Julien J, Tinawi S, Anderson K, Frenette L C, Audrit H, Ferland M C, Feyz M, De Guise E
a Department of Psychology , University of Montréal , Montréal , Canada.
b Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR) , Montreal , Canada.
Brain Inj. 2017;31(13-14):1846-1855. doi: 10.1080/02699052.2017.1346289. Epub 2017 Aug 17.
The goal of the current study is to explore the difference in acute post-concussive symptoms (PCS), headaches, sleep and mood complaints between groups of patients with complicated and uncomplicated mild traumatic brain injuries (mTBIs) and a comparable group of injured controls. Interactions among the following four factors were studied: presence of (1) PCS; (2) headaches; (3) sleep disorders; and (4) psychological status.
A total of 198 patients, followed at the outpatient mTBI clinic of the MUHC-MGH, completed questionnaires and a brief neurological assessment two weeks post-trauma.
Whether they had a TBI or not, all patients presented PCS, headaches, sleep and mood complaints. No significant differences between groups in terms of reported symptoms were found. Variables such as depression and anxiety symptoms, as well as sleep difficulties and headaches were found to correlate with PCS. The high rate of PCS in trauma patients was observed independently of traumatic brain injury status. This study has also shown that patients with complicated mTBI were more likely to have vestibular impairment after their injury.
The vestibular function should be assessed systematically after a complicated mTBI. Furthermore, the mTBI diagnosis should be based on operational criteria, and not on reported symptoms.
本研究的目的是探讨复杂型和非复杂型轻度创伤性脑损伤(mTBI)患者组与一组可比的受伤对照组在急性脑震荡后症状(PCS)、头痛、睡眠和情绪主诉方面的差异。研究了以下四个因素之间的相互作用:(1)PCS的存在;(2)头痛;(3)睡眠障碍;(4)心理状态。
共有198名在MUHC-MGH门诊mTBI诊所接受随访的患者在创伤后两周完成了问卷调查和简短的神经学评估。
无论是否患有TBI,所有患者均出现PCS、头痛、睡眠和情绪主诉。在报告的症状方面,各组之间未发现显著差异。发现抑郁和焦虑症状以及睡眠困难和头痛等变量与PCS相关。观察到创伤患者中PCS的高发生率与创伤性脑损伤状态无关。本研究还表明,复杂型mTBI患者受伤后更有可能出现前庭功能障碍。
复杂型mTBI后应系统评估前庭功能。此外,mTBI的诊断应基于操作标准,而非报告的症状。