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创伤性脑损伤的慢性及渐进性神经后果。

The chronic and evolving neurological consequences of traumatic brain injury.

作者信息

Wilson Lindsay, Stewart William, Dams-O'Connor Kristen, Diaz-Arrastia Ramon, Horton Lindsay, Menon David K, Polinder Suzanne

机构信息

Division of Psychology, University of Stirling, Stirling, UK.

Department of Neuropathology, Queen Elizabeth University Hospital, Glasgow, UK; Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK.

出版信息

Lancet Neurol. 2017 Oct;16(10):813-825. doi: 10.1016/S1474-4422(17)30279-X. Epub 2017 Sep 12.

Abstract

Traumatic brain injury (TBI) can have lifelong and dynamic effects on health and wellbeing. Research on the long-term consequences emphasises that, for many patients, TBI should be conceptualised as a chronic health condition. Evidence suggests that functional outcomes after TBI can show improvement or deterioration up to two decades after injury, and rates of all-cause mortality remain elevated for many years. Furthermore, TBI represents a risk factor for a variety of neurological illnesses, including epilepsy, stroke, and neurodegenerative disease. With respect to neurodegeneration after TBI, post-mortem studies on the long-term neuropathology after injury have identified complex persisting and evolving abnormalities best described as polypathology, which includes chronic traumatic encephalopathy. Despite growing awareness of the lifelong consequences of TBI, substantial gaps in research exist. Improvements are therefore needed in understanding chronic pathologies and their implications for survivors of TBI, which could inform long-term health management in this sizeable patient population.

摘要

创伤性脑损伤(TBI)可对健康和幸福产生终身且动态的影响。对长期后果的研究强调,对许多患者而言,TBI应被视为一种慢性健康状况。有证据表明,TBI后的功能结局在受伤后长达二十年都可能出现改善或恶化,而且全因死亡率在多年内一直居高不下。此外,TBI是包括癫痫、中风和神经退行性疾病在内的多种神经系统疾病的危险因素。关于TBI后的神经退行性变,对损伤后长期神经病理学的尸检研究已经确定了复杂的持续和演变异常,最好将其描述为多病理学,其中包括慢性创伤性脑病。尽管人们越来越意识到TBI的终身后果,但研究中仍存在重大差距。因此,在了解慢性病理学及其对TBI幸存者的影响方面需要取得进展,这可为这一相当规模患者群体的长期健康管理提供依据。

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