Emergency Medicine

Laptop test in an emergency department can help detect subtle cognitive deficits following concussions

Mild traumatic brain injury (MTBI), also known as concussion, is one of the most common neurologic conditions. While some patients bounce back with no complications in the days and weeks after suffering MTBI, studies show that up to 15 percent of patients can experience disability long after their injury. Thus, tests that help flag impairments early can lead to better treatments and outcomes for patients with MTBI. After administering computer tests that detect concussions, researchers found that patients with MTBIs are not as quick at recognizing or reacting to visual objects as patients with no concussions. Researchers gave the Immediate Post-concussion Assessment and Cognitive Testing battery to 23 patients with concussions and 31 patients with hand injuries over a 3-month period in 2007 at a university-affiliated hospital emergency department. Patients with MTBI had slower visual motor speeds and reaction times than patients with hand injuries.

Scores for visual and verbal memory were similar for both groups; however, the researchers indicate that these findings might have been different if a larger group had been observed and if trauma patients had been included. The authors believe that administering the Immediate Post-concussion Assessment and Cognitive Testing to detect cognitive deficits can be done effectively in the emergency department. The patients who took the test completed it without assistance in 25 minutes or less, although some suggested that it could stand to be shortened. This study was funded in part by the Agency for Healthcare Research and Quality (HS13628).

See "Neurocognitive function of emergency department patients with mild traumatic brain injury," by Shane E. Peterson, B.S., Matthew J. Stull, B.S., B.A., Michael W. Collins, Ph.D., and Henry E. Wang, M.D., M.S., in the June 2009 Annals of Emergency Medicine 53(6), pp. 796-803.

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