Ruff R M, Jurica P
Department of Neurosurgery and Psychiatry, University of California, San Francisco, USA.
Brain Inj. 1999 Dec;13(12):943-52. doi: 10.1080/026990599120963.
Discrepant criteria are utilized by various disciplines for the diagnosis of mild traumatic brain injury (TBI). This study evaluates 76 patients, all of whom were diagnosed as having sustained a mild TBI according to the diagnostic criteria set forth by the American Congress of Rehabilitation Medicine (ACRM); yet only 34% of these patients were classified as having a concussion according to DSM-IV. A unified definition is proposed which is comprised of grades: Type I for ACRM, Type III for DSM-IV, and Type II to bridge the two discrepant definitions. An examination of the patients, subdivided into the three types, revealed no significant differences for (1) number of subjective complaints, (2) neurocognitive performances, and (3) pre-existing emotional risk factors. Thus, the proposed gradation unifies the definitions across the heterogeneity of mild TBI. However, further research is indicated for their clinical validation.
不同学科采用不同的标准来诊断轻度创伤性脑损伤(TBI)。本研究评估了76例患者,根据美国康复医学大会(ACRM)制定的诊断标准,所有这些患者均被诊断为患有轻度TBI;然而,根据《精神疾病诊断与统计手册》第四版(DSM-IV),这些患者中只有34%被归类为患有脑震荡。本文提出了一个统一的定义,该定义包括几个等级:ACRM的I型、DSM-IV的III型,以及用于弥合这两个不同定义的II型。对分为这三种类型的患者进行检查后发现,在以下方面没有显著差异:(1)主观症状的数量、(2)神经认知表现,以及(3)既往存在的情绪风险因素。因此,所提出的分级统一了轻度TBI异质性中的定义。然而,还需要进一步的研究来对其进行临床验证。