Short-term sequelae of minor head injury (6 years experience of minor headinjury clinic)

Purpose: It is known that post-concussive symptoms may persist after mild h ead injury. However, the majority of those patients are denied follow-up or support. A minor head injury clinic was thus established in North Stafford shire Hospital in 1993 to address these problems. Methods: Patients 16-65 years old attending hospital with minor head injury were invited to attend the clinic two weeks after presentation. A speciali zed brain injury nurse and/or assistant clinical psychologist assessed them . Patients with persistent symptoms were invited to a second assessment fou r weeks later. Results: One thousand two hundred and fifty-five patients were invited for first assessment, the most common cause of head injury was assault (454) fo llowed by road traffic accident (334). Six hundred and sixteen patients did not attend the first assessment; most of non-attendees were those who had been assaulted (281). Six hundred and thirty-nine patients attended, (472) were male, their mean age was 33. Forty-three per cent of them had history of recent alcohol intake. One third had had a previous head injury. Althoug h 391 attendees were in regular employment, 219 patients were unable to ret urn to work 2 weeks after discharge (56%), and 49 people were still off sic k 6 weeks after the injury. The most common complaints at both assessments were fatigue, headache, dizziness, irritability, sleep disturbances, poor c oncentration and poor memory in that order. Conclusion: This study shows a significant number of patients with minor he ad injury still complaining of post concussive symptoms, which may contribu te to a delay in return to work. The high incidence of non-attendance among the assaulted victims may indicate that this group needs to be more effect ively targeted. Further study to look at the longer-term consequences of mi nor head injury is required in view of these findings.