Zink B J
Department of Emergency Medicine, University of Michigan, Ann Arbor, MI 48109-0303, USA.
Ann Emerg Med. 2001 Mar;37(3):318-32. doi: 10.1067/mem.2001.113505.
Injury to the brain is the leading factor in mortality and morbidity from traumatic injury. The devastating personal, social, and financial consequences of traumatic brain injury (TBI) are compounded by the fact that most people with TBI are young and previously healthy. From the emergency physician's standpoint, patients with severe TBI are those with a presenting Glasgow Coma Scale score of less than 9. Over the past 30 years, mortality from severe traumatic brain injury for those patients who survive to the hospital has been reduced by half from nearly 50% to approximately 25%. Because most of the pathologic processes that determine outcome are fully active during the first hours after TBI, the decisions of emergency care providers may be crucial. This review addresses new concepts and information in the pathophysiology of TBI and secondary brain injury and demonstrates how emergency management may be linked to neurologic outcome.
脑损伤是创伤性损伤导致死亡和发病的主要因素。创伤性脑损伤（TBI）给个人、社会和经济带来了毁灭性后果，而大多数TBI患者都是年轻人且此前身体健康，这使得情况更加复杂。从急诊医生的角度来看，重度TBI患者是指格拉斯哥昏迷量表初始评分低于9分的患者。在过去30年里，存活至医院的重度创伤性脑损伤患者的死亡率已从近50%降至约25%，减少了一半。由于大多数决定预后的病理过程在TBI后的最初几个小时内就已充分活跃，急诊护理人员的决策可能至关重要。本综述阐述了TBI和继发性脑损伤病理生理学中的新概念和信息，并展示了急诊管理如何与神经学预后相关联。
