• J David Cassidy, Linda J Carroll, Paul M Peloso, Jörgen Borg, Hans von Holst, Lena Holm, Jess Kraus, Victor G Coronado, and WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury.
• Alberta Centre for Injury Control and Research, Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada. dcassidy@uhnres.utoronto.ca
• J Rehabil Med. 2004 Feb 1 (43 Suppl): 28-60.

ObjectiveWe undertook a best-evidence synthesis on the incidence, risk factors and prevention of mild traumatic brain injury.MethodsMedline, Cinahl, PsycINFO and Embase were searched for relevant articles. After screening 38,806 abstracts, we critically reviewed 169 studies on incidence, risk and prevention, and accepted 121 (72%).ResultsThe accepted articles show that 70-90% of all treated brain injuries are mild, and the incidence of hospital-treated patients with mild traumatic brain injury is about 100-300/100,000 population. However, much mild traumatic brain injury is not treated at hospitals, and the true population-based rate is probably above 600/100,000. Mild traumatic brain injury is more common in males and in teenagers and young adults. Falls and motor-vehicle collisions are common causes.ConclusionStrong evidence supports helmet use to prevent mild traumatic brain injury in motorcyclists and bicyclists. The mild traumatic brain injury literature is of varying quality, and the studies are very heterogeneous. Nevertheless, there is evidence that mild traumatic brain injury is an important public health problem, but we need more high-quality research into this area.

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