Jones Kyle Bradford, Wilson Benjamin, Weedon Dean, Bilder Deborah
Neuro Behavioral Home Program, 650 Komas Drive Suite 200, Salt Lake City, UT 84108,
Neuro Behavioral Home Program, 650 Komas Drive Suite 200, Salt Lake City, UT 84108.
FP Essent. 2015 Dec;439:31-41.
Traumatic brain injuries (TBIs) manifest in various forms and severities, and patients with TBIs can have multiple physical and psychological comorbidities. The physician should be prepared to assess effects of the injury and associated comorbidities, and provide needed social support. Common comorbidities include cognitive changes; epilepsy; chronic pain; headache; sleep disorders; neuroendocrine disorders; dizziness and balance issues; substance abuse; depression and anxiety; dementia; and behavioral disturbances, such as aggression. Early severity and cognitive assessment after TBI is key. For patients with mild TBIs, short-term management focuses on cognitive rest, symptom management, and gradual return to regular activities. Short-term management of patients with moderate to severe TBI often requires intensive care unit admission, early psychological consultation, and use of mannitol and probiotics. Long-term care includes monitoring and managing of the physical, behavioral, emotional, and psychological comorbidities that commonly occur in patients with TBIs. Assisting patients in accessing community and government resources can be crucial for improving their independence and quality of life.
创伤性脑损伤(TBI)有多种形式和严重程度,TBI患者可能有多种身体和心理合并症。医生应准备好评估损伤及相关合并症的影响,并提供所需的社会支持。常见的合并症包括认知改变;癫痫;慢性疼痛;头痛;睡眠障碍;神经内分泌紊乱;头晕和平衡问题;药物滥用;抑郁和焦虑;痴呆;以及行为障碍,如攻击性。TBI后早期的严重程度和认知评估是关键。对于轻度TBI患者,短期管理重点在于认知休息、症状管理以及逐渐恢复正常活动。中重度TBI患者的短期管理通常需要入住重症监护病房、早期心理咨询以及使用甘露醇和益生菌。长期护理包括监测和管理TBI患者常见的身体、行为、情感和心理合并症。协助患者获取社区和政府资源对于提高他们的独立性和生活质量可能至关重要。