It has been thought that the loss of physical and psychological function after traumatic brain injury is closely related to injuries in brain structures. However, in the current edition of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2010; 107[12]: 199-205), Rainer Scheid and D. Yves von Cramon conclude that this is not the case.
In Germany, traumatic brain injury is more frequent than stroke and is mostly caused by traffic accidents, falls, or blows to the head. The authors analyzed the data from 320 patients treated in the Cognitive Neurology Outpatient Clinic at the University of Leipzig between 1996 and 2007. They investigated whether the imaging, clinical, and neuropsychological findings were correlated. The most frequent findings were crush injuries to the brain (contusions), microbleeds, and atrophy. Magnetic resonance imaging revealed no visible changes in 49 of the patients examined. The analysis failed to find any convincing correlations with the patients' general condition or with their performance in neuropsychological tests. However, almost 15% of the patients suffered from posttraumatic epilepsy and the authors showed that this was correlated with isolated brain contusions.