Department of Neurology, University of Duisburg-Essen, Essen, Germany.
Headache. 2010 Apr;50(4):710-5. doi: 10.1111/j.1526-4610.2010.01644.x.
Mild traumatic brain injury is very common in Western societies, affecting approximately 1.8 million individuals in the USA. Even though between 30% and 90% of patients develop post-traumatic headache, post-traumatic headache remains a very controversial disorder. Particularly when it comes to chronic post-traumatic headache following mild closed head injury and headache attributed to whiplash injury. Some experts are disputing its existence as a genuine disorder. Indistinct disease classification, unresolved pathophysiological mechanism, and the role of accident-related legal issues further fuel this controversy. The complex combination of pain and neuropsychological symptoms needs further research in understanding the underlying pathophysiological mechanisms associated with the acute headache following trauma but more so the mechanisms associated with the development of chronic pain in some patients. Investigators should refrain from oversimplifying these complex mechanisms as hysteric exaggeration of everyday complains and from implying greed as motivation for this potentially very disabling disease.
轻度创伤性脑损伤在西方社会非常普遍,影响了美国约 180 万人。尽管 30%至 90%的患者会出现创伤后头痛,但创伤后头痛仍然是一种非常有争议的疾病。特别是对于轻度闭合性颅脑损伤后的慢性创伤后头痛和因挥鞭样损伤引起的头痛。一些专家质疑其作为一种真正疾病的存在。不明确的疾病分类、未解决的病理生理机制以及与事故相关的法律问题进一步加剧了这一争议。疼痛和神经心理症状的复杂组合需要进一步研究,以了解与创伤后急性头痛相关的潜在病理生理机制,但更需要了解与某些患者慢性疼痛发展相关的机制。研究人员不应将这些复杂机制简单化,认为是对日常抱怨的歇斯底里的夸大,也不应暗示贪婪是这种潜在的非常致残疾病的动机。