https://doi.org/10.1140/epjs/s11734-026-02289-9
Review
Consequences of closed head injury: a systematic review
1
Institute of Clinical Medicine, Sechenov First Moscow State Medical University, St. Trubetskaya, 8, 2, 119991, Moscow, Russia
2
Institute of Public Health, Sechenov First Moscow State Medical University, St. Trubetskaya, 8, 2, 119991, Moscow, Russia
3
Moscow Center for Advanced Studies, 20, Kulakova Str., 123592, Moscow, Russia
4
Department of Biomedical Research, State Research Center-Burnasyan Federal Medical Biophysical Center of the Federal Medical Biological Agency, Pictorial Street, 46, 8, 123098, Moscow, Russia
a
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Received:
30
December
2025
Accepted:
17
March
2026
Published online:
6
April
2026
Abstract
Traumatic brain injury (TBI) is one of the common types of mechanical injuries manifesting psychiatric disorders and neurological impairment. The decreasing lethality of severe TBI has drawn attention to its near and distant sequelae associated with epilepsy, stroke, increased incidence of suicide, PTSD, neurodegenerative and depressive disorders, and decreased cognitive, affective, and behavioral functioning. These effects may have a greater impact on quality of life than physical problems. Information was searched in EMBASE, WOS, BCI, CABI, CJD, MEDLINE, RSCI, SCIELO, ZOOREC, Scopus, ICTRP, mRCTs, PubMed (including PMC at NCBI), Web of Science, and Academic Search Premiere databases. All sources were imported into Covidence for screening and processing, providing convenient and efficient systematic screening. Repeated citations were automatically removed by Covidence, and uploaded materials underwent a two-step screening process before being selected for detailed review. The review includes an analysis of the epidemiology of neurologic (epilepsy, stroke, neurodegenerative disorders) and psychiatric (substance use, psychopathology, affective and cognitive disorders) problems in patients after TBI obtained in military, civilian, and sports settings. Clinical evidence from this systematic review indicates that traumatic brain injury should be regarded as a chronic condition with complex, polypathological long-term consequences and an increased risk of neurological, psychiatric, and systemic disorders. Long-term prognosis after TBI depends on injury severity, age, and comorbidities, while even mild TBI is associated with elevated risks of depression, dementia, Parkinson’s disease, stroke, and suicidal behavior. While some adverse outcomes, such as increased risks of affective and certain neurodegenerative disorders, appear across all severity levels, others are more strongly associated with moderate and severe TBI, particularly with respect to functional decline and long-term mortality. At the same time, various factors, including pre-injury cognitive reserve, may modulate the clinical picture once a certain threshold of brain damage and systemic vulnerability is reached. These findings highlight the need for long-term cohort studies with harmonized criteria for TBI severity and outcomes, as well as for validated biomarkers of post-traumatic neurodegeneration to improve risk stratification and long-term management of TBI survivors.
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© The Author(s), under exclusive licence to EDP Sciences, Springer-Verlag GmbH Germany, part of Springer Nature 2026
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
