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Biomedical subjects

D Gronwall

Publications and source records attributed to D Gronwall.

11 recordsLinked to original sources
PubMed1998

Mild head injury in New Zealand: incidence of injury and persisting symptoms.

AIMS: To define mild head injury and determine its incidence and that of persisting symptoms. METHODS: Analysis of an eight week sample of all patients with head injury passing through the Emergency Departments of the four Auckland Hospitals, and of a five year sample of patients attending a clinic for management of symptoms persisting after head injury. RESULTS: Mild head injury was defined by the acute management needed--care out of hospital or not more than 48 hours admission, corresponding reasonably with a definition using post-traumatic amnesia. Incidence in those seen at hospital was 437/10(5) whole population/year for ages 15 and over, and 252/10(5) for ages under 15. Age specific incidences were 1769/10(5)/year for 15 and over, and 2920/10(5) for ages under 15, the major causes being road accidents (RTA) and falls, respectively. For 100 cases seen at hospital approximately 60 were treated by general practitioners alone. Referrals in patients 15 years and over because of persisting symptoms occurred in 5% (95%, CI 3-7), 69% in the first four months and 6% after a year. Referrals were equally likely after RTA, sports injuries and assaults, more frequent after objects striking the head. Older people were marginally more likely to be referred and the probability was significantly greater in women injured in sport and in minor RTA not needing admission to hospital. CONCLUSIONS: Mild head injuries are economically important and deserve efficient management.

Adolescent↗
PubMed1997

Effect of mild head injury during the preschool years.

This article examines the evidence that the effect of head injury on young children may differ from that in adults, in that while in the latter the pattern is of deficits that recover with time since the accident, this is not necessarily the case with very young children. In this group, there may be no evidence of any deficit in the early days or weeks after injury, but the children may fail to develop some skills as quickly as children who have not had a head injury. Results from a series of studies of MHI in preschool children carried out over a more than 10-year period from Auckland Hospital and recently published studies of pediatric MHI from other groups are reviewed. It is concluded from a comparison of these data that there is a need for long-term prospective studies designed within a developmental framework to clarify the issue.

Age Factors↗
PubMed1995

Mild head injury in preschool children: evidence that it can be associated with a persisting cognitive defect.

This study describes the effect of mild head injury in preschool children on aspects of their cognitive performance in the year after injury and at the age of 6.5 years, with particular reference to the development of reading skills. Mild head injury was defined by diagnosis at a hospital emergency department of a head injury which was not severe enough to need admission for observation. Seventy eight such children were compared with a group of 86 with a minor injury elsewhere. The groups had similar developmental, family, and socioeconomic status. There were no differences in cognitive tests soon after the injury, but at six months and one year children with mild head injury scored less than controls on one test, solving a visual puzzle (visual closure); they were also more likely to have had another mild head injury. At 6.5 years of age they still scored less than controls, reading ability was related to their visual closure score at one year, and they were more likely to have needed help with reading. Mild head injury seems to be able to produce subtle but significant changes which can affect school performance.

Child↗
PubMed1981

Time off work and symptoms after minor head injury.

A carefully controlled prospective study was made of 66 men aged 17 to 48 with minor head injuries. The mean time off work was 4.7 days, range 0 to 26 days. Time off work was longer: in older patients; after road traffic accidents compared with sports injuries; in patients who had taken alcohol and in 5 who had needed admission to hospital. Post-traumatic amnesia alone did not relate to time off work but was longer in these groups of patients. Sixty per cent of patients had symptoms on return to work and 46 per cent could not do their job as well as usual for a mean time of 14 days. Leisure activities were affected for a similar period and fatigue was common. Ninety days after the accident 20 per cent still had symptoms, mostly defects of memory, concentration and work capacity. Four patients still had symptoms 2 years later. Though describing symptoms, all patients were back at their usual work and non had any claim for compensation outstanding. Major points emerging are the limitations of post-traumatic amnesia as an index of the severity of a minor head injury, and the high incidence of symptoms on return to work and later, in patients who were at work and without compensation claims. The importance is stressed of an effective programme for the management of minor head injuries.

Absenteeism↗
PubMed1981

Memory and information processing capacity after closed head injury.

The relation between duration of post-traumatic amnesia (PTA), performance on memory tests, and the Paced Auditory Serial Addition Task (PASAT) was examined in two samples of young adult closed head injury patients. Three different effects were isolated: (1) an attention and concentration factor, related to PASAT scores, (2) a deficit in the ability to place material into long-term memory storage, related to PTA durations, and (3) an impairment in the ability to retrieve material once it has been stored, which was not predicted by either PTA or PASAT.

Adolescent↗
PubMed1980

Attitudes to concussion in young New Zealand men.

Sixty-three men aged 17 to 48 who had been concussed were asked 90 days later if it had affected them, if they knew of others who had been affected, and if they would take action to prevent further injury. Twenty percent still had symptoms, mostly impairment of intellectual function. Sixty percent expressed concern about the injury, though only 19 percent intended realistic measures to prevent recurrence, such as giving up football or selling their motorcycle. Concern was commoner after sports than road accidents. Sixty percent had friends who had been concussed, and a third of these had given up sport because of the effects. It is concluded that there is considerable awareness, particularly amongst sportsmen, of the effects of concussion, and that sports administrators would find considerable support for rules to reduce the risk of brain damage from repeated concussion.

Adolescent↗
PubMed1975

Cumulative effect of concussion.

Twenty young adults were studied after a second concussion. The rate at which they were able to process information was reduced more than in controls who had been concussed only once, and they took longer to recover than the controls. The effects of concussion seem to be cumulative, and this has important implications for sports where concussion injury is common.

Adolescent↗
PubMedDate not supplied

Assessment of pentachlorophenol-exposed timber workers using a test-of-poisoning model.

Sixty-two former New Zealand timber workers who were exposed to pentachlorophenol (PCP) at work were interviewed, examined, and assessed both by laboratory investigations and psychometrically for clinical syndromes that could be related to PCP exposure. Three such syndromes were identified: an acute complex of fever, headaches, upper and lower respiratory tract and eye irritation, skin disease, and foul smelling and discolored sweat; a chronic fatigue syndrome, beginning while still at work and frequently persisting; and a delayed encephalopathy. Neither of the sustained syndromes was considered characteristic of PCP poisoning, and many confounders were identified. An exposure index and a test-of-poisoning score had a statistically insignificant correlation.

Adult↗