The high variability in mTBI recovery creates a prognosis that is widely unknown and unstable. In a literature review presented by Levin and Diaz-Arrastia (2015), one source found that confusion could clear within the first day after the injury and post-concussion symptoms can resolve within twelve weeks. Conversely, another source in Levin and Diaz-Arrastia’s literature review found a new onset or intensification of these symptoms could manifest three months after the injury, especially if a pre-existing condition or neuropsychiatric disorder was present. Interestingly, while it was found that athletes can heal faster from the effects of mTBI by Levin and Diaz-Arrastia’s literature review, it was also found that athletes are at a higher risk for reoccurring head injuries and therefor may develop permanent impairment (West & Marion, 2014). Ultimately, organizations such as the American Medical Society for Sports Medicine and the American Academy of Neurology suggests that neurological impairment from mTBI can be chronic and last a lifetime (West & Marion, 2014). Even the Department of Veterans Affair’s screening found symptoms persisting in their veterans when assessed up to three years after their injury (Belanger, Vanderploeg, & Sayer, 2016). The need to understand why there are such varying degrees of recovery is more evident than ever.
Interestingly, for more recent injuries assessed, victims commonly report physical issues such as headaches, dizziness, and cognitive impairment. In a comparison study of 50 patients who sustained an mTBI to 100 control subjects, within an average of 2.42 days it was found that the mTBI patients had significantly higher rates of headaches, dizziness, and cognitive dysfunction compared to the control subjects, though sleep disorders and emotional issues were also significantly more common (Hoffer, et al., 2016). While these results were expected, they showed that it is possible that mostly physical and cognitive symptoms are present immediately following an mTBI and more psychological dysfunction can become visible later on. Just three months following the injury, a longitudinal study showed that sadness and fatigue can linger on. Participants were assessed with a battery of tests at one week and three months following their injuries. The results showed that while the complaints lessened over time, there were significantly higher rates of sadness and fatigue compared to the trauma control group at one week and three months after the injury. (Ponsford, Cameron, Fitzgerald, Grant, & Mikocka-Walus, 2011). Although these results are varying, it proves that more longitudinal research following a head injury is needed to determine when symptoms appear and if they can be attributable to the injury itself or other factors.
Belanger, H. G., Vanderploeg, R. D., & Sayer, N. (2016). Screening for remote history of mild traumatic brain injury in VHA. Journal of Head Trauma Rehabilitation, 31(3), 204-214. doi:10.1097/HTR.0000000000000168
Hoffer, M. E., Szczupak, M., Kiderman, A., Crawford, J., Murphy, S., Marshall, K., … & Balaban, C. (2016). Neurosensory symptom complexes after acute mild traumatic brain injury. PloS one, 11(1). doi:10.1371/journal.pone.0146039
Levin, H. S., & Diaz-Arrastia, R. (2015). Diagnosis, prognosis, and clinical management of mild traumatic brain injury. The Lancet Neurology, 14(5), 506-517. doi:http://dx.doi.org.tcsedsystem.idm.oclc.org/10.1016/S1474-4422(15)00002-2
Ponsford, J., Cameron, P., Fitzgerald, M., Grant, M., & Mikocka-Walus, A. (2011). Long-term outcomes after uncomplicated mild traumatic brain injury: A comparison with trauma controls. J Neurotrauma, 28(6), 937-946. doi:10.1089/neu.2010.1516
West, T. A., & Marion, D. W. (2014). Current recommendations for the diagnosis and treatment of concussion in sport: A comparison of three new guidelines. Journal of Neurotrauma, 31(2), 159-68. doi:http://dx.doi.org.tcsedsystem.idm.oclc.org/10.1089/neu.2013.3031