Objective: Mild traumatic brain injury (mTBI) is frequently overlooked in polytrauma patients due to the overshadowing of more severe injuries, a fact that makes its identification in post-acute settings challenging since symptoms overlap with other conditions and no validated diagnostic tools exist. To address this gap, this scoping review explored the literature on mTBI diagnosis in post-acute civilian polytrauma settings.
Methods: By utilizing the Arksey and O'Malley framework and PRISMA-ScR guidelines, the review focused on studies from 2010 to 2024 related to delayed mTBI diagnosis in adults. Of the 696 studies identified, only six met the inclusion criteria, highlighting the limited research in this area.
Results: The review assessed various diagnostic tools including the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), neuropsychological tests, advanced imaging, and oculomotor assessments. However, these tools are limited in their ability to confirm whether an mTBI has occurred. The American Congress of Rehabilitation Medicine's updated mTBI criteria may offer the best diagnostic potential but require validation.
Conclusion: According to the findings, there is a significant gap in validated diagnostic tools for mTBI in post-acute settings, which may negatively affect patient outcomes. Developing and validating effective screening tools for mTBI in the post-acute polytrauma setting should be the priority of future research in this area.
Keywords: Concussion; adult brain injury; guidelines; head trauma; polytrauma; rehabilitation; screening tools.