Well, this is interesting! This article is saying that they’ve come up with a simple blood test that can predict the outcomes of a brain injury patient’s recovery at 6 months. I thought their criteria for being healed/not healed was interesting too. Their criteria to have “incomplete recovery” was to have post-concussive syndrome (PCS) or a Glasgow Coma Scale score of <8.
Let’s see what Post-Concussive Syndrome looks like a moment, shall we? A person with post-concussive syndrome may present with some of the following characteristics 3 months or more after the initial incident– physical symptoms: headache, dizziness, sensitivity to light or noise, decreased taste or smell, blurry vision, double vision, tinnitus, sleep disturbances like insomnia; behavioral symptoms: irritability, anxiety, depression, personality change, restlessness, aggression, mood swings; higher mental function symptoms affecting cognition, memory (especially short term memory) and attention. So if the patients falls into this category, they are “incompletely recovered” from the brain injury.
So on the GCS you give the patient a rating from 3-15 on their motor and verbal responses and their ability to open their eyes. So a person less than 8 might only open their eyes and go into an extension muscular response (decerebrate) when you pinch them and just mumble (score of 6). I love the reminder on the bottom of the drawing there: even a toaster has a score of 3! Yes, I would say a person that looks like that was “incompletely recovered.”
Remember that the GCS does have a ceiling effect. As you will note, there are no functional mobility (getting in/out of bed, walking) or activities of daily living (dressing/showering) in the GCS. So the patient may not be able to physically do anything (beyond simple, 1 joint movement of any strength rating), but they would have a score of 15. For this reason, I think I would take the GCS into consideration for the lower level “incompletely recovered” people and the PCS symptoms/diagnosis for the functionally higher level people in this study.
But, backing away from those criteria, I wonder how the blood test will be used. I hope the test will not be used to screen for services rendered. “Eh, the test says this person probably won’t be ‘completely recovered,’ so let’s not waste too much time and resources on them,” says the insurance companies. There is life in an “incompletely recovered” state. I’ve seen plenty of people on my case load that I would say probably had post-concussive syndrome and were making plans on going back to work. Now, that work may have needed to be modified, but they were planning on being productive members of society. Would be a shame to lose a life like that.