Perl Daniel P
J. Edward Hebert School of Medicine, "America's Medical School", Uniformed Services University, Bethesda, MD, USA.
Free Neuropathol. 2020 Mar 30;1:10. doi: 10.17879/freeneuropathology-2020-2662. eCollection 2020 Jan.
Neurotrauma represents a major public health problem and is one of the leading causes of death and disability worldwide. Despite its high prevalence, there are major gaps in our understanding of the underlying pathophysiology leading to the substantial morbidity and mortality associated with this problem. Here, ten studies published in 2019 are reviewed that addressed issues related to the acute and long-term effects of neurotrauma. These studies can be broken down into three separate categories, namely, the importance of neurotrauma-based damage to the cerebrovascular unit, white matter damage following neurotrauma, and research related to the long-term neurodegenerative consequences of repeated head trauma, especially chronic traumatic encephalopathy. The advances highlighted here indicate that progress has been made. However, major gaps in knowledge remain which will require additional neuropathologic studies of clinical specimens, as well as the development and investigation of a wide range of relevant pre-clinical models. Further efforts in this field are clearly needed if there are to emerge better clinical outcomes for the numerous patients that suffer neurotrauma each year as well as those currently suffering from its long-term effects.
神经创伤是一个重大的公共卫生问题,是全球范围内死亡和残疾的主要原因之一。尽管其发病率很高,但我们对导致该问题相关严重发病率和死亡率的潜在病理生理学的理解仍存在重大差距。在此,对2019年发表的十项研究进行综述,这些研究涉及与神经创伤的急性和长期影响相关的问题。这些研究可分为三个独立类别,即基于神经创伤对脑血管单元的损伤的重要性、神经创伤后的白质损伤以及与反复头部创伤尤其是慢性创伤性脑病的长期神经退行性后果相关的研究。此处强调的进展表明已经取得了进步。然而,知识上仍存在重大差距,这将需要对临床标本进行额外的神经病理学研究,以及开发和研究广泛的相关临床前模型。如果要为每年遭受神经创伤的众多患者以及目前受其长期影响的患者带来更好的临床结果,显然需要在该领域进一步努力。