Schulich School of Medicine & Dentistry, Western University, Clinical Skills Building, London, Ontario N6A 5C1, Canada.
Division of Pediatric Neurology, Department of Pediatrics, McMaster Children's Hospital, Pediatric Neurology, MUMC 3A, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
Brain Behav Immun. 2015 May;46:1-16. doi: 10.1016/j.bbi.2015.02.009. Epub 2015 Feb 28.
Post-concussion syndrome is an aggregate of symptoms that commonly present together after head injury. These symptoms, depending on definition, include headaches, dizziness, neuropsychiatric symptoms, and cognitive impairment. However, these symptoms are common, occurring frequently in non-head injured controls, leading some to question the existence of post-concussion syndrome as a unique syndrome. Therefore, some have attempted to explain post-concussion symptoms as post-traumatic stress disorder, as they share many similar symptoms and post-traumatic stress disorder does not require head injury. This explanation falls short as patients with post-concussion syndrome do not necessarily experience many key symptoms of post-traumatic stress disorder. Therefore, other explanations must be sought to explain the prevalence of post-concussion like symptoms in non-head injury patients. Many of the situations in which post-concussion syndrome like symptoms may be experienced such as infection and post-surgery are associated with systemic inflammatory responses, and even neuroinflammation. Post-concussion syndrome itself has a significant neuroinflammatory component. In this review we examine the evidence of neuroinflammation in post-concussion syndrome and the potential role systemic inflammation plays in post-concussion syndrome like symptoms. We conclude that given the overlap between these conditions and the role of inflammation in their etiologies, a new term, post-inflammatory brain syndromes (PIBS), is necessary to describe the common outcomes of many different inflammatory insults. The concept of post-concussion syndrome is in its evolution therefore, the new term post-inflammatory brain syndromes provides a better understanding of etiology of its wide-array of symptoms and the wide array of conditions they can be seen in.
脑震荡后综合征是一种在头部受伤后常见的综合症状。这些症状根据定义包括头痛、头晕、神经精神症状和认知障碍。然而，这些症状很常见，在非头部受伤的对照组中经常出现，这导致一些人质疑脑震荡后综合征作为一种独特综合征的存在。因此，一些人试图将脑震荡后的症状解释为创伤后应激障碍，因为它们有许多相似的症状，而且创伤后应激障碍并不需要头部受伤。这种解释并不完全正确，因为脑震荡后综合征的患者不一定会经历许多创伤后应激障碍的关键症状。因此，必须寻求其他解释来解释非头部受伤患者中常见的脑震荡后类似症状。许多可能经历脑震荡后类似症状的情况，如感染和手术后，都与全身炎症反应有关，甚至与神经炎症有关。脑震荡后综合征本身就有明显的神经炎症成分。在这篇综述中，我们检查了脑震荡后综合征中神经炎症的证据，以及全身炎症在脑震荡后类似症状中可能发挥的作用。我们的结论是，鉴于这些情况之间的重叠以及炎症在其发病机制中的作用，有必要用一个新的术语，即“炎症后脑综合征”（PIBS）来描述许多不同炎症性损伤的共同结局。脑震荡后综合征的概念正在不断发展，因此，新术语“炎症后脑综合征”为理解其广泛症状和它们可能出现的广泛疾病提供了更好的病因理解。
