system opieki zdrowotnej. W 2020 roku w Stanach Zjednoczonych było około 214 110 hospitalizacji związanych z TBI, a w 2021 roku odnotowano 69 473 zgony związane z TBI. Oznacza to ponad 586 hospitalizacji i 190 zgonów dziennie związanych z TBI 58.

Osoby w wieku 75 lat i starsze miały najwyższą liczbę i wskaźniki hospitalizacji i zgonów związanych z TBI. Ta grupa wiekowa stanowi około 32% hospitalizacji i 28% zgonów związanych z TBI 59. Mężczyźni byli prawie dwukrotnie bardziej narażeni na hospitalizację i trzykrotnie bardziej narażeni na śmierć z powodu TBI niż kobiety 60.

Pacjenci z obszarów wiejskich napotykają na unikalne wyzwania w dostępie do opieki po wstrząśnieniu mózgu. Bariery obejmują niższy status społeczno-ekonomiczny, większe odległości do regionalnych centrów medycznych oraz zmniejszoną dostępność do diagnostyki obrazowej i konsultacji 6162.

Wpływ na edukację i rozwój dzieci

Wstrząśnienia mózgu mogą mieć długoterminowy wpływ na edukację i rozwój dzieci. Badanie przeprowadzone w Finlandii, które objęło ponad 24 000 dzieci, wykazało, że dzieci z urazami głowy były mniej skłonne do kontynuowania edukacji na poziomie wyższym niż te z urazami ortopedycznymi 63. Nawet dzieci, które doświadczyły tylko wstrząśnienia mózgu, były znacznie mniej skłonne do kontynuowania edukacji na wyższym poziomie 64.

Im poważniejszy był uraz mózgu, tym większy był spadek osiągnięć edukacyjnych 65. Sugeruje to, że wczesne urazy mogą zmienić ścieżkę, którą dziecko podąża – zarówno akademicką, jak i poza nią 66.

W Connecticut, w roku szkolnym 2023-2024, 1 880 uczennic i 2 340 uczniów zostało zdiagnozowanych z wstrząśnieniem mózgu. Siedemdziesiąt dwa procent (3 133 z 4 220 uczniów z wstrząśnieniem mózgu) opuściło dni szkolne z powodu tych urazów 67.

Inicjatywy w zakresie zapobiegania i polityki publicznej

W odpowiedzi na rosnące zrozumienie obciążenia związanego z urazami głowy i wstrząśnieniami mózgu, wiele krajów i stanów wdrożyło inicjatywy mające na celu zapobieganie tym urazom i łagodzenie ich skutków.

Programy zapobiegania wstrząśnieniom mózgu

CDC opracowało kampanię HEADS UP, która dostarcza materiałów edukacyjnych na temat wstrząśnień mózgu dla trenerów sportów młodzieżowych, trenerów szkolnych, rodziców, sportowców oraz pracowników szkół i służby zdrowia 68. Kampania ta ma na celu zwiększenie świadomości, wspieranie rozpoznawania i reagowania na wstrząśnienia mózgu oraz zapobieganie kumulacyjnym i przewlekłym urazom mózgu 69.

Rodzice, trenerzy i sportowcy mają do odegrania rolę w zapobieganiu wstrząśnieniom mózgu 70. CDC oferuje bezpłatne szkolenie online dla każdego, kto chce dowiedzieć się więcej: HEADS UP to Youth Sports 71. Przed pierwszym treningiem, trenerzy i urzędnicy szkolni powinni rozmawiać z rodzicami i sportowcami o zagrożeniach związanych z wstrząśnieniami mózgu i potencjalnych długoterminowych konsekwencjach 72.

Polityka powrotu do gry i powrotu do nauki

Wiele stanów w USA przyjęło ustawy dotyczące wstrząśnień mózgu w sporcie, które koncentrują się na zapobieganiu, rozpoznawaniu i reagowaniu na te urazy. Na przykład, Ustawa Publiczna 099-0245 w Illinois koncentruje się przede wszystkim na zarządzaniu wstrząśnieniami mózgu na poziomie szkoły średniej/gimnazjum i szkoły średniej 73. Ustawa ta wymaga, aby każda rada szkolna w stanie Illinois przyjęła politykę dotyczącą wstrząśnień mózgu i urazów głowy u uczniów-sportowców, która jest zgodna z protokołami, politykami i przepisami opracowanymi przez Illinois High School Association 74.

W Georgii, ustawa Return-To-Play została uchwalona w 2013 roku i weszła w życie 1 stycznia 2014 roku 75. Ustawa ta, mająca na celu ochronę młodzieży stanu przed urazami związanymi z wstrząśnieniami mózgu, wymaga, aby przy rejestracji do młodzieżowej aktywności sportowej dostarczyć wszystkim młodym sportowcom oraz ich rodzicom lub opiekunom prawnym arkusz informacyjny, który informuje ich o charakterze i ryzyku wstrząśnienia mózgu i urazu głowy 76.

W Pensylwanii, Rada Doradcza ds. Urazów Mózgu (BI) Departamentu Zdrowia Pensylwanii została utworzona w sierpniu 2001 roku przez Sekretarza Zdrowia jako wymóg Federalnego Grantu Planowania TBI Administracji Zasobów i Usług Zdrowotnych oraz Federalnej Ustawy o Urazach Traumatycznych Mózgu z 1996 roku 77. Rada odgrywa integralną rolę w formułowaniu zaleceń dotyczących przyszłych działań, które mają być uwzględnione w Planie Działania Stanu BI, tym samym poprawiając dostęp do usług BI w Pensylwanii poprzez informacje i edukację 78.

Zmiany w przepisach sportowych

Zmiany w przepisach sportowych, szczególnie w sportach z wysokim ryzykiem wstrząśnień mózgu, są ważną strategią prewencyjną. Na przykład, zmiany w polityce dotyczącej bodycheck’ingu (atakowania ciałem) wdrożone przez Hockey Canada i USA Hockey stworzyły okazję do prospektywnego zbadania wpływu reformy na wskaźniki urazów 79. Analiza danych dotyczących urazów u kanadyjskich graczy hokeja Pee Wee (poniżej 13 roku życia), zarówno przed, jak i po zmianie przepisów dotyczących bodycheck’ingu, wykazała 50% względną redukcję wskaźnika urazów i 64% redukcję wskaźnika wstrząśnień mózgu 80.

Współczynniki urazów i wstrząśnień mózgu okazały się być trzykrotnie wyższe wśród niebędących elitą graczy hokeja na lodzie Pee Wee w ligach, gdzie bodycheck’ing jest dozwolony, w porównaniu z ligami, gdzie bodycheck’ing jest zabroniony 81. Zbadano również koszty opieki zdrowotnej, z szacowanym 2,5-krotnym zmniejszeniem kosztów zdrowotnych w ligach, gdzie bodycheck’ing jest niedozwolony wśród 11-12-latków 82.

Zmiana polityki, egzekwowanie przepisów i edukacja są najlepszymi strategiami opartymi na dowodach w zapobieganiu urazom głowy 83.

Wyzwania i perspektywy w nadzorze nad wstrząśnieniami mózgu

Mimo postępów w zrozumieniu i monitorowaniu urazów głowy i wstrząśnień mózgu, nadal istnieją znaczące wyzwania i potrzeby w zakresie badań.

Potrzeba standaryzacji metod zbierania danych

Istnieje potrzeba optymalizacji i standaryzacji podejść do zbierania danych, aby zapewnić spójny pomiar we wszystkich środowiskach i populacjach 84. Analiza różnych badań wykazała, że sposób zadawania pytań i używana terminologia mogą znacząco wpływać na obserwowane szacunki 85.

CDC opracowało stopniowaną definicję przypadku dla samo-zgłaszanych TBI, która ma być stosowana do celów nadzoru 86. Definicja ta opiera się na rodzaju zgłaszanych objawów/oznak, liczbie zgłaszanych objawów oraz czasie wystąpienia objawów 87.

Przyszłe badania mogą koncentrować się na dopracowaniu treści i sformułowań pytań dotyczących TBI w ankietach na podstawie wyników tego podsumowania 88. Badania ankietowe oparte na samo-zgłaszanych urazach wykazały, że są skutecznym sposobem uzyskiwania informacji o trudnych do zidentyfikowania schorzeniach, w tym TBI 89.

Potrzeba dalszych badań epidemiologicznych

Istnieje potrzeba dalszych badań epidemiologicznych w celu lepszego zrozumienia prawdziwego obciążenia związanego z urazami głowy i wstrząśnieniami mózgu. Badanie przeprowadzone w Kanadzie wykazało, że istotne prace epidemiologiczne dotyczące wstrząśnień mózgu zostały przeprowadzone w ostatnich latach, podkreślając skalę tego urazu w określonych regionach 90. Jednak w szacunkach z tych badań nie są uwzględnione przypadki, w których po wstrząśnieniu mózgu nie szuka się opieki medycznej, co prawdopodobnie zaniża częstość występowania tego urazu 91.

Lepsza kwantyfikacja ekspozycji na mTBI, a także prospektywne, długoterminowe badania wyników i czynników ryzyka będą miały kluczowe znaczenie dla wyjaśnienia rzeczywistego obciążenia chorobami neurodegeneracyjnymi, w tym przewlekłą encefalopatią pourazową (CTE), wśród sportowców, personelu wojskowego i cywilów narażonych na pojedyncze lub powtarzające się mTBI 92.

Wyzwania w rozpoznawaniu i leczeniu wstrząśnień mózgu

Wstrząśnienia mózgu pozostają wyzwaniem diagnostycznym i terapeutycznym. Mimo że nasze zrozumienie urazów wstrząśnieniowych ewoluuje, wstrząśnienie mózgu pozostaje diagnozą kliniczną, a klinicyści oceniają pacjentów przy użyciu standardowych metod oceny klinicznej 93.

Choć rokowanie jest ogólnie dobre, a większość osób doświadcza ustąpienia objawów w ciągu kilku tygodni do miesięcy, ustąpienie objawów niekoniecznie wskazuje na pełne fizjologiczne wyzdrowienie, a subtelne deficyty, które nie są mierzalne za pomocą subiektywnych ocen, mogą się utrzymywać 94. Pacjenci są narażeni na zwiększone ryzyko ponownego urazu w okresie powrotu do zdrowia, nawet jeśli nie mają objawów 95. Ponowny uraz przed pełnym powrotem do zdrowia może prowadzić do poważniejszych i dłużej trwających zaburzeń fizjologicznych/klinicznych 96.

Chociaż większość pacjentów dobrze wraca do zdrowia, jeden na cztery młode osoby i co najmniej jeden na sześć dorosłych ma utrzymujące się objawy (tj. te, które pozostają przez 4 tygodnie) i niepełnosprawność związaną z wstrząśnieniem mózgu 97. Wysoka początkowa nasilenie objawów jest najsilniejszym, najbardziej wiarygodnym predyktorem utrzymujących się objawów 98.

Zespół po wstrząśnieniu mózgu (Post-Concussion Syndrome, PCS) występuje po łagodnych urazach mózgu, z częstością występowania 29-90% wśród pacjentów z urazami głowy 99. Charakteryzuje się objawami takimi jak drażliwość, bóle głowy i problemy z koncentracją, które rozwijają się wkrótce po urazie i mogą trwać tygodniami lub miesiącami 100. Przetrwały PCS jest identyfikowany, jeśli objawy utrzymują się ponad sześć miesięcy 101.

Zarządzanie pacjentami z atypowym powrotem do zdrowia jest wyzwaniem i najlepiej kierować ich do specjalistycznej kliniki, która może zapewnić wielodyscyplinarne i interdyscyplinarne podejście do opieki 102.

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  1. 09.04.2026
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Materiały źródłowe

  • #1 Epidemiology of mild traumatic brain injury and neurodegenerative disease
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4461453/
    Every year an estimated 42 million people worldwide suffer a mild traumatic brain injury (MTBI) or concussion. […] Recently, large epidemiological studies have additionally identified MTBI as a risk factor for dementia. […] The prevalence of CTE is unknown and the amount of MTBI or sub-concussive trauma exposure necessary to produce CTE is unclear. […] Currently, CTE is a neuropathological diagnosis that cannot be made during life. […] Thus, the relationship between CTE neuropathology and post-TBI neurodegenerative syndromes (AD, PD, frontotemporal dementia, ALS) is unknown. […] The majority of prior epidemiological studies assessing risk of neurodegenerative diseases following TBI have focused either on risk imparted by a TBI of any severity or of risk imparted by a moderate or severe TBI.
  • #2 Epidemiology of mild traumatic brain injury and neurodegenerative disease
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4461453/
    MTBI is extremely common affecting roughly 42 million people annually worldwide. […] Moderate or severe TBI is an established risk factor for neurodegenerative diseases such as dementia, PD, and ALS. […] Recently, large epidemiological studies have reported that MTBI and repetitive MTBI are also significant risk factors for neurodegenerative diseases, but these associations are not yet as well established and require further replication. […] Prevalence of CTE is unknown due to referral bias limiting autopsy studies and lack of consensus clinical criteria limiting unbiased population-based studies. […] Improved quantification of MTBI exposure as well as prospective longitudinal studies of outcomes and risk factors will be critical to elucidate the actual burden of neurodegenerative diseases including CTE among athletes, military personnel, and civilians exposed to single or repetitive MTBI.
  • #3 Epidemiology, Pathophysiology, and Treatment Strategies of Concussions: A Comprehensive Review
    https://www.fortunejournals.com/articles/epidemiology-pathophysiology-and-treatment-strategies-of-concussions-a-comprehensive-review.html
    A concussion is a particular manifestation of a traumatic brain injury, which is the leading cause of mortality and disabilities across the globe. The global prevalence of traumatic brain injury is estimated to be 939 instances per 100,000 individuals, with approximately 5.48 million people per year experiencing severe traumatic brain injury. […] Epidemiology varies amongst different countries by socioeconomic status with diverse clinical manifestations. […] According to Dewan et al. [6], the reported TBIs on a global scale are distributed as follows: mild TBIs account for 81%, moderate TBIs account for 11%, and severe TBIs account for 8%. […] According to the initial findings of the 2010 Global Burden of Disease (GBD) Project conducted by Bryan-Hancock and Harrison [9], the worldwide occurrence rate of TBI was 200 cases per 100,000 individuals annually, resulting in an estimated impact on about 15 million individuals.
  • #4 Epidemiology, Pathophysiology, and Treatment Strategies of Concussions: A Comprehensive Review
    https://www.fortunejournals.com/articles/epidemiology-pathophysiology-and-treatment-strategies-of-concussions-a-comprehensive-review.html
    Dewan et al. [6] quantitatively assessed the prevalence of TBI across various regions defined by the WHO and income classes categorized by the World Bank. These investigators estimated the worldwide prevalence of TBI across all causes and severities to be 939 instances per 100,000 individuals, with approximately 5.48 million people experiencing severe TBI annually, corresponding to a rate of 73 cases per 100,000 individuals. […] In a study for the Italian National reference guideline, the authors presented epidemiological data on TBI generally encountered in high-income nations [11]. […] The research conducted in this study revealed the presence of two separate peaks in incidence rates. […] The second peak, which exhibited a diminished prominence, was linked to occurrences of falls, and frequently manifested in those aged 70 and above [11].
  • #5 Concussion – AANS
    https://www.aans.org/patients/conditions-treatments/concussion/
    According to the Centers for Disease Control and Prevention (CDC) surveillance report of traumatic brain injuries, about 2.87 million TBI-related ED visits, hospitalizations and deaths occurred in the United States in 2014. […] University of Pittsburghs Brain Trauma Research Center reports more than 300,000 sports-related concussions occur annually in the U.S. Additionally, the likelihood of suffering a concussion while playing a contact sport is estimated to be as high as 19% per year of play; in other words, almost all athletes of contact sports suffer from a concussion within five years of participation. […] A study conducted by McGill University in Montreal found that 60% of college soccer players reported symptoms of a concussion at least once during the season. […] The NCAA defines concussion or mild traumatic brain injury as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. […] The NCAA handbook includes much more information on concussions starting on page 55.
  • #6 Concussion epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Concussion_epidemiology_and_demographics
    Most cases of traumatic brain injury are concussions. A World Health Organization (WHO) study estimated that between 70 and 90% of head injuries that receive treatment are mild. […] Estimates of the incidence of concussion may be artificially low, for example due to underreporting. At least 25% of MTBI sufferers fail to get assessed by a medical professional. […] The WHO group reviewed studies on the epidemiology of MTBI and found a hospital treatment rate of 13 per 1000 people, but since not all concussions are treated in hospitals, they estimated that the rate per year in the general population is over 6 per 1000 people. […] Young children have the highest concussion rate among all age groups. […] Studies suggest males suffer MTBI at about twice the rate of their female counterparts.
  • #7
    https://journals.lww.com/headtraumarehab/fulltext/2025/01000/summary_of_the_centers_for_disease_control_and.7.aspx
    Objective: Surveillance of traumatic brain injury (TBI), including concussion, in the United States has historically relied on healthcare administrative datasets, but these methods likely underestimate the true burden of TBI. […] The objective of this article is to summarize their recent efforts and report TBI prevalence estimates. […] Overall 12-month prevalence of concussion/TBI among adults ranged from 2% to 12% while overall lifetime prevalence of concussion or TBI ranged from 19% to 29%. Overall 12-month prevalence of concussion/TBI among children and adolescents was 10% while 12-month prevalence of sports- and recreation-related concussion for youth ranged from 7% to 15%. Overall lifetime prevalence of TBI among youth ranged from 6% to 14%. […] Survey data based on self-reported concussions and TBIs resulted in larger prevalence estimates than would be expected based on traditional surveillance methods.
  • #8
    https://journals.lww.com/headtraumarehab/fulltext/2025/01000/summary_of_the_centers_for_disease_control_and.7.aspx
    Based on the self-report surveys included in this review, the past year prevalence of TBI among adults varied, ranging from 2% to 12%, while the past year prevalence of TBI among youth was about 10%. […] Lifetime prevalence of TBI among adults likely ranges around 19% to 29% and the lifetime prevalence of TBI in children and adolescents likely ranges between 7% and 14%. […] These results demonstrate that TBI is a common health condition in the United States, and one that is likely underestimated by typical healthcare surveillance estimates that only capture the number of Americans who are seen in an emergency department or hospitalized for a TBI. […] Even compared to the lowest past 12-month estimate of TBI provided in this review (2%), healthcare-based surveillance estimates are likely missing a large proportion of those with suspected TBI.
  • #9
    https://journals.lww.com/headtraumarehab/fulltext/2025/01000/summary_of_the_centers_for_disease_control_and.7.aspx
    Objective: Surveillance of traumatic brain injury (TBI), including concussion, in the United States has historically relied on healthcare administrative datasets, but these methods likely underestimate the true burden of TBI. […] The objective of this article is to summarize their recent efforts and report TBI prevalence estimates. […] Overall 12-month prevalence of concussion/TBI among adults ranged from 2% to 12% while overall lifetime prevalence of concussion or TBI ranged from 19% to 29%. Overall 12-month prevalence of concussion/TBI among children and adolescents was 10% while 12-month prevalence of sports- and recreation-related concussion for youth ranged from 7% to 15%. Overall lifetime prevalence of TBI among youth ranged from 6% to 14%. […] Survey data based on self-reported concussions and TBIs resulted in larger prevalence estimates than would be expected based on traditional surveillance methods.
  • #10 Youth Sports Concussions | Florida Department of Health
    https://www.floridahealth.gov/programs-and-services/prevention/injury-prevention/youth-sports-concussions/index.html
    A concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head that causes the head and brain to move quickly back and forth. A blow elsewhere on the body can cause a concussion even if an athlete does not hit his/her head directly. Concussions can range from mild to severe, and athletes can get a concussion even if they are wearing a helmet. […] In 2022 the Centers for Disease Control and Prevention (CDC) estimated that a total of 6.8% of children who were 17 years old or younger experienced symptoms of a concussion or brain injury at some point in their lives. Furthermore, 3.9% of children in this age group had received a formal diagnosis of a concussion or brain injury from a healthcare professional. […] When comparing different groups, boys (4.7%) and Non-Hispanic White children (5.2%) were found to have a higher probability of being diagnosed with a concussion or brain injury compared to their peers.
  • #11 Youth Sports Concussions | Florida Department of Health
    https://www.floridahealth.gov/programs-and-services/prevention/injury-prevention/youth-sports-concussions/index.html
    A concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head that causes the head and brain to move quickly back and forth. A blow elsewhere on the body can cause a concussion even if an athlete does not hit his/her head directly. Concussions can range from mild to severe, and athletes can get a concussion even if they are wearing a helmet. […] In 2022 the Centers for Disease Control and Prevention (CDC) estimated that a total of 6.8% of children who were 17 years old or younger experienced symptoms of a concussion or brain injury at some point in their lives. Furthermore, 3.9% of children in this age group had received a formal diagnosis of a concussion or brain injury from a healthcare professional. […] When comparing different groups, boys (4.7%) and Non-Hispanic White children (5.2%) were found to have a higher probability of being diagnosed with a concussion or brain injury compared to their peers.
  • #12 Sport-related concussion and bodychecking in children and youth: Evaluation, management, and policy implications | Canadian Paediatric Society
    https://cps.ca/en/documents/position/sport-related-concussion-and-bodychecking
    Concussions are a common injury both within and outside sport and recreational settings, and they remain a serious concern for children and youth. […] An estimated 200,000 concussions occur annually in Canada, with children and youth affected primarily. […] Major advancements in our understanding of concussions since have necessitated a revision to capture these developments, with additional focus on the role of bodychecking in hockey-related concussion epidemiology. […] The relationship between bodychecking and injury in hockey has been studied for decades. […] Numerous studies have since confirmed a strong correlation between bodychecking and injury rates in children and youth. […] Bodychecking is also a significant risk factor for concussion. […] One meta-analysis of strategies to reduce concussion numbers estimated that eliminating bodychecking would decrease concussion rates in Canada by 20% to 90% in all age groups.
  • #13 Self-reported concussions in Canada: A cross-sectional study
    https://www150.statcan.gc.ca/n1/pub/82-003-x/2023006/article/00002-eng.htm
    Traumatic brain injuries (TBIs) are a major public health concern impacting the lives of many Canadians. Among all TBI s, concussions are the most common. However, to date, the incidence of concussions among the Canadian population, has remained unknown. To address this data surveillance gap, this study presents national estimates on the percentage of Canadians aged 12 years or older (excluding those living in the territories) who sustained one or more concussions in 2019. […] This study found that approximately 1.6% of Canadians aged 12 years or older reported sustaining one or more concussions in 2019. […] Monitoring concussions among the national population is an important activity in injury surveillance, as it can help evaluate the efficacy of injury prevention intervention and better understand knowledge gaps and the burden of this injury.
  • #14 Traumatic Brain Injury (TBI) – Definition, Epidemiology, Pathophysiology: Overview, Epidemiology, Primary Injury
    https://emedicine.medscape.com/article/326510-overview
    Using the National Trauma Data Bank, a study by Rosenfeld et al of indicated that TBI is the most prevalent nonaccidental trauma (NAT) suffered by children in the United States. […] Some particular segments of the populace are at increased risk of sustaining a TBI, including the following: Young people, Low-income individuals, Unmarried individuals, Members of ethnic minority groups, Residents of inner cities, Men, Individuals with a history of substance abuse, Individuals who have suffered a previous TBI. […] Men are approximately twice as likely as women to sustain a TBI. […] The risk of TBI peaks when individuals are aged 15-30 years. […] The highest mortality rate (32.8 cases per 100,000 people) is found in persons aged 15-24 years. […] A study by Haring et al of TBI in the elderly found that between 2000 and 2010, 950,132 TBI-related hospitalizations occurred in adults aged 65 years or older in the United States, along with 107,666 TBI-related deaths.
  • #15 Traumatic Brain Injury (TBI) – Definition, Epidemiology, Pathophysiology: Overview, Epidemiology, Primary Injury
    https://emedicine.medscape.com/article/326510-overview
    Using the National Trauma Data Bank, a study by Rosenfeld et al of indicated that TBI is the most prevalent nonaccidental trauma (NAT) suffered by children in the United States. […] Some particular segments of the populace are at increased risk of sustaining a TBI, including the following: Young people, Low-income individuals, Unmarried individuals, Members of ethnic minority groups, Residents of inner cities, Men, Individuals with a history of substance abuse, Individuals who have suffered a previous TBI. […] Men are approximately twice as likely as women to sustain a TBI. […] The risk of TBI peaks when individuals are aged 15-30 years. […] The highest mortality rate (32.8 cases per 100,000 people) is found in persons aged 15-24 years. […] A study by Haring et al of TBI in the elderly found that between 2000 and 2010, 950,132 TBI-related hospitalizations occurred in adults aged 65 years or older in the United States, along with 107,666 TBI-related deaths.
  • #16 Traumatic Brain Injury (TBI) – Definition, Epidemiology, Pathophysiology: Overview, Epidemiology, Primary Injury
    https://emedicine.medscape.com/article/326510-overview
    Using the National Trauma Data Bank, a study by Rosenfeld et al of indicated that TBI is the most prevalent nonaccidental trauma (NAT) suffered by children in the United States. […] Some particular segments of the populace are at increased risk of sustaining a TBI, including the following: Young people, Low-income individuals, Unmarried individuals, Members of ethnic minority groups, Residents of inner cities, Men, Individuals with a history of substance abuse, Individuals who have suffered a previous TBI. […] Men are approximately twice as likely as women to sustain a TBI. […] The risk of TBI peaks when individuals are aged 15-30 years. […] The highest mortality rate (32.8 cases per 100,000 people) is found in persons aged 15-24 years. […] A study by Haring et al of TBI in the elderly found that between 2000 and 2010, 950,132 TBI-related hospitalizations occurred in adults aged 65 years or older in the United States, along with 107,666 TBI-related deaths.
  • #17 TBI Data | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/data-research/index.html
    Males were nearly two times more likely to be hospitalized and three times more likely to die from a TBI than females. […] CDC conducts research on preventing TBIs and reducing the chance for disability and other potential effects of these injuries. […] Learn more about the National Concussion Surveillance System, a state-of-the-art data collection effort designed to learn how many Americans (children and adults) get a concussion each year and the leading causes of this injury.
  • #18 A cohort study to identify and evaluate concussion risk factors across multiple injury settings: findings from the CARE Consortium | Injury Epidemiology | Full Text
    https://injepijournal.biomedcentral.com/articles/10.1186/s40621-018-0178-3
    Female high school and college athletes have 1.5 to 2.1 times greater concussion risk than their male peers. […] A combination of physical, psychological, and physiological differences are possible reasons for increase female concussion risk. […] Previous concussion and increased baseline psychological symptoms are also expected to increase concussion risk. […] Relative to other medical comorbidities, having a previous concussion had the strongest evidence for increasing subsequent concussion risk. […] Baseline or pre-concussion symptoms, such as headache, have been associated with increased concussion risk in youth ice hockey players. […] Psychological symptoms and disorders, such as anxiety and depression, also are hypothesized to increase concussion risk. […] The current study aimed to address whether a variety of factors influence concussion risk across different injury settings.
  • #19 Avenues for prevention using the epidemiology of sport-related concussion from a large high school surveillance study in: Neurosurgical Focus Volume 57 Issue 1 (2024) Journals
    https://thejns.org/focus/view/journals/neurosurg-focus/57/1/article-pE3.xml
    Additionally, girls consistently had higher SRC rates relative to boys for baseball/softball, basketball, and soccer, whereas lacrosse presented conflicting results depending on the year of the study period. […] We identified common causes of SRC, with boys injuries occurring from person-to-person contact (62.8%), whereas girls commonly sustained SRC from person-to-object contact (33.4%) or person-to-person contact (33.4%). […] Therefore, the results from this study may help researchers and leaders in policy to direct SRC primary prevention in the high school athletic setting.
  • #20 A cohort study to identify and evaluate concussion risk factors across multiple injury settings: findings from the CARE Consortium | Injury Epidemiology | Full Text
    https://injepijournal.biomedcentral.com/articles/10.1186/s40621-018-0178-3
    Concussion, or mild traumatic brain injury, is a major public health concern affecting 42 million individuals globally each year. However, little is known regarding concussion risk factors across all concussion settings as most concussion research has focused on only sport-related or military-related concussive injuries. […] Female sex and previous concussion were the most consistent estimators of concussion risk across all concussion settings. Compared to males, females had 2.02 (95% CI: 1.70-2.40) times the risk of a concussion regardless of injury setting, and greater relative risk when the concussion occurred during sport (Odds Ratio (OR): 1.38 95% CI: 1.07-1.78). Previous concussion was associated with 1.98 (95% CI: 1.65-2.37) times increased risk for any incident concussion, and the magnitude was relatively stable across all concussion settings (OR: 1.73 to 2.01).
  • #21 Epidemiology of children with head injury: a national overview | Archives of Disease in Childhood
    https://adc.bmj.com/content/101/6/527
    The National Confidential Enquiry describes the epidemiology of children admitted to hospital with head injury. […] Children (15 years old) who died or were admitted for 4h with head injury were identified from 216 UK hospitals (1 September 2009 to 28 February 2010). […] There was a significant association of head injury with social deprivation 39.7/100 000 (95% CI 37.0 to 42.6) in the least deprived first quintile vs. 55.1 (95% CI 52.1 to 58.2) in the most deprived fifth quintile (p<0.01). [...] The data described highlight priorities for targeted age-specific head injury prevention and have the potential to provide a baseline to evaluate the effects of regional trauma networks (2012) and National Institute of Health and Care Excellence (NICE) head injury guidelines (2014), which were revised after the study was completed.
  • #22 Traumatic Brain Injury (TBI) – Definition, Epidemiology, Pathophysiology: Overview, Epidemiology, Primary Injury
    https://emedicine.medscape.com/article/326510-overview
    MVAs are the leading cause of TBI in the general population, especially among whites in the United States. […] Falls are the second leading cause of TBI. […] Firearms are the third leading cause of TBI (12% of all TBIs) and are a leading cause of TBI among individuals aged 25-34 years. […] The incidence of TBI has been decreasing because of the introduction of preventive measures and as a result of better enforcement of drunk driving laws.
  • #23 Traumatic Brain Injury (TBI) – Definition, Epidemiology, Pathophysiology: Overview, Epidemiology, Primary Injury
    https://emedicine.medscape.com/article/326510-overview
    MVAs are the leading cause of TBI in the general population, especially among whites in the United States. […] Falls are the second leading cause of TBI. […] Firearms are the third leading cause of TBI (12% of all TBIs) and are a leading cause of TBI among individuals aged 25-34 years. […] The incidence of TBI has been decreasing because of the introduction of preventive measures and as a result of better enforcement of drunk driving laws.
  • #24 Concussive head injury in children and adolescents
    https://www.racgp.org.au/afp/2016/july/concussive-head-injury-in-children-and-adolescents
    Awareness of concussive head injury continues to grow, aided by greater understanding of the neurobiological underpinnings of concussions and its short-term and long-term consequences. […] Traumatic brain injury is one of the most common causes of neurological morbidity, and is more common in childhood and adolescence than at any other time of life. Concussions in young people account for 90% of all traumatic brain injuries. […] Falls (51%) and sports-related activities (25%) are the most common causes of concussion. […] The highest rates of sports-related concussion are reported in males aged 10-19 years, although young females also sustain concussions. […] Early detection of injury, proper evaluation and appropriate decision-making for return to activity (physical and cognitive) remain paramount for the treating clinician in the care of post-concussive injury in young people.
  • #25 Sports-related Head Injury – AANS
    https://www.aans.org/patients/conditions-treatments/sports-related-head-injury/
    There are an estimated 1.7 to 3.8 million traumatic brain injuries each year in the United States, according to the CDC, of which 10 percent arise due to sports and recreational activities. […] Amongst American children and adolescents, sports and recreational activities contribute to over 21 percent of all traumatic brain injuries. […] A traumatic brain injury (TBI) is defined as a form of acquired brain injury from a blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. […] Concussions frequently affect athletes in both contact and non-contact sports, and are considered to be diffuse brain injuries that traumatically induce alterations of mental status. […] The 5th International Conference on Concussion in Sport held in Berlin, Germany, in 2016 defined Sport-related Concussion as: Sport-related concussion is the historical term representing low velocity injuries that cause brain shaking resulting in clinical symptoms and that are not necessarily related to a pathological injury.
  • #26 Concussion epidemiology and demographics – wikidoc
    https://www.wikidoc.org/index.php/Concussion_epidemiology_and_demographics
    Up to five percent of sports injuries are concussions. […] The U.S. Centers for Disease Control and Prevention estimates that 300,000 sports-related concussions occur yearly in the U.S., but that number includes only athletes who lost consciousness. […] Since loss of consciousness is thought to occur in less than 10% of concussions, the CDC estimate is likely lower than the real number. […] Due to the lack of a consistent definition, the economic costs of MTBI are not known, but they are estimated to be very high. […] These high costs are due in part to the large percentage of hospital admissions for head injury that are due to mild head trauma, but indirect costs such as lost work time and early retirement account for the bulk of the costs.
  • #27 Traumatic Brain Injury (TBI) – Definition, Epidemiology, Pathophysiology: Overview, Epidemiology, Primary Injury
    https://emedicine.medscape.com/article/326510-overview
    MVAs are the leading cause of TBI in the general population, especially among whites in the United States. […] Falls are the second leading cause of TBI. […] Firearms are the third leading cause of TBI (12% of all TBIs) and are a leading cause of TBI among individuals aged 25-34 years. […] The incidence of TBI has been decreasing because of the introduction of preventive measures and as a result of better enforcement of drunk driving laws.
  • #28 Concussive head injury in children and adolescents
    https://www.racgp.org.au/afp/2016/july/concussive-head-injury-in-children-and-adolescents
    Awareness of concussive head injury continues to grow, aided by greater understanding of the neurobiological underpinnings of concussions and its short-term and long-term consequences. […] Traumatic brain injury is one of the most common causes of neurological morbidity, and is more common in childhood and adolescence than at any other time of life. Concussions in young people account for 90% of all traumatic brain injuries. […] Falls (51%) and sports-related activities (25%) are the most common causes of concussion. […] The highest rates of sports-related concussion are reported in males aged 10-19 years, although young females also sustain concussions. […] Early detection of injury, proper evaluation and appropriate decision-making for return to activity (physical and cognitive) remain paramount for the treating clinician in the care of post-concussive injury in young people.
  • #29 Epidemiology and risk stratification of minor head injuries in school-going children – Annals Singapore
    https://annals.edu.sg/epidemiology-and-risk-stratification-of-minor-head-injuries-in-school-going-children/
    Head injuries occur commonly in children and can lead to concussion injuries. We aim to describe the epidemiology of head injuries among school-going children and identify predictors of brain concussions in Singapore. […] Among 1,233 children (mean age, 6.6 years; 72.6% boys) analysed, the commonest mechanism was falls (64.6%). […] A total of 395 (32.0%) patients required admission, and 277 (22.5%) had symptoms of concussion. […] Older age (1316 years old) (adjusted odds ratio [aOR] 1.53, 95% confidence interval [CI] 1.122.08), children involved in road traffic accidents (aOR 2.12, CI 1.173.85) and a presenting complaint of headache (aOR 2.64, CI 1.993.50) were significantly associated with symptoms of concussion. […] High risk patients may require closer monitoring to detect post-concussion syndrome early.
  • #30
    https://journals.lww.com/headtraumarehab/fulltext/2024/03000/rationale_for_the_development_of_a_traumatic_brain.3.aspx
    Current methods of traumatic brain injury (TBI) morbidity surveillance in the United States have primarily relied on hospital-based data sets. However, these methods undercount TBIs as they do not include TBIs seen in outpatient settings and those that are untreated and undiagnosed. […] A 2014 National Academy of Science Engineering and Medicine report recommended that the Centers for Disease Control and Prevention (CDC) establish and manage a national surveillance system to better describe the burden of sports- and recreation-related TBI, including concussion, among youth. […] Given the limitations of TBI surveillance in general, CDC took this recommendation as a call to action to formulate and implement a robust pilot National Concussion Surveillance System that could estimate the public health burden of concussion and TBI among Americans from all causes of brain injury.
  • #31 CDC Publishes Reports on National Concussion Surveillance System Pilot – RCPA
    https://paproviders.org/cdc-publishes-reports-on-national-concussion-surveillance-system-pilot/
    The Centers for Disease Control and Prevention (CDC) recently published the following reports in the Journal of Head Trauma Rehabilitation that examine and address gaps in traumatic brain injury (TBI) surveillance, including concussions that occur in youth sports. […] Many concussions and other TBIs are first treated outside of emergency departments, suggesting that surveillance systems that rely only on hospital datasets are undercounting the true number of these injuries in the United States. […] CDCs National Concussion Surveillance System (NCSS) Pilot used a random-digit-dial telephone survey to collect information on concussions and other TBIs. In addition to gathering data on more than just hospital-treated TBIs, the CDC report also describes a new tiered case definition with rising levels of certainty that a concussion or other TBI occurred based on the number and types of symptoms reported.
  • #32 CDC Publishes Reports on National Concussion Surveillance System Pilot – RCPA
    https://paproviders.org/cdc-publishes-reports-on-national-concussion-surveillance-system-pilot/
    The Centers for Disease Control and Prevention (CDC) recently published the following reports in the Journal of Head Trauma Rehabilitation that examine and address gaps in traumatic brain injury (TBI) surveillance, including concussions that occur in youth sports. […] Many concussions and other TBIs are first treated outside of emergency departments, suggesting that surveillance systems that rely only on hospital datasets are undercounting the true number of these injuries in the United States. […] CDCs National Concussion Surveillance System (NCSS) Pilot used a random-digit-dial telephone survey to collect information on concussions and other TBIs. In addition to gathering data on more than just hospital-treated TBIs, the CDC report also describes a new tiered case definition with rising levels of certainty that a concussion or other TBI occurred based on the number and types of symptoms reported.
  • #33 National Concussion Surveillance System | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/programs/index.html
    CDC finished pilot testing a survey about TBI experienced by children and adults in fall 2019. […] The pilot results are helping to refine plans for a National Concussion Surveillance System (NCSS). […] The state-of-the-art NCSS will be able to accurately determine how many Americans (children and adults) get a concussion each year and determine the cause. […] In addition, the results of a national system would inform and equip leaders within communities and states across the U.S. by: Creating for the first time ever true national estimates of the number of people living with a disability caused by a brain injury. […] Providing the first national estimates of sports-related concussions among youth that occur both in and outside of organized sports. […] Providing information about the most common cause of injury for concussion, including motor vehicle crashes, falls, and self-harm. […] Monitoring trends to understand whether the number of concussions is increasing or decreasing, and assessing whether prevention efforts are working. […] Giving insight to healthcare providers and hospitals about where patients seek care for concussion and their recovery needs.
  • #34 National Concussion Surveillance System | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/programs/index.html
    CDC finished pilot testing a survey about TBI experienced by children and adults in fall 2019. […] The pilot results are helping to refine plans for a National Concussion Surveillance System (NCSS). […] The state-of-the-art NCSS will be able to accurately determine how many Americans (children and adults) get a concussion each year and determine the cause. […] In addition, the results of a national system would inform and equip leaders within communities and states across the U.S. by: Creating for the first time ever true national estimates of the number of people living with a disability caused by a brain injury. […] Providing the first national estimates of sports-related concussions among youth that occur both in and outside of organized sports. […] Providing information about the most common cause of injury for concussion, including motor vehicle crashes, falls, and self-harm. […] Monitoring trends to understand whether the number of concussions is increasing or decreasing, and assessing whether prevention efforts are working. […] Giving insight to healthcare providers and hospitals about where patients seek care for concussion and their recovery needs.
  • #35 National Concussion Surveillance System | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/programs/index.html
    CDC finished pilot testing a survey about TBI experienced by children and adults in fall 2019. […] The pilot results are helping to refine plans for a National Concussion Surveillance System (NCSS). […] The state-of-the-art NCSS will be able to accurately determine how many Americans (children and adults) get a concussion each year and determine the cause. […] In addition, the results of a national system would inform and equip leaders within communities and states across the U.S. by: Creating for the first time ever true national estimates of the number of people living with a disability caused by a brain injury. […] Providing the first national estimates of sports-related concussions among youth that occur both in and outside of organized sports. […] Providing information about the most common cause of injury for concussion, including motor vehicle crashes, falls, and self-harm. […] Monitoring trends to understand whether the number of concussions is increasing or decreasing, and assessing whether prevention efforts are working. […] Giving insight to healthcare providers and hospitals about where patients seek care for concussion and their recovery needs.
  • #36 National Concussion Surveillance System | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/programs/index.html
    CDC finished pilot testing a survey about TBI experienced by children and adults in fall 2019. […] The pilot results are helping to refine plans for a National Concussion Surveillance System (NCSS). […] The state-of-the-art NCSS will be able to accurately determine how many Americans (children and adults) get a concussion each year and determine the cause. […] In addition, the results of a national system would inform and equip leaders within communities and states across the U.S. by: Creating for the first time ever true national estimates of the number of people living with a disability caused by a brain injury. […] Providing the first national estimates of sports-related concussions among youth that occur both in and outside of organized sports. […] Providing information about the most common cause of injury for concussion, including motor vehicle crashes, falls, and self-harm. […] Monitoring trends to understand whether the number of concussions is increasing or decreasing, and assessing whether prevention efforts are working. […] Giving insight to healthcare providers and hospitals about where patients seek care for concussion and their recovery needs.
  • #37 National Concussion Surveillance System | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/programs/index.html
    CDC finished pilot testing a survey about TBI experienced by children and adults in fall 2019. […] The pilot results are helping to refine plans for a National Concussion Surveillance System (NCSS). […] The state-of-the-art NCSS will be able to accurately determine how many Americans (children and adults) get a concussion each year and determine the cause. […] In addition, the results of a national system would inform and equip leaders within communities and states across the U.S. by: Creating for the first time ever true national estimates of the number of people living with a disability caused by a brain injury. […] Providing the first national estimates of sports-related concussions among youth that occur both in and outside of organized sports. […] Providing information about the most common cause of injury for concussion, including motor vehicle crashes, falls, and self-harm. […] Monitoring trends to understand whether the number of concussions is increasing or decreasing, and assessing whether prevention efforts are working. […] Giving insight to healthcare providers and hospitals about where patients seek care for concussion and their recovery needs.
  • #38 National Concussion Surveillance System | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/programs/index.html
    CDC finished pilot testing a survey about TBI experienced by children and adults in fall 2019. […] The pilot results are helping to refine plans for a National Concussion Surveillance System (NCSS). […] The state-of-the-art NCSS will be able to accurately determine how many Americans (children and adults) get a concussion each year and determine the cause. […] In addition, the results of a national system would inform and equip leaders within communities and states across the U.S. by: Creating for the first time ever true national estimates of the number of people living with a disability caused by a brain injury. […] Providing the first national estimates of sports-related concussions among youth that occur both in and outside of organized sports. […] Providing information about the most common cause of injury for concussion, including motor vehicle crashes, falls, and self-harm. […] Monitoring trends to understand whether the number of concussions is increasing or decreasing, and assessing whether prevention efforts are working. […] Giving insight to healthcare providers and hospitals about where patients seek care for concussion and their recovery needs.
  • #39 National Concussion Surveillance System | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/programs/index.html
    CDC finished pilot testing a survey about TBI experienced by children and adults in fall 2019. […] The pilot results are helping to refine plans for a National Concussion Surveillance System (NCSS). […] The state-of-the-art NCSS will be able to accurately determine how many Americans (children and adults) get a concussion each year and determine the cause. […] In addition, the results of a national system would inform and equip leaders within communities and states across the U.S. by: Creating for the first time ever true national estimates of the number of people living with a disability caused by a brain injury. […] Providing the first national estimates of sports-related concussions among youth that occur both in and outside of organized sports. […] Providing information about the most common cause of injury for concussion, including motor vehicle crashes, falls, and self-harm. […] Monitoring trends to understand whether the number of concussions is increasing or decreasing, and assessing whether prevention efforts are working. […] Giving insight to healthcare providers and hospitals about where patients seek care for concussion and their recovery needs.
  • #40 National Concussion Surveillance System | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/programs/index.html
    CDC finished pilot testing a survey about TBI experienced by children and adults in fall 2019. […] The pilot results are helping to refine plans for a National Concussion Surveillance System (NCSS). […] The state-of-the-art NCSS will be able to accurately determine how many Americans (children and adults) get a concussion each year and determine the cause. […] In addition, the results of a national system would inform and equip leaders within communities and states across the U.S. by: Creating for the first time ever true national estimates of the number of people living with a disability caused by a brain injury. […] Providing the first national estimates of sports-related concussions among youth that occur both in and outside of organized sports. […] Providing information about the most common cause of injury for concussion, including motor vehicle crashes, falls, and self-harm. […] Monitoring trends to understand whether the number of concussions is increasing or decreasing, and assessing whether prevention efforts are working. […] Giving insight to healthcare providers and hospitals about where patients seek care for concussion and their recovery needs.
  • #41 Traumatic Brain Injury Center of Excellence | Health.mil
    https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence
    Traumatic brain injury is a significant health issue which affects service members and veterans during times of both peace and war. The high rate of TBI and blast-related concussion events resulting from current combat operations directly impacts the health and safety of individual service members and subsequently the level of unit readiness and troop retention. […] Active duty and reserve service members are at increased risk for sustaining a TBI compared to their civilian peers. This is a result of several factors, including the specific demographics of the military; in general, young men between the ages of 18 to 24 are at greatest risk for TBI. […] TBICoE is the Defense Departments office of responsibility for tracking traumatic brain injury data in the U.S. military. Here you’ll find data on the number of active duty service members anywhere U.S. forces are located with a first-time TBI diagnosis in calendar year 2023.
  • #42 Traumatic Brain Injury Center of Excellence | Health.mil
    https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Traumatic-Brain-Injury-Center-of-Excellence
    TBICoE will continue to oversee and conduct TBI clinically relevant research addressing gaps in TBI knowledge for our service members and veterans who have sustained a TBI. Additionally, TBICoE continues to provide training and materials to military medical personnel for diagnosis, prevention and treatment of TBIs. […] The DOD has further solidified TBICoE’s role by naming it the Office of Responsibility for these tasks: Creation and maintenance of a TBI surveillance database.
  • #43 Concussion: Practice Essentials, Background, Epidemiology
    https://emedicine.medscape.com/article/92095-overview
    The incidence of concussion varies with the sport and the age of participants. Many head injuries are likely unreported owing to their supposed mild nature; mild concussions may go unnoticed by teammates, coaches, and even the athletes themselves. An athlete’s fear of medical disqualification may also lead to underreporting. […] Data from emergency department (ED) visits, office visits, and a high school injury surveillance system estimated 1.0-1.8 million sports related concussions (SRCs) per year in the 0-18 years age range and a subset of about 400,000 SRCs in high school athletes. […] Sports activities that place the athlete at high risk for a head injury include boxing, football, ice hockey, wrestling, rugby, and soccer. Physicians and other allied health professionals who are responsible for the medical care of such contact or collision sports participants should be adept at evaluating, treating, and making playability decisions related to the short- and long-term consequences of an injury to the brain. […] The purpose of this article is to review the epidemiology and diagnosis (but not necessarily the classification) of mTBI, as well as the role of imaging studies, issues regarding return to play, and complications surrounding mTBI.
  • #44 Concussion: Practice Essentials, Background, Epidemiology
    https://emedicine.medscape.com/article/92095-overview
    The incidence of concussion varies with the sport and the age of participants. Many head injuries are likely unreported owing to their supposed mild nature; mild concussions may go unnoticed by teammates, coaches, and even the athletes themselves. An athlete’s fear of medical disqualification may also lead to underreporting. […] Data from emergency department (ED) visits, office visits, and a high school injury surveillance system estimated 1.0-1.8 million sports related concussions (SRCs) per year in the 0-18 years age range and a subset of about 400,000 SRCs in high school athletes. […] Sports activities that place the athlete at high risk for a head injury include boxing, football, ice hockey, wrestling, rugby, and soccer. Physicians and other allied health professionals who are responsible for the medical care of such contact or collision sports participants should be adept at evaluating, treating, and making playability decisions related to the short- and long-term consequences of an injury to the brain. […] The purpose of this article is to review the epidemiology and diagnosis (but not necessarily the classification) of mTBI, as well as the role of imaging studies, issues regarding return to play, and complications surrounding mTBI.
  • #45 Traumatic Brain Injury (TBI) – Definition, Epidemiology, Pathophysiology: Overview, Epidemiology, Primary Injury
    https://emedicine.medscape.com/article/326510-overview
    Inconsistency in the definition and classification of traumatic brain injury (TBI), along with discrepancies in data collection, has made the epidemiology of TBI difficult to describe accurately. […] Problems with TBI data collection include the fact many patients with mild TBI may not present to the hospital, and the ones who do present may be discharged at the emergency department (ED) without adequate documentation. Severe TBI with associated death at the scene of the accident or during transport to a hospital also may not be accounted for completely in data collection for TBI epidemiologic studies. […] TBI accounts for approximately 40% of all deaths from acute injuries in the United States. Annually, 200,000 victims of TBI need hospitalization, and 1.74 million persons sustain mild TBI requiring an office visit or temporary disability for at least 1 day.
  • #46 Summary of the Centers for Disease Control and Prevention’s Self-reported Traumatic Brain Injury Survey Efforts – PubMed
    https://pubmed.ncbi.nlm.nih.gov/39038104/
    Survey data based on self-reported concussions and TBIs resulted in larger prevalence estimates than would be expected based on traditional surveillance methods. Analyses of the various surveys shows that how the questions are asked and what terminology is used can notably affect the estimates observed. Efforts can be made to optimize and standardize data collection approaches to ensure consistent measurement across settings and populations.
  • #47
    https://journals.lww.com/headtraumarehab/fulltext/2025/01000/summary_of_the_centers_for_disease_control_and.7.aspx
    Specific head injury terminology was an important factor that impacted the prevalence. […] Future research may focus on refining the content and wording of TBI questions for surveys based on the findings of this summary. […] Self-report surveys have shown to be an effective way to gain information about difficult to identify conditions including TBI.
  • #48
    https://journals.lww.com/headtraumarehab/fulltext/2025/01000/summary_of_the_centers_for_disease_control_and.7.aspx
    Based on the self-report surveys included in this review, the past year prevalence of TBI among adults varied, ranging from 2% to 12%, while the past year prevalence of TBI among youth was about 10%. […] Lifetime prevalence of TBI among adults likely ranges around 19% to 29% and the lifetime prevalence of TBI in children and adolescents likely ranges between 7% and 14%. […] These results demonstrate that TBI is a common health condition in the United States, and one that is likely underestimated by typical healthcare surveillance estimates that only capture the number of Americans who are seen in an emergency department or hospitalized for a TBI. […] Even compared to the lowest past 12-month estimate of TBI provided in this review (2%), healthcare-based surveillance estimates are likely missing a large proportion of those with suspected TBI.
  • #49
    https://journals.lww.com/headtraumarehab/fulltext/2025/01000/summary_of_the_centers_for_disease_control_and.7.aspx
    Based on the self-report surveys included in this review, the past year prevalence of TBI among adults varied, ranging from 2% to 12%, while the past year prevalence of TBI among youth was about 10%. […] Lifetime prevalence of TBI among adults likely ranges around 19% to 29% and the lifetime prevalence of TBI in children and adolescents likely ranges between 7% and 14%. […] These results demonstrate that TBI is a common health condition in the United States, and one that is likely underestimated by typical healthcare surveillance estimates that only capture the number of Americans who are seen in an emergency department or hospitalized for a TBI. […] Even compared to the lowest past 12-month estimate of TBI provided in this review (2%), healthcare-based surveillance estimates are likely missing a large proportion of those with suspected TBI.
  • #50 Self-reported concussions in Canada: A cross-sectional study
    https://www150.statcan.gc.ca/n1/pub/82-003-x/2023006/article/00002-eng.htm
    The ongoing monitoring of concussions among the national population is an important activity in injury surveillance, as it can help evaluate the efficacy of injury prevention intervention, better understand knowledge gaps and the burden of this injury, inform public health policy, and complement future research examining potential long-term outcomes related to concussions.
  • #51 National Concussion Surveillance System | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/programs/index.html
    CDC finished pilot testing a survey about TBI experienced by children and adults in fall 2019. […] The pilot results are helping to refine plans for a National Concussion Surveillance System (NCSS). […] The state-of-the-art NCSS will be able to accurately determine how many Americans (children and adults) get a concussion each year and determine the cause. […] In addition, the results of a national system would inform and equip leaders within communities and states across the U.S. by: Creating for the first time ever true national estimates of the number of people living with a disability caused by a brain injury. […] Providing the first national estimates of sports-related concussions among youth that occur both in and outside of organized sports. […] Providing information about the most common cause of injury for concussion, including motor vehicle crashes, falls, and self-harm. […] Monitoring trends to understand whether the number of concussions is increasing or decreasing, and assessing whether prevention efforts are working. […] Giving insight to healthcare providers and hospitals about where patients seek care for concussion and their recovery needs.
  • #52 National Concussion Surveillance System | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/programs/index.html
    CDC finished pilot testing a survey about TBI experienced by children and adults in fall 2019. […] The pilot results are helping to refine plans for a National Concussion Surveillance System (NCSS). […] The state-of-the-art NCSS will be able to accurately determine how many Americans (children and adults) get a concussion each year and determine the cause. […] In addition, the results of a national system would inform and equip leaders within communities and states across the U.S. by: Creating for the first time ever true national estimates of the number of people living with a disability caused by a brain injury. […] Providing the first national estimates of sports-related concussions among youth that occur both in and outside of organized sports. […] Providing information about the most common cause of injury for concussion, including motor vehicle crashes, falls, and self-harm. […] Monitoring trends to understand whether the number of concussions is increasing or decreasing, and assessing whether prevention efforts are working. […] Giving insight to healthcare providers and hospitals about where patients seek care for concussion and their recovery needs.
  • #53 Avenues for prevention using the epidemiology of sport-related concussion from a large high school surveillance study in: Neurosurgical Focus Volume 57 Issue 1 (2024) Journals
    https://thejns.org/focus/view/journals/neurosurg-focus/57/1/article-pE3.xml
    These findings can help understand the potential impact of interventions aimed at preventing or reducing SRC. […] Prior studies indicate that high school girls participating in sports comparable to those played by boys have a 2-times-higher SRC injury rate. […] The current study describes the epidemiology of SRCs among 33 high school sports across 8 years (2015/20162022/2023). […] Comprehending the epidemiology of SRCs among adolescent athletes is imperative for developing effective, focused primary prevention initiatives in this population. […] The findings from this large epidemiology study of high school SRC across a statewide surveillance system provide continued insights into the clinical incidence of SRC among this younger population. […] Our study identified 25,482 total SRCs, with an overall clinical incidence of 1.17 per 100 player-seasons across all years.
  • #54 Avenues for prevention using the epidemiology of sport-related concussion from a large high school surveillance study in: Neurosurgical Focus Volume 57 Issue 1 (2024) Journals
    https://thejns.org/focus/view/journals/neurosurg-focus/57/1/article-pE3.xml
    These findings can help understand the potential impact of interventions aimed at preventing or reducing SRC. […] Prior studies indicate that high school girls participating in sports comparable to those played by boys have a 2-times-higher SRC injury rate. […] The current study describes the epidemiology of SRCs among 33 high school sports across 8 years (2015/20162022/2023). […] Comprehending the epidemiology of SRCs among adolescent athletes is imperative for developing effective, focused primary prevention initiatives in this population. […] The findings from this large epidemiology study of high school SRC across a statewide surveillance system provide continued insights into the clinical incidence of SRC among this younger population. […] Our study identified 25,482 total SRCs, with an overall clinical incidence of 1.17 per 100 player-seasons across all years.
  • #55 Traumatic brain injury: Epidemiology, classification, and pathophysiology – UpToDate
    https://www.uptodate.com/contents/traumatic-brain-injury-epidemiology-classification-and-pathophysiology
    Traumatic brain injury (TBI) is a major source of health loss and disability worldwide. Globally, the annual incidence of TBI is variably estimated at 27 to 69 million. Many survivors live with significant disabilities, resulting in major socioeconomic burden. In 2010, the economic impact of TBI in the United States was estimated to be $76.5 billion in direct and indirect costs. […] A simple, consistent definition of TBI is critical in estimating its burden. In 2010, the international interagency initiative toward common data elements for research in TBI and psychological health proposed a definition of TBI applicable across the spectrum of injury severity. […] This definition states that TBI is an alteration in brain function, or other evidence of brain pathology, caused by an external force.
  • #56 Concussion Epidemiology, Natural History and Long Term Outcomes – Lab Foci – Bazarian Lab – University of Rochester Medical Center
    https://www.urmc.rochester.edu/labs/bazarian/foci/concussion-epidemiology
    Concussionalso known as mild TBI– is a growing public health problem affecting over 3.8 million Americans annually and resulting in over 2.2 million emergency department visits each year. […] Between 2010 and 2015, diagnoses for concussion and post-concussion syndrome increased by 43% and 81%, respectively. […] Disability resulting from concussion costs the US nearly $17 billion each year. […] However, several studies published since 2004 suggest that as many as 40-50% of concussion patients are not recovered at 3 months, and that there are large differences in the percent of recovered subjects across studies.
  • #57 Concussion and Traumatic Brain Injury Prevention Program
    https://portal.ct.gov/dph/health-education-management–surveillance/the-office-of-injury-prevention/concussion-and-traumatic-brain-injury-prevention-program
    The CDC identifies traumatic brain injury (TBI) as a major cause of death and disability in the United States. TBIs contribute to about 30% of all injury deaths. Every day, 153 people in the United States die from injuries that include TBI. […] Most TBIs that occur each year are mild, commonly called concussions. […] A more common type of TBI, concussions, are caused by a blow or jolt to the head or body that results in rapid movement to the head that disrupts the function of the brain. […] In Connecticut, from 2007 to 2013 there were 22,047 hospital in-patient discharges and about 40,096 emergency department encounters. The emergency department costs totaled over $138 million. […] The Connecticut State Department of Education Health (CSDE) Services Concussion Reports indicate an overall decline (about 67% lower) in student concussions from the 2015-2016 school year to the 2022-2023 school year.
  • #58 TBI Data | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/data-research/index.html
    CDC collects and reports TBI data to understand: how many people are affected by this injury, who is most at risk, the leading ways a person may get a TBI, and whether programs to prevent TBI are working. […] TBI is a major cause of death. This interactive chart shows the number of TBI-related deaths by month and year, including the most recent provisional data available. […] There were approximately 214,110 TBI-related hospitalizations in 2020 and 69,473 TBI-related deaths in 2021. This represents more than 586 TBI-related hospitalizations and 190 TBI-related deaths per day. […] People age 75 years and older had the highest numbers and rates of TBI-related hospitalizations and deaths. This age group accounts for about 32% of TBI-related hospitalizations and 28% of TBI-related deaths.
  • #59 TBI Data | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/data-research/index.html
    CDC collects and reports TBI data to understand: how many people are affected by this injury, who is most at risk, the leading ways a person may get a TBI, and whether programs to prevent TBI are working. […] TBI is a major cause of death. This interactive chart shows the number of TBI-related deaths by month and year, including the most recent provisional data available. […] There were approximately 214,110 TBI-related hospitalizations in 2020 and 69,473 TBI-related deaths in 2021. This represents more than 586 TBI-related hospitalizations and 190 TBI-related deaths per day. […] People age 75 years and older had the highest numbers and rates of TBI-related hospitalizations and deaths. This age group accounts for about 32% of TBI-related hospitalizations and 28% of TBI-related deaths.
  • #60 TBI Data | Traumatic Brain Injury & Concussion | CDC
    https://www.cdc.gov/traumatic-brain-injury/data-research/index.html
    Males were nearly two times more likely to be hospitalized and three times more likely to die from a TBI than females. […] CDC conducts research on preventing TBIs and reducing the chance for disability and other potential effects of these injuries. […] Learn more about the National Concussion Surveillance System, a state-of-the-art data collection effort designed to learn how many Americans (children and adults) get a concussion each year and the leading causes of this injury.
  • #61 Concussion and Mild-Traumatic Brain Injury in Rural Settings: Epidemiology and Specific Health Care Considerations – Journal of Neurosciences in Rural Practice
    https://ruralneuropractice.com/concussion-and-mild-traumatic-brain-injury-in-rural-settings-epidemiology-and-specific-health-care-considerations/
    Mild-traumatic brain injury (mTBI) and concussions cause significant morbidity. To date, synthesis of specific health care disparities and gaps in care for rural mTBI/concussion patients remains needed. […] mTBI/concussion incidence was higher in rural compared with urban areas. Compared with urban patients, rural patients were at increased risk for vehicular injuries, lifetime number of concussions, admissions for observation without neuroimaging, and injury-related costs. Rural patients were less likely to utilize ambulatory and mental health services following mTBI/concussion. […] Rural patients are at unique risk for mTBI/concussions and health care costs. Barriers to care include lower socioeconomic status, longer distances to regional medical center, and decreased availability of neuroimaging and consultants.
  • #62 Concussion and Mild-Traumatic Brain Injury in Rural Settings: Epidemiology and Specific Health Care Considerations – Journal of Neurosciences in Rural Practice
    https://ruralneuropractice.com/concussion-and-mild-traumatic-brain-injury-in-rural-settings-epidemiology-and-specific-health-care-considerations/
    Understanding unique considerations in rural health care utilization after mTBI/concussion is critical to improve access and reduce health care burden. […] Access to neurological/neurosurgical care is limited by decreased hospital and specialty physician coverage, lack of transportation, financial constraints, and cultural attitudes. […] The mTBI/concussion treatment is typically conservative, with a clinical diagnosis supported by neuroimaging and often a period of observation, cognitive rest, and return precautions. […] Recovery in rural and/or low-resource settings presents additional challenges for rehabilitation and training for both patients and providers. […] Telemedicine is an emerging tool for remote triage and evaluation. Future studies applying mTBI management practices to specific rural locales are needed.
  • #63 Study Links Childhood Concussions to Lower Educational Attainment
    https://natlawreview.com/article/what-every-parent-should-know-about-childhood-concussions-and-long-term-learning
    What Every Parent Should Know About Childhood Concussions and Long-Term Learning by: Bruce H. Stern of Stark Stark – Personal Injury Law Journal Friday, April 25, 2025 Study Links Childhood Concussions to Lower Educational Attainment […] A new Finnish study is giving parents a reason to take pediatric concussions seriouslynot just in the moment, but for years to come. […] Researchers in Finland followed over 24,000 children from the time of their injury (between 1998 and 2018) into adulthood. They wanted to know: how does a traumatic brain injury (TBI)including concussionsaffect educational success? […] Kids with head injuries were less likely to go on to college or advanced education than those with orthopedic injuries. […] Even children who just had a concussion were significantly less likely to pursue higher levels of education.
  • #64 Study Links Childhood Concussions to Lower Educational Attainment
    https://natlawreview.com/article/what-every-parent-should-know-about-childhood-concussions-and-long-term-learning
    What Every Parent Should Know About Childhood Concussions and Long-Term Learning by: Bruce H. Stern of Stark Stark – Personal Injury Law Journal Friday, April 25, 2025 Study Links Childhood Concussions to Lower Educational Attainment […] A new Finnish study is giving parents a reason to take pediatric concussions seriouslynot just in the moment, but for years to come. […] Researchers in Finland followed over 24,000 children from the time of their injury (between 1998 and 2018) into adulthood. They wanted to know: how does a traumatic brain injury (TBI)including concussionsaffect educational success? […] Kids with head injuries were less likely to go on to college or advanced education than those with orthopedic injuries. […] Even children who just had a concussion were significantly less likely to pursue higher levels of education.
  • #65 Study Links Childhood Concussions to Lower Educational Attainment
    https://natlawreview.com/article/what-every-parent-should-know-about-childhood-concussions-and-long-term-learning
    The more serious the brain injury, the steeper the drop in educational achievement. […] It means that a head injury may have more than short-term effects. […] This study suggests that those early injuries can change the path your child takesacademically and beyond. […] Childhood brain injuries arent just a medical issuetheyre an educational and developmental issue.
  • #66 Study Links Childhood Concussions to Lower Educational Attainment
    https://natlawreview.com/article/what-every-parent-should-know-about-childhood-concussions-and-long-term-learning
    The more serious the brain injury, the steeper the drop in educational achievement. […] It means that a head injury may have more than short-term effects. […] This study suggests that those early injuries can change the path your child takesacademically and beyond. […] Childhood brain injuries arent just a medical issuetheyre an educational and developmental issue.
  • #67 Concussion and Traumatic Brain Injury Prevention Program
    https://portal.ct.gov/dph/health-education-management–surveillance/the-office-of-injury-prevention/concussion-and-traumatic-brain-injury-prevention-program
    During the 2023-2024 school year, 1,880 female and 2,340 male students were diagnosed with a concussion. Seventy-two percent (3,133 of 4,220 concussed students) missed school days because of these injuries. […] During the 2022-2023 school year, 1,447 female and 1,610 male students were diagnosed with a concussion. Ninety-one percent (2,796 of 3,057 concussed students) missed school days because of these injuries.
  • #68 Concussion
    https://dph.illinois.gov/topics-services/prevention-wellness/injury-violence-prevention/concussion.html
    A concussion is a traumatic brain injury that alters the way your brain functions. Effects are usually temporary but can include headaches and problems with concentration, memory, balance and coordination. […] Concussions are common, particularly if you play a contact sport. But every concussion injures your brain to some extent. This injury needs time and rest to heal properly. Most concussive traumatic brain injuries are mild, and people usually recover fully. However, for some people, symptoms may last for months or longer and can lead to short- and long-term problems affecting how they think, act, learn, and feel. […] The Centers for Disease Control and Preventions (CDC) Injury Center has developed the public health response to concussion. Through the HEADS UP campaign, concussion educational materials are available at no cost for youth sports coaches, school coaches, parents, athletes, and school and health care professionals.
  • #69 Acute mild traumatic brain injury (concussion) in adults – UpToDate
    https://www.uptodate.com/contents/acute-mild-traumatic-brain-injury-concussion-in-adults
    Mild traumatic brain injury (TBI) is common and, while typically benign, has a risk of serious short- and long-term sequelae. […] Important considerations in the management of mild TBI include [1]: Identification of immediate neurologic emergencies, Recognition and management of neurologic sequelae, Prevention of cumulative and chronic brain injury.
  • #70 Youth Sports Concussions | Florida Department of Health
    https://www.floridahealth.gov/programs-and-services/prevention/injury-prevention/youth-sports-concussions/index.html
    Coaches, parents and athletes all play a role in preventing concussions. […] The CDC provides a free online training for anyone to learn more: HEADS UP to Youth Sports. […] Before the first practice, coaches and school officials should talk to the parents and athletes about the dangers of concussions and potential long-term consequences of concussions. […] Coaches should ask if an athlete has ever had a concussion and insist that athletes are medically evaluated and are in a condition to participate. […] Coaches should work with other school or league officials to review injuries that occurred during the season.
  • #71 Youth Sports Concussions | Florida Department of Health
    https://www.floridahealth.gov/programs-and-services/prevention/injury-prevention/youth-sports-concussions/index.html
    Coaches, parents and athletes all play a role in preventing concussions. […] The CDC provides a free online training for anyone to learn more: HEADS UP to Youth Sports. […] Before the first practice, coaches and school officials should talk to the parents and athletes about the dangers of concussions and potential long-term consequences of concussions. […] Coaches should ask if an athlete has ever had a concussion and insist that athletes are medically evaluated and are in a condition to participate. […] Coaches should work with other school or league officials to review injuries that occurred during the season.
  • #72 Youth Sports Concussions | Florida Department of Health
    https://www.floridahealth.gov/programs-and-services/prevention/injury-prevention/youth-sports-concussions/index.html
    Coaches, parents and athletes all play a role in preventing concussions. […] The CDC provides a free online training for anyone to learn more: HEADS UP to Youth Sports. […] Before the first practice, coaches and school officials should talk to the parents and athletes about the dangers of concussions and potential long-term consequences of concussions. […] Coaches should ask if an athlete has ever had a concussion and insist that athletes are medically evaluated and are in a condition to participate. […] Coaches should work with other school or league officials to review injuries that occurred during the season.
  • #73 Concussion
    https://dph.illinois.gov/topics-services/prevention-wellness/injury-violence-prevention/concussion.html
    Public Act 099-0245 focuses primarily on concussion management at the middle school/junior high school and high school levels. The legislation amends the School Code and is a requirement for all schools. […] Each school board in the state of Illinois is required to adopt a policy regarding student athlete concussions and head injuries that is in compliance with the protocols, policies, and by-laws developed by the Illinois High School Association. […] Each school district must use education materials provided by the Illinois High School Association to educate coaches, student-athletes, and parents/guardians of student-athletes about the nature and risk of concussions and head injuries, including continuing play after a concussion or head injury. […] All public, private, or charter schools must convene a Concussion Oversight Teams (COT). The COTs primary function will be to develop return-to-play and return-to-learn protocols for students believed to have experienced a concussion. The protocols should be based on peer-reviewed scientific evidence consistent with guidelines from the Center for Disease Control and Prevention.
  • #74 Concussion
    https://dph.illinois.gov/topics-services/prevention-wellness/injury-violence-prevention/concussion.html
    Public Act 099-0245 focuses primarily on concussion management at the middle school/junior high school and high school levels. The legislation amends the School Code and is a requirement for all schools. […] Each school board in the state of Illinois is required to adopt a policy regarding student athlete concussions and head injuries that is in compliance with the protocols, policies, and by-laws developed by the Illinois High School Association. […] Each school district must use education materials provided by the Illinois High School Association to educate coaches, student-athletes, and parents/guardians of student-athletes about the nature and risk of concussions and head injuries, including continuing play after a concussion or head injury. […] All public, private, or charter schools must convene a Concussion Oversight Teams (COT). The COTs primary function will be to develop return-to-play and return-to-learn protocols for students believed to have experienced a concussion. The protocols should be based on peer-reviewed scientific evidence consistent with guidelines from the Center for Disease Control and Prevention.
  • #75 Traumatic Brain Injury | Georgia Department of Public Health
    https://dph.georgia.gov/health-topics/injury-prevention-program/cdc-core/traumatic-brain-injury
    A concussion is a type of TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a ding, getting your bell rung, or what seems to be a mild bump or blow to the head can be serious. […] Recognition and proper response to concussions when they first occur can help prevent further injury or even death. […] Georgias Return-To-Play law passed during the 2013 Legislative session and was signed by Governor Nathan Deal on April 23, 2013. The bill, aimed at protecting the states youth from concussion-related injuries, became effective January 1, 2014. Georgia joined 43 other states that passed similar legislation. […] At registration for a youth athletic activity, provide to all youth athletes parents or legal guardians an information sheet that informs them about the nature and risk of concussion and head injury. These organizations are also strongly encouraged to establish and implement a concussion management and return to play policy. […] Centers for Disease Control and Prevention (2022). Surveillance Report of Traumatic Brain Injury-related Deaths by Age Group, Sex, and Mechanism of InjuryUnited States, 2018 and 2019. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.
  • #76 Traumatic Brain Injury | Georgia Department of Public Health
    https://dph.georgia.gov/health-topics/injury-prevention-program/cdc-core/traumatic-brain-injury
    A concussion is a type of TBI, caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a ding, getting your bell rung, or what seems to be a mild bump or blow to the head can be serious. […] Recognition and proper response to concussions when they first occur can help prevent further injury or even death. […] Georgias Return-To-Play law passed during the 2013 Legislative session and was signed by Governor Nathan Deal on April 23, 2013. The bill, aimed at protecting the states youth from concussion-related injuries, became effective January 1, 2014. Georgia joined 43 other states that passed similar legislation. […] At registration for a youth athletic activity, provide to all youth athletes parents or legal guardians an information sheet that informs them about the nature and risk of concussion and head injury. These organizations are also strongly encouraged to establish and implement a concussion management and return to play policy. […] Centers for Disease Control and Prevention (2022). Surveillance Report of Traumatic Brain Injury-related Deaths by Age Group, Sex, and Mechanism of InjuryUnited States, 2018 and 2019. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.
  • #77 Traumatic Brain Injury | Department of Health | Commonwealth of Pennsylvania
    https://www.pa.gov/agencies/health/diseases-conditions/brain-and-neurological/traumatic-brain-injury.html
    The Department of Health is committed to expanding public knowledge regarding Traumatic Brain Injury (TBI) and increasing coordination and integration within existing service delivery systems, thereby enhancing the infrastructure needed for persons with TBI and their Families. […] A concussion is a type of traumatic brain injury, or TBI, caused by a bump, blow or jolt to the head that can change the way your brain normally works. […] Health care professionals may describe a concussion as a „mild” brain injury because concussions are usually not life-threatening. […] Most people with a concussion recover quickly and fully. But for some people, symptoms can last for days, weeks or longer. […] The Brain Injury (BI) Advisory Board of the Pennsylvania Department of Health was established in August 2001 by the Secretary of Health as a requirement of the Health Resources and Services Administration Federal TBI Planning Grant and Federal Traumatic Brain Injury Act of 1996 (42 U.S.C.A. 300d – 52 et seq.)
  • #78 Traumatic Brain Injury | Department of Health | Commonwealth of Pennsylvania
    https://www.pa.gov/agencies/health/diseases-conditions/brain-and-neurological/traumatic-brain-injury.html
    The board provides advice and expertise to the Pennsylvania Department of Health in the determination of service and support needs of individuals with BI and the implementation of services to those individuals and their families. […] The board plays an integral role in making recommendations regarding future activities to be placed in the BI State Action Plan thereby improving access to BI services in Pennsylvania through information and education. […] In accordance with Act 101 of 2011, the Pa. Department of Education has posted concussion related materials to their website in an effort to inform and educate student athletes, parents and coaches about the nature and risk of concussion and traumatic brain injury. […] An Act establishing standards for managing concussions and traumatic brain injuries to student athletes.
  • #79 Sport-related concussion and bodychecking in children and youth: Evaluation, management, and policy implications | Canadian Paediatric Society
    https://cps.ca/en/documents/position/sport-related-concussion-and-bodychecking
    Advanced video technology measuring brain strain provides further insight into the true impacts of bodychecking. […] In 2021, one study recorded 172 games from six different age groups over a 2-year period and recreated the amount of head trauma in a laboratory setting. […] The changes to bodychecking policy implemented by Hockey Canada and USA Hockey provided an opportunity to study the effects of reform on injury rates prospectively. […] Another analysis of injury data in Canadian Pee Wee hockey players (under 13 years old) both before and after bodychecking rules changed, found a 50% relative reduction in injury rate and a 64% reduction in concussion rate. […] More than 150 pre-eminent stakeholders in youth hockey met in 2017, with the aim of making hockey as safe as possible. […] Injury and concussion rates have been shown to be higher by three-fold among non-elite Pee Wee ice hockey players in leagues where bodychecking is permitted compared with leagues where bodychecking is prohibited. […] Health care costs were also examined, with an estimated 2.5 x reduction in health costs in leagues where bodychecking is disallowed among 11- to 12-year-olds. […] Policy change, rule enforcement, and education are the best evidence-based strategies to prevent head injuries.
  • #80 Sport-related concussion and bodychecking in children and youth: Evaluation, management, and policy implications | Canadian Paediatric Society
    https://cps.ca/en/documents/position/sport-related-concussion-and-bodychecking
    Advanced video technology measuring brain strain provides further insight into the true impacts of bodychecking. […] In 2021, one study recorded 172 games from six different age groups over a 2-year period and recreated the amount of head trauma in a laboratory setting. […] The changes to bodychecking policy implemented by Hockey Canada and USA Hockey provided an opportunity to study the effects of reform on injury rates prospectively. […] Another analysis of injury data in Canadian Pee Wee hockey players (under 13 years old) both before and after bodychecking rules changed, found a 50% relative reduction in injury rate and a 64% reduction in concussion rate. […] More than 150 pre-eminent stakeholders in youth hockey met in 2017, with the aim of making hockey as safe as possible. […] Injury and concussion rates have been shown to be higher by three-fold among non-elite Pee Wee ice hockey players in leagues where bodychecking is permitted compared with leagues where bodychecking is prohibited. […] Health care costs were also examined, with an estimated 2.5 x reduction in health costs in leagues where bodychecking is disallowed among 11- to 12-year-olds. […] Policy change, rule enforcement, and education are the best evidence-based strategies to prevent head injuries.
  • #81 Sport-related concussion and bodychecking in children and youth: Evaluation, management, and policy implications | Canadian Paediatric Society
    https://cps.ca/en/documents/position/sport-related-concussion-and-bodychecking
    Advanced video technology measuring brain strain provides further insight into the true impacts of bodychecking. […] In 2021, one study recorded 172 games from six different age groups over a 2-year period and recreated the amount of head trauma in a laboratory setting. […] The changes to bodychecking policy implemented by Hockey Canada and USA Hockey provided an opportunity to study the effects of reform on injury rates prospectively. […] Another analysis of injury data in Canadian Pee Wee hockey players (under 13 years old) both before and after bodychecking rules changed, found a 50% relative reduction in injury rate and a 64% reduction in concussion rate. […] More than 150 pre-eminent stakeholders in youth hockey met in 2017, with the aim of making hockey as safe as possible. […] Injury and concussion rates have been shown to be higher by three-fold among non-elite Pee Wee ice hockey players in leagues where bodychecking is permitted compared with leagues where bodychecking is prohibited. […] Health care costs were also examined, with an estimated 2.5 x reduction in health costs in leagues where bodychecking is disallowed among 11- to 12-year-olds. […] Policy change, rule enforcement, and education are the best evidence-based strategies to prevent head injuries.
  • #82 Sport-related concussion and bodychecking in children and youth: Evaluation, management, and policy implications | Canadian Paediatric Society
    https://cps.ca/en/documents/position/sport-related-concussion-and-bodychecking
    Advanced video technology measuring brain strain provides further insight into the true impacts of bodychecking. […] In 2021, one study recorded 172 games from six different age groups over a 2-year period and recreated the amount of head trauma in a laboratory setting. […] The changes to bodychecking policy implemented by Hockey Canada and USA Hockey provided an opportunity to study the effects of reform on injury rates prospectively. […] Another analysis of injury data in Canadian Pee Wee hockey players (under 13 years old) both before and after bodychecking rules changed, found a 50% relative reduction in injury rate and a 64% reduction in concussion rate. […] More than 150 pre-eminent stakeholders in youth hockey met in 2017, with the aim of making hockey as safe as possible. […] Injury and concussion rates have been shown to be higher by three-fold among non-elite Pee Wee ice hockey players in leagues where bodychecking is permitted compared with leagues where bodychecking is prohibited. […] Health care costs were also examined, with an estimated 2.5 x reduction in health costs in leagues where bodychecking is disallowed among 11- to 12-year-olds. […] Policy change, rule enforcement, and education are the best evidence-based strategies to prevent head injuries.
  • #83 Sport-related concussion and bodychecking in children and youth: Evaluation, management, and policy implications | Canadian Paediatric Society
    https://cps.ca/en/documents/position/sport-related-concussion-and-bodychecking
    Advanced video technology measuring brain strain provides further insight into the true impacts of bodychecking. […] In 2021, one study recorded 172 games from six different age groups over a 2-year period and recreated the amount of head trauma in a laboratory setting. […] The changes to bodychecking policy implemented by Hockey Canada and USA Hockey provided an opportunity to study the effects of reform on injury rates prospectively. […] Another analysis of injury data in Canadian Pee Wee hockey players (under 13 years old) both before and after bodychecking rules changed, found a 50% relative reduction in injury rate and a 64% reduction in concussion rate. […] More than 150 pre-eminent stakeholders in youth hockey met in 2017, with the aim of making hockey as safe as possible. […] Injury and concussion rates have been shown to be higher by three-fold among non-elite Pee Wee ice hockey players in leagues where bodychecking is permitted compared with leagues where bodychecking is prohibited. […] Health care costs were also examined, with an estimated 2.5 x reduction in health costs in leagues where bodychecking is disallowed among 11- to 12-year-olds. […] Policy change, rule enforcement, and education are the best evidence-based strategies to prevent head injuries.
  • #84
    https://journals.lww.com/headtraumarehab/fulltext/2025/01000/summary_of_the_centers_for_disease_control_and.7.aspx
    Efforts can be made to optimize and standardize data collection approaches to ensure consistent measurement across settings and populations. […] An alternative approach to TBI surveillance is to make use of national self-report surveys that ask respondents to report their experience with head injuries. […] In recent years, programs within the Centers for Disease Control and Prevention (CDC), the United States federal public health agency, have sponsored questions in several national surveys in an attempt to better quantify the burden of TBI in the United States. […] Without such estimates, it is difficult to determine whether strategies and programs to prevent TBI have been effective. […] Capturing and reflecting on recent TBI surveillance efforts will help support continued refinement of methods aimed at obtaining the most accurate and reliable estimates of TBI burden.
  • #85 Summary of the Centers for Disease Control and Prevention’s Self-reported Traumatic Brain Injury Survey Efforts – PubMed
    https://pubmed.ncbi.nlm.nih.gov/39038104/
    Survey data based on self-reported concussions and TBIs resulted in larger prevalence estimates than would be expected based on traditional surveillance methods. Analyses of the various surveys shows that how the questions are asked and what terminology is used can notably affect the estimates observed. Efforts can be made to optimize and standardize data collection approaches to ensure consistent measurement across settings and populations.
  • #86 Rationale for the Development of a Traumatic Brain Injury Case Definition for the Pilot National Concussion Surveillance System | MSKTC
    https://msktc.org/tbi/publications/rationale-development-traumatic-brain-injury-case-definition-pilot-national
    Because of the constraints of identifying TBI in clinical settings, an alternative surveillance approach is to collect TBI data via a self-report survey. […] A tiered TBI case definition is proposed with tiers based on the type of sign/symptom(s) reported the number of symptoms reported, and the timing of symptom onset.
  • #87
    https://journals.lww.com/headtraumarehab/fulltext/2024/03000/rationale_for_the_development_of_a_traumatic_brain.3.aspx
    Because of the constraints of identifying TBI in clinical settings, an alternative surveillance approach is to collect TBI data via a self-report survey. […] This article outlines the rationale and process the CDC used to develop a tiered case definition for self-reported TBI to be used for surveillance purposes. […] A tiered TBI case definition is proposed with tiers based on the type of sign/symptom(s) reported the number of symptoms reported, and the timing of symptom onset.
  • #88
    https://journals.lww.com/headtraumarehab/fulltext/2025/01000/summary_of_the_centers_for_disease_control_and.7.aspx
    Specific head injury terminology was an important factor that impacted the prevalence. […] Future research may focus on refining the content and wording of TBI questions for surveys based on the findings of this summary. […] Self-report surveys have shown to be an effective way to gain information about difficult to identify conditions including TBI.
  • #89
    https://journals.lww.com/headtraumarehab/fulltext/2025/01000/summary_of_the_centers_for_disease_control_and.7.aspx
    Specific head injury terminology was an important factor that impacted the prevalence. […] Future research may focus on refining the content and wording of TBI questions for surveys based on the findings of this summary. […] Self-report surveys have shown to be an effective way to gain information about difficult to identify conditions including TBI.
  • #90 Self-reported concussions in Canada: A cross-sectional study
    https://www150.statcan.gc.ca/n1/pub/82-003-x/2023006/article/00002-eng.htm
    In Canada, important epidemiological work on concussions has been conducted in recent years, highlighting the magnitude of this injury in specific regions. […] Not captured in the above studies’ estimates, however, are incidents where no medical care is sought following a concussion, likely underestimating the incidence of this injury. […] To address this gap, the 2020 CCHS cycle included the Traumatic Brain Injury Rapid Response (TBIRR) module, which allowed for the examination of the incidence of concussions in 2019 among Canadians aged 12 years or older residing in the 10 Canadian provinces. […] This research provides a national examination on the incidence of self-reported concussions occurring in 2019. The results of this study suggest that certain populations, particularly younger individuals, may be more affected by concussions.
  • #91 Self-reported concussions in Canada: A cross-sectional study
    https://www150.statcan.gc.ca/n1/pub/82-003-x/2023006/article/00002-eng.htm
    In Canada, important epidemiological work on concussions has been conducted in recent years, highlighting the magnitude of this injury in specific regions. […] Not captured in the above studies’ estimates, however, are incidents where no medical care is sought following a concussion, likely underestimating the incidence of this injury. […] To address this gap, the 2020 CCHS cycle included the Traumatic Brain Injury Rapid Response (TBIRR) module, which allowed for the examination of the incidence of concussions in 2019 among Canadians aged 12 years or older residing in the 10 Canadian provinces. […] This research provides a national examination on the incidence of self-reported concussions occurring in 2019. The results of this study suggest that certain populations, particularly younger individuals, may be more affected by concussions.
  • #92 Epidemiology of mild traumatic brain injury and neurodegenerative disease
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4461453/
    MTBI is extremely common affecting roughly 42 million people annually worldwide. […] Moderate or severe TBI is an established risk factor for neurodegenerative diseases such as dementia, PD, and ALS. […] Recently, large epidemiological studies have reported that MTBI and repetitive MTBI are also significant risk factors for neurodegenerative diseases, but these associations are not yet as well established and require further replication. […] Prevalence of CTE is unknown due to referral bias limiting autopsy studies and lack of consensus clinical criteria limiting unbiased population-based studies. […] Improved quantification of MTBI exposure as well as prospective longitudinal studies of outcomes and risk factors will be critical to elucidate the actual burden of neurodegenerative diseases including CTE among athletes, military personnel, and civilians exposed to single or repetitive MTBI.
  • #93 Concussive head injury in children and adolescents
    https://www.racgp.org.au/afp/2016/july/concussive-head-injury-in-children-and-adolescents
    The current understanding of concussion in children and adolescents converge around an integrated model of clinical and physiological recovery. […] A proportion of patients (15-20%) have symptoms that do not resolve with appropriate intervention. Management of patients with this atypical recovery is challenging and best referred to a specialist clinic that can provide a multidisciplinary and interdisciplinary approach to care. […] Tremendous concern exists about neurodegeneration induced by repetitive concussions chronic traumatic encephalopathy. […] Although our understanding of concussive injury is evolving, concussion remains a clinical diagnosis, with clinicians assessing patients using standard clinical assessment methods. […] Prevention strategies are critically important, and the GP stands as a key agent for change in this field, as the best prevention is good concussion care.
  • #94 Concussion / Mild Traumatic Brain Injury (mTBI) – Province of British Columbia
    https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/concussion-mild-traumatic-brain-injury-mtbi
    In 2019/20, approximately 19,000 British Columbians visited the emergency department for concussion. These figures likely under-report injury incidence because many either do not seek medical assessment or are seen in community-based clinics. Children aged 0-14 years have the highest rate of emergency department visits for concussion. Older adults also have high concussion rates that are influenced by general frailty and age-specific risk factors for falls (e.g., cognitive impairment, polypharmacy, reduced physical fitness). […] Prognosis is generally good, with most experiencing symptom resolution within a few weeks to months. However, symptom resolution does not necessarily indicate complete physiological recovery and subtle deficits that are not measurable through subjective assessments may persist. Patients are at increased risk of re-injury during the recovery period, even if they are asymptomatic. Re-injury before complete recovery can result in more severe and longer-lasting physiological/clinical disturbances. […] While most patients recover well, one in four youth and at least one in six adults have persisting symptoms (i.e., those that remain 4 weeks) and concussion-related disability. High initial symptom severity is the strongest, most reliable predictor of persisting symptoms.
  • #95 Concussion / Mild Traumatic Brain Injury (mTBI) – Province of British Columbia
    https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/concussion-mild-traumatic-brain-injury-mtbi
    In 2019/20, approximately 19,000 British Columbians visited the emergency department for concussion. These figures likely under-report injury incidence because many either do not seek medical assessment or are seen in community-based clinics. Children aged 0-14 years have the highest rate of emergency department visits for concussion. Older adults also have high concussion rates that are influenced by general frailty and age-specific risk factors for falls (e.g., cognitive impairment, polypharmacy, reduced physical fitness). […] Prognosis is generally good, with most experiencing symptom resolution within a few weeks to months. However, symptom resolution does not necessarily indicate complete physiological recovery and subtle deficits that are not measurable through subjective assessments may persist. Patients are at increased risk of re-injury during the recovery period, even if they are asymptomatic. Re-injury before complete recovery can result in more severe and longer-lasting physiological/clinical disturbances. […] While most patients recover well, one in four youth and at least one in six adults have persisting symptoms (i.e., those that remain 4 weeks) and concussion-related disability. High initial symptom severity is the strongest, most reliable predictor of persisting symptoms.
  • #96 Concussion / Mild Traumatic Brain Injury (mTBI) – Province of British Columbia
    https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/concussion-mild-traumatic-brain-injury-mtbi
    In 2019/20, approximately 19,000 British Columbians visited the emergency department for concussion. These figures likely under-report injury incidence because many either do not seek medical assessment or are seen in community-based clinics. Children aged 0-14 years have the highest rate of emergency department visits for concussion. Older adults also have high concussion rates that are influenced by general frailty and age-specific risk factors for falls (e.g., cognitive impairment, polypharmacy, reduced physical fitness). […] Prognosis is generally good, with most experiencing symptom resolution within a few weeks to months. However, symptom resolution does not necessarily indicate complete physiological recovery and subtle deficits that are not measurable through subjective assessments may persist. Patients are at increased risk of re-injury during the recovery period, even if they are asymptomatic. Re-injury before complete recovery can result in more severe and longer-lasting physiological/clinical disturbances. […] While most patients recover well, one in four youth and at least one in six adults have persisting symptoms (i.e., those that remain 4 weeks) and concussion-related disability. High initial symptom severity is the strongest, most reliable predictor of persisting symptoms.
  • #97 Concussion / Mild Traumatic Brain Injury (mTBI) – Province of British Columbia
    https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/concussion-mild-traumatic-brain-injury-mtbi
    In 2019/20, approximately 19,000 British Columbians visited the emergency department for concussion. These figures likely under-report injury incidence because many either do not seek medical assessment or are seen in community-based clinics. Children aged 0-14 years have the highest rate of emergency department visits for concussion. Older adults also have high concussion rates that are influenced by general frailty and age-specific risk factors for falls (e.g., cognitive impairment, polypharmacy, reduced physical fitness). […] Prognosis is generally good, with most experiencing symptom resolution within a few weeks to months. However, symptom resolution does not necessarily indicate complete physiological recovery and subtle deficits that are not measurable through subjective assessments may persist. Patients are at increased risk of re-injury during the recovery period, even if they are asymptomatic. Re-injury before complete recovery can result in more severe and longer-lasting physiological/clinical disturbances. […] While most patients recover well, one in four youth and at least one in six adults have persisting symptoms (i.e., those that remain 4 weeks) and concussion-related disability. High initial symptom severity is the strongest, most reliable predictor of persisting symptoms.
  • #98 Concussion / Mild Traumatic Brain Injury (mTBI) – Province of British Columbia
    https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/concussion-mild-traumatic-brain-injury-mtbi
    In 2019/20, approximately 19,000 British Columbians visited the emergency department for concussion. These figures likely under-report injury incidence because many either do not seek medical assessment or are seen in community-based clinics. Children aged 0-14 years have the highest rate of emergency department visits for concussion. Older adults also have high concussion rates that are influenced by general frailty and age-specific risk factors for falls (e.g., cognitive impairment, polypharmacy, reduced physical fitness). […] Prognosis is generally good, with most experiencing symptom resolution within a few weeks to months. However, symptom resolution does not necessarily indicate complete physiological recovery and subtle deficits that are not measurable through subjective assessments may persist. Patients are at increased risk of re-injury during the recovery period, even if they are asymptomatic. Re-injury before complete recovery can result in more severe and longer-lasting physiological/clinical disturbances. […] While most patients recover well, one in four youth and at least one in six adults have persisting symptoms (i.e., those that remain 4 weeks) and concussion-related disability. High initial symptom severity is the strongest, most reliable predictor of persisting symptoms.
  • #99 Perspective Chapter: Challenges in the Diagnosis of Post-Concussion Syndrome – Epidemiology, Pathophysiology, Neuropathology, Neuroimaging Biomarkers, and Salivary Biomarkers | IntechOpen
    https://www.intechopen.com/online-first/1188580
    Post-concussion syndrome (PCS) occurs after mild brain injuries, with a prevalence of 29-90% among head injury patients. It is characterized by symptoms like irritability, headaches, and concentration issues, which develop soon after the injury and can last for weeks to months. Persistent PCS is identified if symptoms continue beyond six months. […] Research findings indicate that anywhere from 30 to 80% of individuals with mild to moderate traumatic brain injury (TBI) may display symptoms aligning with PCS. […] Literature reviews have explored the link between TBI severity and PCS occurrence in individuals with mild TBI. Still, findings regarding the correlation between injury severity and PCS risk have been inconsistent. […] Recent cohort studies and analyses have identified women as being particularly vulnerable to persistent PCS symptoms.
  • #100 Perspective Chapter: Challenges in the Diagnosis of Post-Concussion Syndrome – Epidemiology, Pathophysiology, Neuropathology, Neuroimaging Biomarkers, and Salivary Biomarkers | IntechOpen
    https://www.intechopen.com/online-first/1188580
    Post-concussion syndrome (PCS) occurs after mild brain injuries, with a prevalence of 29-90% among head injury patients. It is characterized by symptoms like irritability, headaches, and concentration issues, which develop soon after the injury and can last for weeks to months. Persistent PCS is identified if symptoms continue beyond six months. […] Research findings indicate that anywhere from 30 to 80% of individuals with mild to moderate traumatic brain injury (TBI) may display symptoms aligning with PCS. […] Literature reviews have explored the link between TBI severity and PCS occurrence in individuals with mild TBI. Still, findings regarding the correlation between injury severity and PCS risk have been inconsistent. […] Recent cohort studies and analyses have identified women as being particularly vulnerable to persistent PCS symptoms.
  • #101 Perspective Chapter: Challenges in the Diagnosis of Post-Concussion Syndrome – Epidemiology, Pathophysiology, Neuropathology, Neuroimaging Biomarkers, and Salivary Biomarkers | IntechOpen
    https://www.intechopen.com/online-first/1188580
    Post-concussion syndrome (PCS) occurs after mild brain injuries, with a prevalence of 29-90% among head injury patients. It is characterized by symptoms like irritability, headaches, and concentration issues, which develop soon after the injury and can last for weeks to months. Persistent PCS is identified if symptoms continue beyond six months. […] Research findings indicate that anywhere from 30 to 80% of individuals with mild to moderate traumatic brain injury (TBI) may display symptoms aligning with PCS. […] Literature reviews have explored the link between TBI severity and PCS occurrence in individuals with mild TBI. Still, findings regarding the correlation between injury severity and PCS risk have been inconsistent. […] Recent cohort studies and analyses have identified women as being particularly vulnerable to persistent PCS symptoms.
  • #102 Concussive head injury in children and adolescents
    https://www.racgp.org.au/afp/2016/july/concussive-head-injury-in-children-and-adolescents
    The current understanding of concussion in children and adolescents converge around an integrated model of clinical and physiological recovery. […] A proportion of patients (15-20%) have symptoms that do not resolve with appropriate intervention. Management of patients with this atypical recovery is challenging and best referred to a specialist clinic that can provide a multidisciplinary and interdisciplinary approach to care. […] Tremendous concern exists about neurodegeneration induced by repetitive concussions chronic traumatic encephalopathy. […] Although our understanding of concussive injury is evolving, concussion remains a clinical diagnosis, with clinicians assessing patients using standard clinical assessment methods. […] Prevention strategies are critically important, and the GP stands as a key agent for change in this field, as the best prevention is good concussion care.

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