Photo Credit: Evgeniy Shkolenko

The following is a summary of “Convergence insufficiency as a predictor of poor prognosis after acute mild traumatic brain injury,” published in the November 2024 issue of Emergency Medicine by Devani et al. 

Mild traumatic brain injury (mTBI) is increasing more in emergency departments (EDs), prompting investigations into various acute testing methods, including screening for convergence insufficiency (CI) symptoms, which were frequently reported by the patients with mTBI but rarely assessed in the ED.  

Researchers conducted a retrospective study to analyze the feasibility of CI screening in the ED and to examine its association with adverse events like post-concussive symptoms or hospital admission.   

They received consent from patients aged 18 years or older with a mild head injury leading to mTBI. The patients were screened for CI symptoms using the convergence insufficiency symptom survey (CISS), a standardized 15-question Likert scale instrument, and correlated the data with outcomes such as hospital admission, post-concussive symptoms, and 30-day hospital readmission.  

The results showed that 116 patients enrolled, including 58 males with a median age of 31 years, ranging from 18 to 95 years. The median CISS score was 13, with an interquartile range (IQR) of 6 to 21 and an overall range of 0 to 53. Female patients had a higher median CISS score of 14 compared to a median score of 10 in males. A higher CISS score significantly correlated with an increased likelihood of hospital admission (P = 0.0378), development of post-concussive syndrome symptoms at the 30-day follow-up (P = 0.0322), and readmission within 30 days (P = 0.0098).  

They concluded that screening for CI symptoms using the CISS could be a valuable adjunct in the ED evaluation of mTBI, as it is a simple, rapid tool for stratifying patients’ risk of mTBI-related complications. 

Source: intjem.biomedcentral.com/articles/10.1186/s12245-024-00747-6