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小儿创伤性脑损伤的慢性问题:文献综述

Chronic Aspects of Pediatric Traumatic Brain Injury: Review of the Literature.

作者信息

Babikian Talin, Merkley Tricia, Savage Ronald C, Giza Christopher C, Levin Harvey

机构信息

1 Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and Mattel Children's Hospital at UCLA , Los Angeles, California.

2 Department of Clinical Neuropsychology, Barrow Neurological Institute , Phoenix, Arizona.

出版信息

J Neurotrauma. 2015 Dec 1;32(23):1849-60. doi: 10.1089/neu.2015.3971.

Abstract

Traumatic brain injury (TBI) in children, while the brain is in a state of rapid change and development, can adversely impact their development, their extended environment, and their families. The extant literature has identified several physiological, genetic, and environmental variables that predict outcomes after pediatric TBI; nonetheless, the individual course of recovery and later development of a given child is uniquely shaped by injury-related factors (e.g., nature and extent of the injury itself, the developmental status of the child) as well as a number of personal and family variables (e.g., pre-injury cognitive, genetic, and psychological status of the child, family functioning and resources, coping style). Further, the effects of a brain injury during development may or may not become evident immediately after injury depending on a number of factors. Instead, observing trajectories of development over time may allow for a better understanding of the long-term consequences in many functional domains that interest researchers, clinicians, and families. The current article reviews the chronic aspects of medical/health, cognitive/academic, emotional/behavioral, and family/social outcomes after pediatric TBI, with the goal of providing monitoring and treatment strategies for affected children and their families, as well as serving as a resource for researchers designing studies to better understand this heterogeneous population.

摘要

儿童创伤性脑损伤(TBI)发生时,其大脑正处于快速变化和发育阶段,会对他们的发育、周围环境以及家庭产生不利影响。现有文献已经确定了几个预测小儿创伤性脑损伤后结果的生理、遗传和环境变量;尽管如此,特定儿童的个体恢复过程和后期发育受到损伤相关因素(如损伤本身的性质和程度、儿童的发育状况)以及一些个人和家庭变量(如儿童受伤前的认知、遗传和心理状况、家庭功能和资源、应对方式)的独特影响。此外,发育过程中脑损伤的影响可能在受伤后立即显现,也可能不会,这取决于多种因素。相反,随着时间推移观察发育轨迹可能有助于更好地理解许多功能领域的长期后果,这些领域是研究人员、临床医生和家庭所关注的。本文回顾了小儿创伤性脑损伤后医疗/健康、认知/学业、情感/行为以及家庭/社会结果的慢性方面,目的是为受影响的儿童及其家庭提供监测和治疗策略,并为设计研究以更好理解这一异质性群体的研究人员提供参考资源。

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