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Department Brown Bag Lunch Seminars: Nigel King, University of Oxford

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Location: H1.49 - Humanities Building

Title: Mild Traumatic Brain Injury and Post-concussion Symptoms: Conceptualisation, Measurement and Treatment

 

Abstract:

Mild traumatic Brain Injury (MTBI) is usually defined as a blow to the head resulting in at least one of the following: i) Post Traumatic Amnesia (PTA) of less than 24 hours: ii) an initial Glasgow Coma Scale Score of 13-15 and/or iii) a loss of consciousness of less than 30 minutes. Approximately 50% of MTBIs result in post-concussion symptoms (PCS) and these typically last, at worst, for a few weeks. A minority (approximately 15%) however experience more persisting symptoms (3 -12 months) and a small minority have long-term or permanent symptoms of a very disabling nature (12+ months).

The economic and employment impact of head injury is substantial and almost half (44%) of such has been calculated as due to MTBI. Current estimates in the UK would therefore be a cost of £6.6 billion pounds per year due to lost wages, increased use of services for physical and mental health and reduced tax yields.

The papers submitted for the Phd were written over a twenty six year period and include five original empirical research studies, two literature reviews and a case study.

Two papers were contributions to the early empirical investigations examining how MTBI and PCS should be best conceptualized.

Two papers examined the measurement of key areas of MTBI – the reliability of a novel questionnaire measuring PCS and the reliability of measuring PTA by retrospective questioning.

Two papers examined the treatment of PCS - one via a large-scale randomized controlled trial of an early intervention for MTBI, and one via an examination of early factors which might predict persistent PCS.

More recently, the MTBI literature has started to exhibit a significant divergence between the broader literature and the one specifically relating to Sport Related Concussion (SRC). This unhelpful development is addressed for the first time in a literature review and a final paper which presents a case study highlighting some of the clinical implications of this.

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