Mild traumatic brain injury after motor vehicle collisions: what are the symptoms and who treats them? A population-based 1-year inception cohort study

Abstract

Objective: To describe the 1-year course of symptoms following mild traumatic brain injury (MTBI) sustained in a motor vehicle collision as well as patterns of care-seeking.

Design: One-year follow-up of a population-based inception cohort.

Setting: The province of Saskatchewan, Canada, with a population of about 1,000,000 inhabitants.

Participants: Persons (N=1716) sustaining an MTBI during a car collision between November 1997 and December 1999.

Interventions: Not applicable.

Main outcome measures: We report the prevalence of sleep disturbances, tiredness, dizziness, forgetfulness, vision problems, hearing problems, headache, neck pain, mid back pain, and low back pain at 6 weeks and 3, 6, 9, and 12 months postcollision. At the same time points, we report self-reported care-seeking from registered health care professionals.

Results: A total of 1716 adults suffered MTBI after a motor vehicle collision over the 2-year inception period. Six weeks after the collision, 75% reported having more than 3 symptoms and 30% had clinically significant pain in more than 3 body sites. Over time, the prevalence of symptoms and pain decreased but they were still common after 1 year. Almost all participants sought care for their symptoms at all time points, most commonly from a physician. Care-seeking from physiotherapists, chiropractors, and massage therapists was also very common, and most participants sought care from 2 or 3 providers at all follow-up points.

Conclusions: Up to 1 year after sustaining an MTBI during a motor vehicle collision, multiple symptoms and pain in several anatomical sites are common. Care-seeking from multiple providers continues throughout the first year postinjury.

Keywords: Brain concussion; Cohort studies; Health care seeking behaviour; Rehabilitation.