Citation

Ramos-Zúñiga R, González-de la Torre M, Jiménez-Maldonado M, Villaseñor-Cabrera T, Bañuelos-Acosta R, Aguirre-Portillo L, Genoveva RC, Jáuregui-Huerta F. World Neurosurg. 2013; 82(5): 828-835.

Affiliation

Depto. De Neurociencias, CUCS. Universidad de Guadalajara. Electronic address: rodrigor@cencar.udg.mx.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.wneu.2013.09.018

PMID

24055567

Abstract

OBJETIVE: Post concussion syndrome (PCS) is usually underestimated in cases of mild head injury (MHI). It is one of the most common causes of physical, cognitive and psychomotor disturbances that affect the quality of life, work and social reintegration of individuals. Until now, we don't have evidence of structural abnormalities shown by traditional imaging methods. We describe a series of instruments that confirm PCS with satisfactory evidence. METHODS: A clinical prospective study of 19 adult patients selected from a pool of 320 adults who had MHI. The cognitive, executive and memory functions of subjects were examined within the first 72 hours using neuropsychological (NPS) tests. These results were analyzed with neurological examination and functional MR/spectroscopy. RESULTS: Neurobehavioral alterations were found in 47% of cases, with posttraumatic amnesia (PTA). Around 55% of subjects experienced physical disturbances such as headache and postural vertigo due to PCS. The spectroscopy reports revealed neurometabolite disturbances in 54% of cases, particularly Naa (N-acetylaspartate) and the Naa/lactate ratio in the frontal lobe. We observed a relationship between metabolite disturbances in spectroscopy and the digit span backward test (p= 0.045). CONCLUSION: This first diagnostic strategy supports the presence of PCS in MHI supported with scientific evidence. We identified physical and neuropsychological abnormalities from this group, affecting the areas of memory and learning. Evidence of neurometabolite disturbances were found specifically in the frontal lobe. It is necessary to complete comparative follow-ups for an extended period of time. The neuropsychological and spectroscopy tests allow us to confirm the diagnosis of a syndrome that is usually neglected.

Language: en