Kapadia Mitul, Scheid Alison, Fine Eric, Zoffness Rachel
Division of Pediatric Rehabilitation Medicine, Mission Hall, UCSF Benioff Children's Hospital, Box 0110, 550 16th Street, 4th Floor, San Francisco, CA, 34143, USA.
University of California, San Francisco, CA, USA.
Curr Rev Musculoskelet Med. 2019 Mar;12(1):57-66. doi: 10.1007/s12178-019-09533-x.
Post-concussion syndrome (PCS), when the patient's concussion symptoms last longer than 4-6 weeks, affects 10-30% of concussion patients. PCS presents a significant source of morbidity to patients and a management challenge to providers. In this review, we present the current evidence and best management approaches for pediatric PCS.
There is limited high-quality evidence in pediatric PCS. There is some evidence supporting pharmaceutical management of post-traumatic headaches, cognitive symptoms, and emotional symptoms. Vestibular-ocular dysfunction should be evaluated and managed appropriately. Neuropsychological recovery is expected, but requires appropriate attention to Return to Learn. Emotional symptoms are common in PCS and the evidence supports treatment with cognitive behavioral therapy. PCS presents a unique therapeutic challenge affecting multiple domains for patients-physical, sleep, cognitive, and emotional. Successful management of PCS requires a multi-disciplinary and individualized approach. There remains a significant need for further research, specifically looking into the outcomes and effective interventions in pediatric PCS.
脑震荡后综合征(PCS)是指患者脑震荡症状持续超过4 - 6周,影响10% - 30%的脑震荡患者。PCS给患者带来了显著的发病源,也给医疗服务提供者带来了管理挑战。在本综述中,我们介绍了小儿PCS的当前证据和最佳管理方法。
小儿PCS的高质量证据有限。有一些证据支持对创伤后头痛、认知症状和情绪症状进行药物治疗。应适当评估和管理前庭眼功能障碍。神经心理恢复是可以预期的,但需要适当关注复学问题。情绪症状在PCS中很常见,证据支持采用认知行为疗法进行治疗。PCS给患者的多个领域——身体、睡眠、认知和情绪——带来了独特的治疗挑战。成功管理PCS需要多学科和个性化的方法。仍非常需要进一步的研究,特别是针对小儿PCS的结果和有效干预措施的研究。