Rozbacher Adrian, Selci Erin, Leiter Jeff, Ellis Michael, Russell Kelly
1 Max Rady College of Medicine, University of Manitoba , Winnipeg, Manitoba, Canada .
3 Pediatrics and Child Health, University of Manitoba , Winnipeg, Manitoba, Canada .
J Neurotrauma. 2017 Jul 15;34(14):2195-2203. doi: 10.1089/neu.2016.4765. Epub 2017 Feb 27.
Concussion often results in symptoms, including difficulty concentrating, focusing, and remembering, that are typically managed with cognitive and physical rest. Often, the school environment is not conducive to cognitive rest and may lead to worsening or prolonged symptoms that can contribute to impaired academic performance. The objective of the review was to identify and summarize literature concerning the effects of concussion or mild traumatic brain injury (mTBI) on academic outcomes. MEDLINE, Embase, Scopus, and CINAHL were searched until June 1, 2016. Studies must have been primary literature examining students enrolled in primary, secondary, or post-secondary education, have received a physician diagnosis of concussion or mTBI, and have post-injury academic outcomes assessed in numeric or alphabet grade/grade point average (GPA), school attendance records, or national examination scores. Data were extracted and checked by a second reviewer for accuracy and completeness. Nine studies were included. Among four studies that examined grades, one found a significant difference in pre- and post-grades only in the subject Afrikaans. Three examined national test scores and no significant differences were found between cases and controls. Four examined school absenteeism and found that students who developed post-concussion syndrome missed significantly more school days and took longer to return to school than students with extremity injuries. Although mTBI or concussion is associated with missed school, the results demonstrate minimal impact on school grades and national examination scores at a group level. Further research is needed to identify risk factors for impaired school functioning following mTBI and concussion in individual patients.
脑震荡通常会导致一些症状，包括注意力难以集中、聚焦和记忆，这些症状通常通过认知和身体休息来处理。通常，学校环境不利于认知休息，可能会导致症状恶化或持续时间延长，进而影响学业成绩。本综述的目的是识别和总结有关脑震荡或轻度创伤性脑损伤（mTBI）对学业成绩影响的文献。检索了MEDLINE、Embase、Scopus和CINAHL数据库，截至2016年6月1日。纳入的研究必须是针对小学、中学或高等教育阶段学生的原始文献，这些学生已被医生诊断为脑震荡或mTBI，并通过数字或字母等级/平均绩点（GPA）、出勤记录或国家考试成绩评估了伤后的学业成绩。数据由第二位审阅者提取并检查其准确性和完整性。共纳入9项研究。在4项研究成绩的研究中，有1项发现仅在南非荷兰语科目中，伤前和伤后的成绩存在显著差异。3项研究考察了国家考试成绩，病例组和对照组之间未发现显著差异。4项研究考察了学校缺勤情况，发现发生脑震荡后综合征的学生比肢体受伤的学生缺课天数显著更多，返校所需时间更长。虽然mTBI或脑震荡与缺课有关，但结果表明在群体层面上对学校成绩和国家考试成绩的影响最小。需要进一步研究以确定个体患者在mTBI和脑震荡后学校功能受损的风险因素。
