[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 11,644
Citations 0
JAMA Insights
Clinical Update
December 9, 2019

Mild Traumatic Brain Injury in 2019-2020

Author Affiliations
  • 1Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
  • 2Rehabilitation Research Program, GF Strong Rehab Centre, Vancouver, British Columbia, Canada
  • 3Neurosurgery, Massachusetts General Hospital, Neurosurgery, Harvard Medical School, Boston
  • 4Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston
  • 5Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
JAMA. 2020;323(2):177-178. doi:10.1001/jama.2019.18134

Traumatic brain injuries (TBIs) range in severity, including transient symptoms and fatal hemorrhages. Mild TBI (mTBI) is the most common type of TBI, resulting in approximately 2.5 million emergency department visits per year in the United States.1 The highest rates of mTBI are observed in adults older than 75 years (2232/100 000 population), children younger than 5 years (1592/100 000 population), and adolescents/young adults aged 15 to 24 years (1081/100 000 population), with an 18% to 19% higher age-adjusted rate in men than in women.1 Definitions of mTBI vary; the World Health Organization Neurotrauma Task Force defines mTBI as a blow to or jolting of the head causing an acute disruption of brain function, manifested by a brief loss of consciousness (<30 minutes), confusion, or posttraumatic amnesia (<24 hours) not accounted for by factors such as psychological trauma or alcohol/drug intoxication.2 mTBI typically results in physical, cognitive, and/or emotional symptoms that can worsen transiently with mental or physical exertion (Figure). Previously thought of as a benign and self-limiting injury, it is now well established that mTBI can result in symptoms and disability persisting for more than 1 year.3 Therefore, current practice consists of monitoring symptom resolution by a health care professional, counseling on return to activity, and timely specialty referral (Figure).