What do you guys think of the terms "mild TBI" or "Post-concussive syndrome"? Do they pretty much mean the same thing? They obviously have different connotations. Just wondering because I recently came across a group of patients with these diagnoses (plural?) and they all seem to suffer from these vague memory/concentration/organization defecits. Granted each one of these have had some sort of traumatic experience in their lives that caused some mild head trauma, but when I interviewed them, they all seemed to me like those kids back in my highschool years who were basically underacheivers (perhaps not by choice). I wonder if we have more undiagnosed "mild-TBI" people out there than we know of.... I'm guessing yes. Any of you actually deal with this diagnosis?
Excellent question!
"Mild TBI" is a more powerful term that will grant them better access to the treatments and rehab they need. It infers there was actual damage to the brain and will help the patient with insurance, legal needs, etc. PET scans close to the time of injury can help support the diagnosis when CT and fail to show anything. If these are medico-legal cases, I will often order PET.
"Post-Concussive Syndrome" is more of a descriptive term of the symptoms they are experiencing. It does help the patient to better understand and justify what they are experiencing, but the public understanding of concussion is a bump on the head that goes away quickly, when the reality is it can persist for months or chronically.
I usually Dx TBI as the primary, and then add PCS if they have balance or gait disorder, dizziness and other "come-an-go" symptoms.
I see a lot of MVA pts with neck pain who have undiagnosed TBI, and they don't bring it up unless you ask the right questions. When the head is still traveling forward at 60 mph and an airbag is coming at you at 200 mph, secondary and tertiary injuries to the brain are likely common, but overlooked.
For all neck trauma patients, I inquire about memory loss, balance problems, dizziness, head trauma including LOC, lacerations and bruises at the time of the accident, seat belts and air bags, speed of the accident, other injuries, etc.
