Disclosures: Nicole Diaz-Segarra, MD: No financial relationships or conflicts of interest

Objective: There is minimal literature regarding peripheral nerve injury (PNI) after a traumatic brain injury (TBI), including risk factors. The objectives of this study were: First, determine the prevalence and descriptively characterize PNI after TBI. Second, analyze if comorbid polytrauma increases the risk of developing PNI.

Design: Cross-Sectional StudySetting : OutpatientParticipants : 69 patients who sustained a TBI were seen by physiatry as outpatients over two years, 36 with an isolated TBI and 33 with comorbid polytrauma.

Interventions: After physiatric assessment of all patients, ten patients were suspected of having nerve injury and underwent electrodiagnostic evaluation, with nerve conduction study and electromyography.

Main Outcome Measures: First, the prevalence and descriptive analysis of PNI in the TBI population. Second, the relative risk (RR) of PNI in patients with isolated TBI compared to TBI with comorbid polytrauma.

Results: All patients who underwent electrodiagnostic evaluation had evidence of PNI, with a prevalence of 14% in our TBI population. There were 22 unique nerve injuries identified, including median mononeuropathy (n=7), ulnar mononeuropathy (n=5), radial mononeuropathy (n=3), brachial plexopathy (n=3), sural mononeuropathy (n=1), peroneal neuropathy (n=2), and sciatic neuropathy (n=1), with 70% of patients injuring >1 nerve. The RR of PNI in the comorbid polytrauma population compared to the isolated TBI population was 22.85 (95% confidence interval: 1.39 to 375.29, p=0.028).Conclusions: This study suggests that the prevalence of PNI after TBI is approximately 14% and comorbid polytrauma significantly increases the risk of developing PNI after TBI. Median and ulnar mononeuropathy were the most common PNI encountered, with >1 nerve injury observed in 70% of patients. Clinicians should have a high suspicion for PNI after a TBI with comorbid polytrauma, with a low threshold to perform an electrodiagnostic evaluation. Additional studies with larger sample sizes are needed to support these findings and determine the ideal management of PNI after a TBI.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/comorbid-polytrauma-is-associated-with-increased-risk-of-peripheral-nerve-injury-after-traumatic-brain-injury/