Department of Emergency Medicine, University of Rochester, Rochester, NY 14642, USA. jeff
J Head Trauma Rehabil. 2009 Nov-Dec;24(6):439-51. doi: 10.1097/HTR.0b013e3181c15600.
To determine the relations between traumatic brain injury (TBI) and several neurologic outcomes 6 months or more after TBI.
Not applicable.
Systematic review of the published, peer-reviewed literature.
Not applicable.
We identified 75 studies that examined the relations between TBI and neurologic outcomes. Unprovoked seizures are causally related to penetrating TBI as well as to moderate and severe TBI. There was only limited evidence of an association between seizures and mild TBI. Dementia of the Alzheimer's type (DAT) was associated with moderate and severe TBI, but not with mild TBI unless there was loss of consciousness (LOC); the evidence for the latter was limited. Parkinsonism was associated with moderate and severe TBI, but there was only modest evidence of a link with mild TBI without LOC. Dementia pugilistica was associated with professional boxing. There was insufficient evidence to support an association between TBI and both multiple sclerosis and amyotrophic lateral sclerosis. TBI appeared to produce a host of postconcussive symptoms (eg, memory problems, dizziness, and irritability). Moderate and severe TBI were associated with endocrine problems such as hypopituitarism and growth hormone deficiency and possibly with diabetes insipidus. There was only limited evidence of an association between mild TBI and the development of ocular/visual motor deterioration.
TBI is strongly associated with several neurologic disorders 6 months or more after injury. Clinicians caring for TBI patients should monitor them closely for the development of these disorders. While some of these disorders can be treated after they arise (eg, seizures), a greater public health benefit would be achieved by preventing them before they develop. Research efforts to develop therapies aimed at secondary prevention are currently underway.
确定创伤性脑损伤（TBI）与 TBI 后 6 个月或更长时间出现的几种神经系统结局之间的关系。
不适用。
对已发表的同行评议文献进行系统回顾。
不适用。
我们确定了 75 项研究，这些研究检查了 TBI 与神经系统结局之间的关系。自发性癫痫与穿透性 TBI 以及中度和重度 TBI 有因果关系。轻度 TBI 与癫痫之间的关联仅有有限的证据。阿尔茨海默病型痴呆（DAT）与中度和重度 TBI 相关，但与轻度 TBI 无关，除非有意识丧失（LOC）；后者的证据有限。帕金森病与中度和重度 TBI 相关，但与无 LOC 的轻度 TBI 仅有适度的关联。职业拳击与拳击手痴呆有关。没有足够的证据支持 TBI 与多发性硬化症和肌萎缩侧索硬化症之间存在关联。TBI 似乎会导致一系列脑震荡后症状（例如，记忆问题、头晕和易怒）。中度和重度 TBI 与内分泌问题（如垂体功能减退和生长激素缺乏症）以及可能的尿崩症有关。轻度 TBI 与眼部/视觉运动恶化之间的关联仅有有限的证据。
TBI 与损伤后 6 个月或更长时间出现的几种神经系统疾病密切相关。照顾 TBI 患者的临床医生应密切监测他们是否出现这些疾病。虽然一些这些疾病在出现后可以得到治疗（例如，癫痫），但通过在它们出现之前预防它们，可以实现更大的公共卫生效益。目前正在进行旨在进行二级预防的治疗方法的研究。
