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Traumatic microbleeds in mild traumatic brain injury are not associated with delayed return to work or persisting post-concussion symptoms.

The main objective of this prospective cohort study was to evaluate whether traumatic microbleeds (TMBs) are a significant prognostic factor of return to work (RTW), post-traumatic symptoms and overall recovery in patients with mild traumatic brain injury (MTBI). One hundred and thirteen (n=113) patients with MTBI were recruited from the Helsinki University Hospital emergency units. All patients underwent multicontrast 3T MRI imaging 3-17 days after MTBI. Patients were evaluated in the Traumatic Brain Injury Outpatient Clinic of Helsinki University Hospital one month after injury. Post-concussion symptoms were assessed with Post-Concussion Symptom Questionnaire (RPQ) and overall recovery with Glasgow Outcome Scale Extended (GOS-E). Their time to RTW was continuously measured up to one year after MTBI. Median RTW was 9 days (IQR 4 - 30) after MTBI and full RTW rate after one year was 98%. Patients with TMBs (n=22) did not have more post-concussion symptoms (median RPQ 10.0 vs. 7.0, p=0.217) or worse overall recovery (58% vs. 56% with GOS-E = 8, p=0.853) compared to patients without TMBs (n=91). There was no significant difference in time to RTW (13.5 vs. 7.0 days, p=0.063). In this study, patients with TMBs did not have delayed RTW nor more post-concussion symptoms compared to other patients with MTBI. TMBs in MTBI do not seem to be a significant prognostic factor of RTW.