Convergence insufficiency as a predictor of poor prognosis after acute mild traumatic brain injury
Dublin Core
Title
Convergence insufficiency as a predictor of poor prognosis after acute mild traumatic brain injury
Subject
Convergence insufficiency, Traumatic brain injury, Head injury, Post-concussive syndrome, Extracranial
manifestations of TBI
manifestations of TBI
Description
Abstract
Background Mild traumatic brain injury (mTBI) is becoming a more common emergency department (ED) presen-
tation. Towards this end, many types of testing in the acute setting are being investigated. One of these is screening
for convergence insufficiency (CI) symptoms. These are common problems reported by patients with mTBI, but such
oculomotor testing is rarely performed in the ED.
Objective To assess the feasibility of convergence insufficiency screening in the ED and investigate whether CI
is associated with adverse events such as post-concussive symptoms or hospital admission.
Methods Written informed consent was obtained from patients age 18 years or older who experienced a mild head
injury from any mechanism resulting in an mTBI. Patients underwent screening for CI symptoms using a standardized
instrument of 15 questions, known as the convergence insufficiency symptom survey (CISS), with responses based
on the Likert scale. These data were correlated to outcomes of hospital admission, occurrence of post-concussive
symptoms, and 30-day hospital re-admission.
Results A total of 116 patients were prospectively enrolled, of which 58 were male. The median age was 31 years,
with a range of 18 to 95 years of age. The median CISS score was 13, with an interquartile range (IQR) of 6 to 21
and an overall range of 0 to 53. Females presented with a median CISS score of 14, which was higher compared
to the male median score of 10. The higher the CISS score, the more likely the patient was to be admitted to the hos-
pital (p = 0.0378), develop symptoms of post-concussive syndrome at 30-day follow up (p = 0.0322), and be readmit-
ted within 30 days (p = 0.0098).
Conclusions Screening for CI symptoms using the CISS can be a solid adjunct in the evaluation of mTBI in the ED.
The CISS is easy and fast to administer, and it is a useful tool to stratify patients in terms of who is at the highest risk
of developing complications related to the mTBI.
Keywords Convergence insufficiency, Traumatic brain injury, Head injury, Post-concussive syndrome, Extracranial
manifestations of TBI
Background Mild traumatic brain injury (mTBI) is becoming a more common emergency department (ED) presen-
tation. Towards this end, many types of testing in the acute setting are being investigated. One of these is screening
for convergence insufficiency (CI) symptoms. These are common problems reported by patients with mTBI, but such
oculomotor testing is rarely performed in the ED.
Objective To assess the feasibility of convergence insufficiency screening in the ED and investigate whether CI
is associated with adverse events such as post-concussive symptoms or hospital admission.
Methods Written informed consent was obtained from patients age 18 years or older who experienced a mild head
injury from any mechanism resulting in an mTBI. Patients underwent screening for CI symptoms using a standardized
instrument of 15 questions, known as the convergence insufficiency symptom survey (CISS), with responses based
on the Likert scale. These data were correlated to outcomes of hospital admission, occurrence of post-concussive
symptoms, and 30-day hospital re-admission.
Results A total of 116 patients were prospectively enrolled, of which 58 were male. The median age was 31 years,
with a range of 18 to 95 years of age. The median CISS score was 13, with an interquartile range (IQR) of 6 to 21
and an overall range of 0 to 53. Females presented with a median CISS score of 14, which was higher compared
to the male median score of 10. The higher the CISS score, the more likely the patient was to be admitted to the hos-
pital (p = 0.0378), develop symptoms of post-concussive syndrome at 30-day follow up (p = 0.0322), and be readmit-
ted within 30 days (p = 0.0098).
Conclusions Screening for CI symptoms using the CISS can be a solid adjunct in the evaluation of mTBI in the ED.
The CISS is easy and fast to administer, and it is a useful tool to stratify patients in terms of who is at the highest risk
of developing complications related to the mTBI.
Keywords Convergence insufficiency, Traumatic brain injury, Head injury, Post-concussive syndrome, Extracranial
manifestations of TBI
Creator
Kavya Devani1
, Neera Kapoor2 and Latha Ganti3,4*
, Neera Kapoor2 and Latha Ganti3,4*
Source
https://doi.org/10.1186/s12245-024-00747-6
Date
2024
Contributor
Peri Irawan
Format
PDF
Language
ENGLISH
Type
TEXT
Files
Collection
Citation
Kavya Devani1
, Neera Kapoor2 and Latha Ganti3,4*, “Convergence insufficiency as a predictor of poor prognosis after acute mild traumatic brain injury,” Repository Horizon University Indonesia, accessed April 25, 2026, https://repository.horizon.ac.id/items/show/12515.