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轻度创伤性脑损伤后的脑震荡症状:来自儿科门诊的研究结果

Post-concussion symptoms in mild traumatic brain injury: findings from a paediatric outpatient clinic.

作者信息

Dillard Charles, Ditchman Nicole, Nersessova Karine, Foster Nicola, Wehman Paul, West Michael, Riedlinger Brendalin, Monasterio Eugenio, Shaw Bill, Neblett Julie

机构信息

a Pediatric TBI Program , Children's Hospital of Richmond at Virginia Commonwealth University , Richmond , VA , USA.

b Department of Physical Medicine and Rehabilitation , Virginia Commonwealth University , Richmond , VA , USA.

出版信息

Disabil Rehabil. 2017 Mar;39(6):544-550. doi: 10.3109/09638288.2016.1152602. Epub 2016 Mar 13.

Abstract

Purpose Mild traumatic brain injury (mTBI) is common among children and is associated with a range of symptomatology and clinical presentations. This study uses data from a paediatric outpatient TBI clinic to (1) investigate characteristics associated with more severe post-concussive symptoms and (2) examine differences in the proportion of individuals endorsing specific post-concussion symptoms based on group (e.g., sex, type of injury, and psychiatric history). Methods Data from the Children's Hospital of Richmond's TBI outpatient programme were analysed (N = 157). Results Gender and sports injury were associated with severity of symptoms. In addition, females endorsed a greater number of overall symptoms than males. A number of specific symptoms were found to be endorsed to a greater extent based on psychiatric history and type of injury; however, overall total number of symptoms endorsed did not differ based on these characteristics. Conclusions Findings from this study provide further evidence that mTBI affects a wide range of youth and that associated symptomatology can indeed be varied. Moreover, results revealed differences in endorsement of specific symptoms and symptom severity based on patient and injury characteristics which have implications for concussion assessment and treatment. Implications for Rehabilitation Symptoms following mild traumatic brain injury (mTBI) in children and adolescents can have varied presentation, ranging from minimal to severe. Females and those with non-sports-related injuries are more likely to endorse greater symptoms following concussion. Symptom evaluation is an essential component of the concussion assessment and treatment of paediatric patients following mTBI, and clinicians should be aware of patient characteristics associated with increased symptoms, especially when baseline symptom data are not available.

摘要

目的 轻度创伤性脑损伤(mTBI)在儿童中很常见,且与一系列症状和临床表现相关。本研究使用一家儿科门诊TBI诊所的数据来(1)调查与更严重的脑震荡后症状相关的特征,以及(2)根据组别(如性别、损伤类型和精神病史)检查认可特定脑震荡后症状的个体比例差异。方法 对里士满儿童医院TBI门诊项目的数据进行分析(N = 157)。结果 性别和运动损伤与症状严重程度相关。此外,女性认可的总体症状数量多于男性。根据精神病史和损伤类型,发现一些特定症状得到了更高程度的认可;然而,认可的症状总数并未因这些特征而有所不同。结论 本研究结果提供了进一步的证据,表明mTBI影响广泛的青少年,且相关症状确实可能各不相同。此外,结果揭示了根据患者和损伤特征在特定症状认可和症状严重程度方面的差异,这对脑震荡评估和治疗具有启示意义。对康复的启示 儿童和青少年轻度创伤性脑损伤(mTBI)后的症状表现可能各不相同,从轻微到严重不等。女性和那些有非运动相关损伤的人在脑震荡后更有可能认可更多症状。症状评估是mTBI后儿科患者脑震荡评估和治疗的重要组成部分,临床医生应了解与症状增加相关的患者特征,尤其是在没有基线症状数据的情况下。

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