1 Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, NY, USA.
2 VA Health Care Upstate New York, Syracuse VA Medical Center, Syracuse, NY, USA.
Cell Transplant. 2017 Jul;26(7):1118-1130. doi: 10.1177/0963689717714102.
Traumatic brain injury (TBI) presents in various forms ranging from mild alterations of consciousness to an unrelenting comatose state and death. In the most severe form of TBI, the entirety of the brain is affected by a diffuse type of injury and swelling. Treatment modalities vary extensively based on the severity of the injury and range from daily cognitive therapy sessions to radical surgery such as bilateral decompressive craniectomies. Guidelines have been set forth regarding the optimal management of TBI, but they must be taken in context of the situation and cannot be used in every individual circumstance. In this review article, we have summarized the current status of treatment for TBI in both clinical practice and basic research. We have put forth a brief overview of the various subtypes of traumatic injuries, optimal medical management, and both the noninvasive and invasive monitoring modalities, in addition to the surgical interventions necessary in particular instances. We have overviewed the main achievements in searching for therapeutic strategies of TBI in basic science. We have also discussed the future direction for developing TBI treatment from an experimental perspective.
创伤性脑损伤（TBI）表现形式多样，从轻度意识改变到持续昏迷甚至死亡。在最严重的 TBI 形式中，整个大脑都会受到弥漫性损伤和肿胀的影响。治疗方式因损伤的严重程度而广泛变化，从日常认知疗法到双侧去骨瓣减压术等激进手术。已经制定了关于 TBI 最佳管理的指南，但必须结合具体情况考虑，不能在每个个体情况下使用。在这篇综述文章中，我们总结了 TBI 在临床实践和基础研究中的治疗现状。我们简要概述了各种创伤性损伤亚型、最佳药物治疗以及非侵入性和侵入性监测方式，以及在特殊情况下需要进行的手术干预。我们综述了在基础科学中寻找 TBI 治疗策略的主要成果。我们还从实验角度讨论了开发 TBI 治疗的未来方向。
