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By Ryan L. Davis, Carolyn M. Sue

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Eighty-five percent of all mildly brain-injured patients seen in hospitals have either a concussion or another intracranial injury. However, 15% of these mildly brain-injured patients with a Glasgow Coma Score of 13-15 were diagnosed as having a contusion, laceration, or hemorrhage of the brain. It may be that the diagnoses for these cases may be incomplete or inaccurate. It is difficult to believe that a patient diagnosed with a GCS of 13 or 14 and with a contusion or hemorrhage would have been discharged from the hospital in two to four days, yet, for purposes of this study, we abstracted verbatim not only the Glasgow Coma Score, but the actual diagnoses as recorded in the medical record.

Microscopic lesions in the brain following head injury. J Neurol Neurosurg Psychiatry 21:299-306, 1968. Rimel RW. A prospective study of patients with central nervous system trauma. J Neurosurg Nurs 13:132-141, 1981. Rimel RW, Girodani B, Barth JT, Boll TJ, Jane JA. Disability caused by minor head injury. Neurosurgery 9:221-228, 1981. Rutherford W, Merrett J, McDonald J. Sequelae of concussion caused by minor head injury. Lancet 1:1-4, 1977. Symonds C. Concussion and its sequelae. Lancet 1:1-5, 1962.

The International Classification of Diseases (ICD) coding is unhelpful, not only because the terms used are ill-defined but also because there is wide variation in how they are used (Jennett and Teasdale, 1981). Some institutions code most mild injuries as concussion (No. 850); others prefer "unspecified intracranial injury" (No. 854); yet others use "unqualified skull fracture" (No. 803) without any serious regard to whether or not a fracture was diagnosed. The inclusion of patients with injuries limited to the face inflates some statistics.

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The Genetics of Mitochondrial Disease by Ryan L. Davis, Carolyn M. Sue

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