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轻度创伤性脑损伤的诊断、预后和临床管理。

Diagnosis, prognosis, and clinical management of mild traumatic brain injury.

机构信息

Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Departments of Physical Medicine and Rehabilitation, Neurology, Neurosurgery, Pediatrics, and Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.

Center for Neuroscience and Regenerative Medicine, Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

出版信息

Lancet Neurol. 2015 May;14(5):506-17. doi: 10.1016/S1474-4422(15)00002-2. Epub 2015 Mar 20.

Abstract

Concussion and mild traumatic brain injury (TBI) are interchangeable terms to describe a common disorder with substantial effects on public health. Advances in brain imaging, non-imaging biomarkers, and neuropathology during the past 15 years have required researchers, clinicians, and policy makers to revise their views about mild TBI as a fully reversible insult that can be repeated without consequences. These advances have led to guidelines on management of mild TBI in civilians, military personnel, and athletes, but their widespread dissemination to clinical management in emergency departments and community-based health care is still needed. The absence of unity on the definition of mild TBI, the scarcity of prospective data concerning the long-term effects of repeated mild TBI and subconcussive impacts, and the need to further develop evidence-based interventions to mitigate the long-term sequelae are areas for future research that will improve outcomes, reduce morbidity and costs, and alleviate delayed consequences that have only recently come to light.

摘要

脑震荡和轻度创伤性脑损伤(TBI)是可互换的术语,用于描述一种常见的疾病,对公众健康有重大影响。在过去的 15 年中,脑成像、非成像生物标志物和神经病理学的进展要求研究人员、临床医生和政策制定者修改他们对轻度 TBI 的看法,即轻度 TBI 是一种完全可逆的损伤,可以在没有后果的情况下反复发生。这些进展导致了针对平民、军事人员和运动员的轻度 TBI 管理指南,但仍需要将其广泛传播到急诊科和社区医疗保健的临床管理中。目前仍缺乏对轻度 TBI 定义的统一认识,缺乏关于反复轻度 TBI 和亚脑震荡影响的长期影响的前瞻性数据,需要进一步开发基于证据的干预措施来减轻长期后果,这些都是未来研究的领域,未来的研究将改善结果,降低发病率和成本,并减轻最近才开始显现的延迟后果。

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