De Kruijk J R, Twijnstra A, Leffers P
Department of Neurology, University Hospital Maastricht, The Netherlands.
Brain Inj. 2001 Feb;15(2):99-106. doi: 10.1080/026990501458335.
Brain injury is classified clinically as severe, moderate or mild brain injury characteristics, including admission Glasgow coma score, duration of unconsciousness and post-traumatic amnesia and any focal neurological findings. Most traumatic brain injuries are classified as mild traumatic brain injury (MTBI). Headache, nausea and dizziness are frequent symptoms after MTBI and may continue for weeks to months after the trauma. MTBI may also be complicated by intracranial injuries. Experimental animal models and post-mortem studies have shown axonal damage and dysfunction in MTBI. This damage is mostly localized in the frontal lobes. Serum S-100 and NSE have been reported to be markers for the seventy of brain damage. In the literature, indications for radiodiagnostic evaluation following MTBI have been the subject of debate. Radiographs of the skull are used to exclude skull fractures, but are not useful for an evaluation of brain injury. Computed tomography of the brain seems to be the best way to exclude the development of relevant intracranial lesions. MTBI has a good clinical outcome, although a substantial group of patients develop post-concussional complaints (PCC). There is little information on the effectiveness of various methods suggested for reducing the frequency of PCC.
脑损伤在临床上根据严重程度分为重度、中度或轻度脑损伤，其特征包括入院时的格拉斯哥昏迷评分、昏迷持续时间、创伤后遗忘以及任何局灶性神经学表现。大多数创伤性脑损伤被归类为轻度创伤性脑损伤（MTBI）。头痛、恶心和头晕是MTBI后的常见症状，可能在创伤后持续数周甚至数月。MTBI也可能并发颅内损伤。实验动物模型和尸检研究表明，MTBI存在轴突损伤和功能障碍。这种损伤主要局限于额叶。据报道，血清S-100和NSE是脑损伤严重程度的标志物。在文献中，MTBI后放射诊断评估的指征一直是争论的焦点。颅骨X线片用于排除颅骨骨折，但对脑损伤评估无用。脑部计算机断层扫描似乎是排除相关颅内病变发展的最佳方法。尽管有相当一部分患者出现脑震荡后症状（PCC），但MTBI的临床预后良好。关于各种减少PCC发生频率方法的有效性，目前信息较少。
