Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, US Army Medical Research and Materiel Command, Silver Spring, Maryland 20910, USA.
J Head Trauma Rehabil. 2010 Jan-Feb;25(1):9-14. doi: 10.1097/HTR.0b013e3181bd090f.
To determine whether screening for a blast mechanism of concussion identifies individuals at higher risk of persistent postconcussive symptoms (PCS).
United States Army post.
3952 US Army infantry soldiers were administered anonymous surveys 3 to 6 months after returning from a yearlong deployment to Iraq.
Self-reported concussion (defined as an injury that resulted in being "dazed, confused, or 'seeing stars'"; "not remembering the injury"; or "losing consciousness [knocked out]): Patient Health Questionnaire 15-item scale for physical symptoms and PCS; Posttraumatic Stress Disorder Checklist; and Patient Health Questionnaire depression module.
Of the 587 soldiers (14.9% of the total sample) who met criteria for concussion, 201 (34.2%) reported loss of consciousness, and 373 (63.5%) reported only an alteration of consciousness without loss of consciousness; 424 (72.2%) reported a blast mechanism, and 150 (25.6%) reported a nonblast mechanism. Among soldiers who lost consciousness, blast mechanism was significantly associated with headaches and tinnitus 3 to 6 months postdeployment compared with a nonblast mechanism. However, among the larger group of soldiers reporting concussions without loss of consciousness, blast was not associated with adverse health outcomes.
Blast mechanism of concussion was inconsistently associated with PCS, depending on the definition of concussion utilized. A self-reported history of blast mechanism was not associated with persistent PCS for the majority of US soldiers with concussions.
确定脑震荡的冲击机制筛查是否能识别出持续性脑震荡后症状（PCS）风险较高的个体。
美国陆军驻地。
3952 名美国陆军步兵士兵在从伊拉克长达一年的部署中返回后 3 至 6 个月接受了匿名调查。
自我报告的脑震荡（定义为导致“头晕、困惑或“眼前有星星”；“不记得受伤”；或“失去意识[昏迷]”）：15 项患者健康问卷用于评估身体症状和 PCS；创伤后应激障碍检查表；以及患者健康问卷抑郁模块。
在 587 名（总样本的 14.9%）符合脑震荡标准的士兵中，201 名（34.2%）报告失去意识，373 名（63.5%）报告仅意识改变而没有失去意识；424 名（72.2%）报告冲击机制，150 名（25.6%）报告非冲击机制。在失去意识的士兵中，与非冲击机制相比，冲击机制与脑震荡后 3 至 6 个月的头痛和耳鸣显著相关。然而，在报告无意识脑震荡的较大士兵群体中，冲击与不良健康结果无关。
脑震荡的冲击机制与 PCS 的相关性不一致，这取决于所使用的脑震荡定义。大多数患有脑震荡的美国士兵自我报告的冲击机制历史与持续性 PCS 无关。
