COGNITIVE SCREENING IN MILD TRAUMATIC BRAIN INJURIES - ANALYSIS OF THE NEUROBEHAVIORAL COGNITIVE STATUS EXAMINATION WHEN UTILIZED DURING INITIAL TRAUMA HOSPITALIZATION

Cognitive screening following mild traumatic brain injury (MTBI) remai ns variable with method of diagnosis, indications for testing, and uti lization of results differing between institutions. The Neurobehaviora l Cognitive Status Examination (NCSE) was originally developed for use in organic brain dysfunction and central nervous system (CNS) lesions . When attention is given to both the objective cognitive area scores and the ''process features'' component of the exam, it is an effective tool for identifying cognitive deficits associated with MTBI. One hun dred seven MTBI patients underwent cognitive screening in the acute ca re setting. Memory was the function most frequently affected in patien ts with positive cognitive screens. Several of the NCSE deficits also correlated significantly with each other but not with memory. Age, len gth of stay, injury severity score (ISS), and cranial computed tomogra phy scan were not associated with cognitive screen results. An admissi on Glasgow Coma Scale (GCS) of 13 or 14 was significantly associated w ith a positive cognitive screen, but a GCS of 15 did not predict a neg ative cognitive screen. All patients with MTBI require cognitive scree ning to identify deficits, ensure patient and family education, and wh en necessary facilitate treatment.