However, a generally accepted definition proposed by the American Congress of Rehabilitation Medicine includes (1) associated diminished or altered state of or loss of consciousness (LOC), i.e., interruption of awareness of oneself and surroundings for less than 30 minutes; (2) posttraumatic amnesia
(PTA), i.e., memory disruption following injury (not able to store or retrieve new information) for less than 24 hours, and (3) a Glasgow Coma Scale score of 13 or greater quantifying level of consciousness .
Abbreviations: ANAM = Automated Neuropsychological Assessment Metrics, DOD = Department of Defense, DVBIC = Defense and Veterans Brain Injury Center, LOC = loss of conciousness, MS = multiple sclerosis, OCC = Office of Care Coordination, PA = physician's assistant, PCS = postconcussion syndrome, PDA = personal data assistant, PTA = posttraumatic amnesia
, PTSD = posttraumatic stress disorder, SCI = spinal cord injury, TBI = traumatic brain injury, VA = Department of Veterans Affairs, VAMC = VA medical center, VHA = Veterans Health Administration, VISN = Veterans Integrated Service Network, VTC = video-teleconferencing, WRAMC = Walter Reed Army Medical Center.
[PMID: 9065530] LOC = loss of consciousness, PTA = posttraumatic amnesia
. Table 2.
The independent variables were (1) interval in months from last blast exposure associated with loss of consciousness, alteration in consciousness, or posttraumatic amnesia
; (2) number of historical blast exposures associated with lost or altered level of consciousness; (3) presence of PTSD; presence of abnormalities on elements of the neurological examination including (4) olfaction, (5) eye movements, (6) motor examination, (7) sensory examination, (8) balance, (9) coordination, (10) gait, and (11) reflex evaluation; (12) presence of abnormalities on neuropsychological testing that were most consistent with TBI and not better explained by another process; and (13) presence of disturbed sleep.
Fraser, from Monash University in Melbourne, Australia, and colleagues examined the association of long-term cognitive recovery in 109 adults (71 percent male) experiencing complicated mild-to-severe TBI with age, premorbid intelligence (IQ), and injury severity measured by posttraumatic amnesia
However, duration of lost consciousness or posttraumatic amnesia
, evidence of brain injury on CT, or hospitalization did not predict an increased risk of PTSD or major depression.
Gracie, of Suffolk says: "I had posttraumatic amnesia
. I couldn't remember things and struggled to make new memories.
Agitated behaviors are exhibited during the discrete stage of TBI recovery that is associated with acute confusion, posttraumatic amnesia
, and lack of consistent orientation (Corrigan, Mysiw, Gribble, & Chock, 1992).
(13) Veterans who sustained a TBI that resulted in loss of consciousness or posttraumatic amnesia
longer than 30 minutes but less than 24 hours were more than twice as likely to develop dementia.
The definition includes loss of consciousness of <20 min, posttraumatic amnesia
of fewer than 24 h, and an initial Glasgow Coma Scale (GCS) of 13–15.
As a secondary subandlysis to roughly gauge the validity of self-report, we examined the association of self-reported cognitive dysfunction with proxies for mTBI-related severity (as reported during the comprehensive TBI evaluation), i.e., number of blasts and other injuries resulting in TBI and severity of the injury (number of episodes of loss of consciousness or posttraumatic amnesia