hemorrhages seen on brain images after mild traumatic brain injury may increase the risk of post-concussion syndrome

Background and aim: mild traumatic brain injury (mtbi) mostly develops the symptoms that may persist for over three months known as post-concussion syndrome (pcs). however, the pcs potential risk for mtbi victims is not well-identified. here, we investigated the putative risk factors of pcs. methods and materials/patients: in a cross-sectional study, we collected (his) the demographic, clinical, and radiological data using the hospital information system in 388 mtbi patients who passed at least 3 months since the onset of their injury and referred to poursina hospital from march 2017 to december 2018. the patients were examined to diagnose pcs by a general physician using the phone interview via the rivermead post-concussion symptoms questionnaire (rpq). the subjects were separated into groups with and without pcs. data were analyzed by parametric t-test, chi-square test and multiple logistic regression. results: one-hundred ninety one out of 388 mtbi patients consented to complete the rpq and around 59% of cases experienced pcs. there was no significant difference in the demographic variables and past medical history between groups. however, the previous psychological disease was particularly associated with pcs (p>0.043). length of hospitalization, functional outcome during discharge, and post-resuscitation consciousness did not show any significant association with pcs (p<0.05). interestingly, initial abnormal brain scan, fronto-temporal lesion, and accompanied hematoma (hemorrhages) were identified as risk factors of mtbi-induced pcs. the risk of pcs was found to increase by 7.2 times in mtbi patients demonstrated as an abnormality in their initial brain scans (p<0.001). a directly proportional relationship was found between the occurrence of the syndrome and the fronto-temporal lesion (p<0.017). accompanied hematoma enhanced the risk of pcs by 2.6 times (p<0.04). conclusion: this study emphasized the significance of early brain scan data for the prediction of pcs and the necessity of proper follow-up care for the at-risk population. the reported data from this study might be applied as an objective trajectory to measure pcs in those who simulated pcs for the litigation.