Postconcussion symptoms in patients with injury-related chronic pain.
Background. Postconcussion symptoms (PCSs)-such as fatigue, headache, irritability, dizziness, and impaired memory-are commonly reported in patients who have mild traumatic brain injuries (MTBIs). Evaluation of PCS after MTBI is proposed to have a diagnostic value although it is unclear whether PCS are specific to MTBI. After whiplash injuries, patients most often complain of headaches and neck pain; the other PCS are not as closely evaluated. In patients with chronic pain because of other injuries, the presence of PCS is unclear. This study aimed to describe the frequency of PCS in patients with injury-related pain and to examine the relationships between PCS, pain, and psychological factors. Methods. This study collected data using questionnaires addressing PCS (Rivermead Postconcussion Questionnaire, RPQ), pain intensity (Visual Analogue Scale), depression, anxiety (Hospital, Anxiety, and Depression Scale), and posttraumatic stress (Impact of Event Scale). Results. Fatigue (90.7%), sleep disturbance (84.9%), headache (73.5%), poor concentration (88.2%), and poor memory (67.1%) were some of the most commonly reported PCS. Significant relationships were found between PCS and posttraumatic stress, depression, and anxiety. Conclusion. To optimize treatment, it is important to assess each patient's PCS, the mechanism of injury, and factors such as posttraumatic stress and depression.
Department of Community Medicine and Rehabilitation, Umeå University Hospital, Umeå University, Building 9A, 90185 Umeå, Sweden.
Britt Marie
BM
Stålnacke