University of Birmingham: Half of mild brain injury patients not recovering after six months, new commission warns

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Millions of people experience traumatic brain injury each year, but more than half of patients who experience mild injury aren’t recovering after six months, a new commission has warned.

In a report published in the Lancet Neurology today, a dedicated Commission by world-leading experts including from the University of Birmingham highlights the advances and persisting and new challenges in prevention, clinical care, and research in Traumatic Brain Injury (TBI).

Among a number of key challenges, the report notes that more than 90% of TBIs are categorized as “mild”, but over 50% of such patients do not fully recover by 6 months after injury. Improving outcome in these patients would be a huge public health benefit. A multidimensional approach to outcome assessment is advocated, including a focus on mental health and post-traumatic stress disorder.

Other key issues highlighted in the report include:
Outcome after TBI is poorer in females compared with males, but reasons for this are not clear.
Major disparities in care, including lower treatment intensity for patients injured by low-energy mechanisms, deficiencies in access to rehabilitation and insufficient follow-up in patients with “mild” TBI.
Advances in diagnostics and treatment approaches.
Antonio Belli, Professor of Trauma Neurosurgery in the Institute of Inflammation and Ageing at the University of Birmingham and an author of the commission report said:

“The scale of traumatic brain injury around the world is staggering, with 55 million people affected at an estimated cost of $400bn each year. As a leading cause of injury-related death, this significant report pulls together both the successes in understanding and treating brain injury as well as the task ahead for policy makers, clinicians, and researchers.

“At the University of Birmingham we have a long track record working with clinical partners to better understand brain trauma diagnosis and treatment, and we are proud to have contributed to the commission report.”

The 2022 Commission has been produced by world-leading experts and will be presented to all Participants of the Collaborative European Neurotrauma Effectiveness Research in TBI project (CENTER-TBI) at their meeting on 30th September 2022 in Antwerp, Belgium. This is an update to the first Lancet Neurology Commission on TBI, which was launched at the European Parliament in 2017.

The 2017 Commission set out priorities and recommendations to address the challenges in TBI from the perspectives of policymakers, clinicians, and researchers. Since then, new knowledge has been generated by large observational studies, including CENTER-TBI and other studies conducted under the umbrella of the International Traumatic Brain Injury Research (InTBIR) initiative, designed as a coalition of funding agencies and scientists to advance the care for patients with TBI through collaborative efforts.