Marshall Kathryn R, Holland Sherray L, Meyer Kimberly S, Martin Elisabeth Moy, Wilmore Michael, Grimes Jamie B
Defense and Veterans Brain Injury Center, 1335 East West Highway, Suite 6-100, Silver Spring, MD 20919, USA.
Mil Med. 2012 Aug;177(8 Suppl):67-75. doi: 10.7205/milmed-d-12-00110.
The majority of combat-related traumatic brain injury (TBI) within the U.S. Armed Forces is mild TBI (mTBI). This article focuses specifically on the screening, diagnosis, and treatment aspects of mTBI within the military community. Aggressive screening measures were instituted in 2006 to ensure that the mTBI population is identified and treated. Screenings occur in-theater, outside the contiguous United States, and in-garrison. We discuss specific screening procedures at each screening setting. Current diagnosis of mTBI is based upon self-report or through witnesses to the event. TBI severity is determined by specific Department of Defense criteria. Abundant clinician resources are available for mTBI in the military health care setting. Education resources for both the patient and the clinician are discussed in detail. An evidence-based clinical practice guideline for the care of mTBI was created through collaborative efforts of the DoD and the U.S. Department of Veterans Affairs. Although symptoms following mTBI generally resolve with time, active treatment is centered on symptom management, supervised rest, recovery, and patient education. Medical specialty care, ancillary services, and other therapeutic services may be required.
美国武装部队中与战斗相关的创伤性脑损伤(TBI)大多为轻度创伤性脑损伤(mTBI)。本文专门聚焦于军事群体中mTBI的筛查、诊断和治疗方面。2006年采取了积极的筛查措施,以确保识别和治疗mTBI人群。筛查在战区(美国本土以外)以及驻地进行。我们讨论了在每个筛查地点的具体筛查程序。目前mTBI的诊断基于自我报告或事件目击者的陈述。TBI的严重程度由国防部的特定标准确定。在军事医疗环境中,有大量临床医生资源可用于mTBI。详细讨论了针对患者和临床医生的教育资源。通过国防部和美国退伍军人事务部的共同努力,制定了基于证据的mTBI护理临床实践指南。虽然mTBI后的症状通常会随时间缓解,但积极治疗主要集中在症状管理、监督休息、康复和患者教育上。可能需要专科医疗护理、辅助服务和其他治疗服务。