Epidemiology

Approximately 1.4 million patients are attended annually in hospital following a head injury in England and Wales. About 68% of those admitted (n=15,080) have a mild traumatic brain injury (TBI) on admission.[8]​ Mild TBI is estimated to affect 55.9 million people globally each year.[9]​ Mild TBI, which represents approximately 90% of all TBIs, increasingly affects ageing populations who experience falls, and increasing incidence may also reflect rising numbers of road traffic collisions in low- and middle-income countries and widespread concerns regarding long-term effects of sports-related concussion.[10][11]​​ Young men represent nearly two-thirds of the cases seen each year worldwide.[12][13]​ C​oncussion incidence rates appear to be significantly higher in women than in men for a number of team sports, including soccer, ice hockey, and basketball.[12][13][14]​​ Women typically report more complex symptomatology and slower recovery.[2][15][16][17]​​​

Risk factors

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head injury

A mild traumatic brain injury results from a closed head injury due to a direct blow to the head or deceleration of the head from an impulsive force.[1]

previous brain trauma

Previous brain traumas lower the impact threshold, making mild TBI more likely regardless of the force of impact and, therefore, increasing the chances of future brain trauma. This is an important risk factor in assessing outcome.[29]

alcohol and drug misuse

Alcohol and drug misuse is associated with a significantly higher risk for all forms of traumatic brain injury, but this is confounded by a higher overall risk for all forms of external injury.[30][31]

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poor neck strength

Poor overall neck strength has been associated with an increased risk of concussion in high school sports.[32][33]

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