Late neurological sequelae after traumatic brain injury: analysis of long-term outcomes

Abstract

Background: Traumatic brain injury is an important cause of morbidity, mortality, and disability, with consequences that may persist beyond the acute phase. Among the main long-term outcomes are cognitive deficits, functional limitations, post-traumatic epilepsy, and behavioral changes, all of which have a significant impact on quality of life. Objective: To analyze the main long-term neurological outcomes in patients with traumatic brain injury. Methods: This was an observational, retrospective, and analytical study conducted with patients diagnosed with traumatic brain injury and followed at a specialized center. Clinical variables, initial trauma severity, neuroimaging findings, length of hospital stay, and the presence of late neurological sequelae were evaluated, including cognitive deficits, functional limitations, post-traumatic epilepsy, and behavioral changes. Results: A total of 86 patients with a history of traumatic brain injury were evaluated, of whom 34 (39.5%) presented late neurological sequelae. The most frequent outcomes were cognitive deficit (20.9%), persistent functional limitation (17.4%), post-traumatic epilepsy (10.5%), and behavioral changes (9.3%). A higher frequency of sequelae was observed in patients with greater initial trauma severity, structural abnormalities on neuroimaging, and prolonged hospital stay. Patients with late neurological impairment also showed worse functional evolution during outpatient follow-up. Conclusion: Late neurological sequelae after traumatic brain injury represent an important clinical and functional burden. Greater initial trauma severity, neuroimaging abnormalities, and prolonged hospitalization were associated with worse outcomes, reinforcing the need for long-term follow-up, individualized rehabilitation, and a multidisciplinary approach.