Department of Clinical Neuropsychology, Barrow Neurological Institute, 222 West Thomas Road, #315, Phoenix, AZ 85013, USA.
Curr Opin Psychiatry. 2011 May;24(3):243-50. doi: 10.1097/YCO.0b013e328344698b.
Concussion produces a brief disruption in mental status and is associated with a variety of physical and cognitive symptoms which typically diminish during the first several days to weeks posttrauma. This review highlights problems in defining and measuring concussion, the mildest form of traumatic brain injury (TBI). Furthermore, the 'natural' course of recovery correlates of postconcussion syndrome (PCS) and guidelines for clinical management are discussed.
Traditional measures of TBI severity (e.g. length of loss of consciousness or period of posttraumatic amnesia) do not correlate with persistent concussion symptoms. Abnormal eye movements, cerebrovascular disturbances, extra-axial injuries, alcohol intoxication at time of injury, and presence of an axis I disorder are associated with persistent symptoms. Early management of physical, cognitive, and emotional symptoms following concussion may reduce long-term morbidity. Techniques used to help concussed athletes return to play appear useful when evaluating and treating concussion in nonathletes.
The study of concussion and PCS has increased significantly over the past 10 years, with recent research supporting an underlying biological cause for initial symptomatology. Persistent symptoms may be associated with both neurological and non-neurological variables. Early and serial monitoring and treatment of symptoms appears to result in substantial improvement in the vast majority of concussed patients.
脑震荡导致短暂的精神状态紊乱，伴有各种身体和认知症状，这些症状通常在创伤后数天至数周内逐渐减轻。本综述重点介绍了脑震荡（最轻微的创伤性脑损伤（TBI））定义和测量方面的问题。此外，还讨论了“自然”恢复相关性和临床管理指南。
TBI 严重程度的传统测量方法（例如，意识丧失的时间或创伤后遗忘期）与持续性脑震荡症状无关。异常眼球运动、脑血管紊乱、轴外损伤、受伤时的酒精中毒以及存在轴 I 障碍与持续性症状相关。脑震荡后尽早管理身体、认知和情绪症状可能会降低长期发病率。在评估和治疗非运动员脑震荡时，用于帮助脑震荡运动员重返赛场的技术似乎有用。
过去 10 年来，脑震荡和 PCS 的研究显著增加，最近的研究支持初始症状的潜在生物学原因。持续性症状可能与神经和非神经变量都有关。早期和连续监测和治疗症状可使绝大多数脑震荡患者得到明显改善。
