Highlights
- •A significant number of adult patients with mild traumatic brain injury (mTBI) also report neck pain.
- •Neck pain was often as severe as or worse than other mTBI symptoms.
- •Motor vehicle collision was predictive of neck pain.
Abstract
Objectives
To determine (1) the frequency of neck pain overall and relative to other symptoms
in patients presenting to a level I trauma center emergency department (ED) with mild
traumatic brain injury (mTBI) and (2) the predictors of primary neck pain in this
population.
Design
Cohort study.
Setting
Level I trauma center ED.
Participants
Patients presenting to the ED with symptoms of mTBI having been exposed to an event
that could have caused mTBI (N=95).
Interventions
Not applicable.
Main Outcome Measures
Frequency of self-reported neck pain as measured by Sport Concussion Assessment Tool
3 (SCAT3) symptom questionnaire at <3, 8, 15, and 45 days post injury. Primary neck
pain was defined in 2 ways: (1) neck pain rated as equal or greater in severity than
all other SCAT3 symptoms and (2) neck pain worse than all other symptoms.
Results
The frequency of any reported neck pain was 68.4%, 50.6%, 49%, and 41.9% within 72
hours and at 8, 15, and 45 days, respectively. Frequency of primary neck pain (equal
or worse/worse definitions) was 35.8%/17.9%, 34.9%/14.5%, 37%/14.8%, and 39.2%/10.8%
across the 4 follow-up assessments. Participants who sustained their injuries in motor
vehicle collisions had a higher rate of primary neck pain than those with other mechanisms
of injury.
Conclusions
A sizable percentage of patients who present to level I trauma center EDs with mTBI
report neck pain, which is commonly rated as similar to or worse than other mTBI-related
symptoms. Primary neck pain is more common after motor vehicle collisions than with
other mechanisms of injury. These findings support consensus statements identifying
cervical injury as an important potential concurrent diagnosis in patients with mTBI.
List of abbreviations:
ED (emergency department), LOC (loss of consciousness), mTBI (mild traumatic brain injury), MVC (motor vehicle collision), OR (odds ratio), SCAT3 (Sport Concussion Assessment Tool 3), WTAR (Wechsler Test of Adult Reading)Keywords
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Article info
Publication history
Published online: September 04, 2019
Footnotes
Supported by the US Army Medical Research and Materiel Command (award no. W81XWH-12-1-0004). Michael A McCrea, PhD, was the principal investigator. Secondary data analyses were supported by the National Institutes of Health (grant no. 1R03NS100691-01). The REDCap electronic database service used for the study was supported by the Clinical and Translational Science Institute (grant no. UL1TR001436). Funding sources had no role in study design.
Opinions, interpretations, conclusions, and recommendations are those of the author and are not necessarily endorsed by the US Army. The article’s contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The authors have no conflicts of interest to report.
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© 2019 by the American Congress of Rehabilitation Medicine
