Jay G W, Goka R S, Arakaki A H
Headache and Neurological Rehabilitation Institute of Colorado, Northglenn, USA.
J Insur Med. 1996 Summer;27(4):262-82.
The clinical entity of minor traumatic brain injury (MTBI) is secondary to signs and symptoms encompassing neuropathological, neurochemical, neurobehavioral, neuropsychological and behavioral deficits. The patients who suffer this disorder are often given little help, medically, secondary to issues regarding the perceived reality of the disorder. A few individuals deny the existence of MTBI. Some believe the symptom complex to be strictly functional, while others believe that spontaneous recovery will occur and no treatment is necessary. When discussing traumatic brain injury the descriptors, "mild, moderate, and severe," are used to describe the severity of the acute injury. These labels do not describe the severity of the sequelae nor are they indicative of the intensity of specific treatment. A clear understanding of MTBI, its sequelae and necessary treatment is imperative to insure timely intervention. Delay or lack of early intervention appears to be responsible for "persistent sequelae" in MTBI. This paper will describe various aspects of the etiology of MTBI, with recommended evaluation and treatment guidelines. A functional assessment scale specifically for persons with MTBI is also presented. Several case histories are included for illustration purposes.
轻度创伤性脑损伤(MTBI)的临床实体继发于包括神经病理学、神经化学、神经行为、神经心理学和行为缺陷在内的体征和症状。患有这种疾病的患者在医学上往往得不到多少帮助,这是由于对该疾病认知现实方面的问题所致。一些人否认MTBI的存在。一些人认为症状复合体完全是功能性的,而另一些人则认为会自发恢复,无需治疗。在讨论创伤性脑损伤时,“轻度、中度和重度”这些描述词用于描述急性损伤的严重程度。这些标签既不能描述后遗症的严重程度,也不能表明具体治疗的强度。对MTBI、其后遗症和必要治疗有清晰的认识对于确保及时干预至关重要。延迟或缺乏早期干预似乎是MTBI中“持续性后遗症”的原因。本文将描述MTBI病因的各个方面,并给出推荐的评估和治疗指南。还介绍了一种专门针对MTBI患者的功能评估量表。为便于说明,还纳入了几个病例史。