Desai Masoom, Jain Abhi
Division of Neurocritical Care, Program in Trauma, University of Maryland Medical Center, University of Maryland School of Medicine, Baltimore, MD, USA -
Philadelphia College of Osteopathic Medicine, Philadelphlia, PA, USA.
J Neurosurg Sci. 2018 Oct;62(5):563-573. doi: 10.23736/S0390-5616.18.04476-4. Epub 2018 May 22.
Traumatic brain injury (TBI) has a high incidence worldwide and is associated with significant morbidity and mortality. TBI has enduring implications in several domains and limits overall quality of life even in the survivors. Assessment of failures of different strategies attempted at improving outcomes in traumatic brain injury is required. Several neuroprotective strategies have been studied to limit the morbidity and mortality associated with TBI. Various approaches, both pharmacologic and surgical, have been tried. In this article, we will review the epidemiology of TBI, the impact of secondary brain injury on outcomes and different strategies in traumatic brain injury. Furthermore, discussion into failure of different strategies and necessary future approach will be discussed. TBI remains a challenging condition to intervene on due to its heterogeneity. Future work should incorporate a multi-disciplinary as well as multi-center approach to target specific subset of patient population.
创伤性脑损伤（TBI）在全球范围内发病率很高，并且与显著的发病率和死亡率相关。TBI在多个领域具有持久影响，即使在幸存者中也会限制整体生活质量。需要评估为改善创伤性脑损伤预后而尝试的不同策略的失败情况。已经研究了几种神经保护策略来限制与TBI相关的发病率和死亡率。已经尝试了各种方法，包括药物和手术方法。在本文中，我们将回顾TBI的流行病学、继发性脑损伤对预后的影响以及创伤性脑损伤的不同策略。此外，还将讨论不同策略的失败情况以及未来必要的方法。由于TBI的异质性，对其进行干预仍然是一项具有挑战性的工作。未来的工作应采用多学科以及多中心方法来针对特定的患者群体子集。
