Proceedings of the 2016 Spring Meeting of the Society of British Neurological Surgeons. British Journal of Neurosurgery 2016;30(2):130–186. http://dx.doi.org/10.3109/02688697.2016.1161985.
When the above article was first published online, two abstracts contained typographical errors. They have been presented correctly below.
Taylor & Francis apologises for this error.
WM2-5: Ultra-early biomarkers of outcomes following major trauma: a longitudinal observational study from the ‘Golden Hour’ project
Z. Sua, D.J. Daviesa, J. Hazeldineb, E. Tomana, D. Hackerc, P. Harrisonb, J. Lordb and A. Bellia
aNIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital Birmingham; bSchool of Immunity and Infection, University of Birmingham; cDepartment of Neuropsychology, University Hospitals Birmingham NHS Foundation Trust
Objectives To assist early characterisation and prognostication of traumatic brain injury (TBI) by identifying biomarkers released in the early hours of trauma in relation to medium term functional and psychological outcomes of TBI patients versus those with extra-cranial trauma (ECT).
Design Longitudinal observational study.
Subjects 67 patients were recruited with 16 (6 TBI and 10 ECT) completing 6-month follow-up.
Methods Blood samples were taken within the first hour (H1), 4–12 hours (H2), 48–72 hours (H3) and 6 months post-injury for biomarker evaluation. Patients were assessed at 6-month using the Neuropsychological Assessment Battery (NAB), Glasgow Outcome Scale-Extended (GOSE), and self-reported questionnaires for multi-dimensional outcomes.
Results The ratios of neutrophils:lymphocytes (N:L) at H1 correlated with the mean T scores derived from 5 subtests most sensitive to TBI in NAB (p = −0.62). The H3 N:L ratios also correlated with the mean T scores (p = −0.62) and the total screening index of the NAB (p = −0.59). Furthermore, the N:L ratios at 6-month correlated with the mean T scores (p = −0.61). Compared with the ECT controls, TBI patients performed less well in the NAB (p = 0.039). No significant differences were found in GOSE or other outcome variables between the two groups.
Conclusions Ultra-early increase of N:L ratios appear to indicate worse neuropsychological performance in the recovery. Even when achieving similar global functional recovery, TBI patients still show neuropsychological decline compared with ECT patients.
WM2-10: The effect of prolonged post-concussional symptoms on cognitive performance after sport concussion
Z. Sua, D.J. Daviesa, D. Hammonda, D. Hackerb, S. Evansb, S. Griffinc, M. Greyd and A. Bellia
aNIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital Birmingham, Birmingham, UK; bDepartment of Neuropsychology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; cCollege of Medical and Dental Sciences, University of Birmingham, Birmingham, UK; dSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
Objectives Over 20% of concussed patients experience persistent symptoms, affecting their functional outcomes. This study investigated the effect of prolonged symptoms on cognitive performance of concussed athletes.
Design Cross-sectional control study with follow up.
Subjects 7 athletes with prolonged symptoms (>2 weeks) compared with 10 acute patients (symptomatic <3 days) post-concussion and 9 healthy subjects.
Methods Subjects were assessed with the Sport Concussion Assessment Tool, Immediate Post-concussion Assessment and Cognitive Testing, WAIS symbol search and digit span backward tests 31 days (median) after the injury.
Results Patients with prolonged symptoms scored less in the symbol search test than the acute patients and controls (p = 0.039 and 0.004). No significant differences were found in other test components among the 3 groups. Within the 17 patients, symptom scores correlated inversely with reaction time (p = −0.61); and visual motor speed correlated with symbol search scores (p = 0.59). Six patients had also completed a follow up assessment when they became symptom-free and showed significant improvement in their symbol search (p = 0.042) and visual memory (p = 0.028).
Conclusions Concussed athletes with prolonged symptoms performed poorly in visual perception and information processing. Post-concussional symptoms, especially persistent ones, could affect athletes’ visual memory, perception/analysis, reaction time and information processing speed, thus precipitating them to further injuries if they return to play prematurely.