Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France.
Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France.
Rev Neurol (Paris). 2017 Jul-Aug;173(7-8):461-472. doi: 10.1016/j.neurol.2017.07.006. Epub 2017 Aug 26.
Traumatic brain injury (TBI) is a serious healthcare problem, and this report is a selective review of recent findings on the epidemiology, pathophysiology and neuropsychological impairments following TBI. Patients who survive moderate-to-severe TBI frequently suffer from a wide range of cognitive deficits and behavioral changes due to diffuse axonal injury. These deficits include slowed information-processing and impaired long-term memory, attention, working memory, executive function, social cognition and self-awareness. Mental fatigue is frequently also associated and can exacerbate the consequences of neuropsychological deficits. Personality and behavioral changes can include combinations of impulsivity and apathy. Even mild TBI raises specific problems: while most patients recover within a few weeks or months, a minority of patients may suffer from long-lasting symptoms (post-concussion syndrome). The pathophysiology of such persistent problems remains a subject of debate, but seems to be due to both injury-related and non-injury-related factors.
创伤性脑损伤(TBI)是一个严重的医疗保健问题,本报告是对 TBI 后流行病学、病理生理学和神经心理学损伤的最新发现的选择性回顾。由于弥漫性轴索损伤,中度至重度 TBI 幸存患者经常遭受广泛的认知缺陷和行为改变。这些缺陷包括信息处理速度减慢和长期记忆、注意力、工作记忆、执行功能、社会认知和自我意识受损。精神疲劳也经常与之相关,并可能加重神经心理学缺陷的后果。人格和行为改变可能包括冲动和冷漠的组合。即使是轻度 TBI 也会引发特定问题:虽然大多数患者在几周或几个月内康复,但少数患者可能会出现长期症状(脑震荡后综合征)。这种持续存在问题的病理生理学仍然存在争议,但似乎是由于与损伤相关和非损伤相关的因素造成的。