Hindawi Publishing Corporation Rehabilitation Research and Practice Volume 2012, Article ID 415740, 7 pages doi:10.1155/2012/415740 Clinical Study Outcome from Complicated versus Uncomplicated Mild Traumatic Brain Injury Grant L. Iverson,1 Rael T. Lange,1, 2 Minna Wa¨ljas,3 Suvi Liimatainen,4 Prasun Dastidar,5 Kaisa M. Hartikainen,3 Seppo Soimakallio,5 and Juha O¨hman3 1 Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, Canada V6T 2A1 2 Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center and Defense and Veterans Brain Injury Center, 11300 Rockville Pike, Suite 1100, North Bethesda, MD 20852, USA 3 Department of Neurosciences and Rehabilitation, Tampere University Hospital and University of Tampere Medical School, PL 2000, 33521 Tampere, Finland 4 Department of Neurosciences and Rehabilitation and Emergency Department Acuta, Tampere University Hospital, PL 2000, 33521 Tampere, Finland 5 Medical Imaging Centre of Pirkanmaa Hospital District and University of Tampere Medical School, PL 2000, 33521 Tampere, Finland Correspondence should be addressed to Grant L. Iverson, giverson@interchange.ubc.ca Received 4 November 2011; Revised 3 February 2012; Accepted 27 February 2012 Academic Editor: Anne Felicia Ambrose Copyright © 2012 Grant L. Iverson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To compare acute outcome following complicated versus uncomplicated mild traumatic brain injury (MTBI) using neurocognitive and self-report measures. Method. Participants were 47 patients who presented to the emergency department of Tampere University Hospital, Finland. All completed MRI scanning, self-report measures, and neurocognitive testing at 3-4 weeks after injury. Participants were classiﬁed into the complicated MTBI or uncomplicated MTBI group based on the presence/absence of intracranial abnormality on day-of-injury CT scan or 3-4 week MRI scan. Results. There was a large statistically signiﬁcant diﬀerence in time to return to work between groups. The patients with uncomplicated MTBIs had a median of 6.0 days (IQR = 0.75–14.75, range = 0–77) oﬀ work compared to a median of 36 days (IQR = 13.5–53, range = 3–315) for the complicated group. There were no signiﬁcant diﬀerences between groups for any of the neurocognitive or self-report measures. There were no diﬀerences in the proportion of patients who (a) met criteria for ICD-10 postconcussional disorder or (b) had multiple low scores on the neurocognitive measures. Conclusion. Patients with complicated MTBIs took considerably longer to return to work. They did not perform more poorly on neurocognitive measures or report more symptoms, at 3-4 weeks after injury compared to patients with uncomplicated MTBIs. 1. Introduction Most mild traumatic brain injuries (MTBIs) are not associ- ated with visible abnormalities on structural neuroimaging. A complicated MTBI, in the original deﬁnition [1], was dif- ferentiated from an uncomplicated mild TBI by the presence of (a) a depressed skull fracture and/or (b) a trauma-related intracranial abnormality (e.g., hemorrhage, contusion, or edema). Other researchers have dropped the depressed skull fracture from the criteria and simply retained the criterion for an intracranial abnormality. The rates of complicated MTBIs, based on cohorts of patients who underwent acute computed tomography following head trauma, are presented in Table 1. The rates of abnormalities vary considerably. In general, when examining details within these studies, patients with GCS scores of 13 or 14 are more likely to have an abnormality than patients with a GCS score of 15. Other possible reasons for diﬀerences in abnormality rates could relate to technology (e.g., older scanners versus newer scanners) and referral patterns for neuroimaging (i.e., more liberal versus more conservative use of imaging). It is seems logical to assume that worse short-, medium-, and long-term neuropsychological and functional outcome would result from complicated versus uncomplicated MTBIs.