Sbordone R J, Liter J C
Department of Neurosurgery, University of California, Irvine, College of Medicine, USA.
Brain Inj. 1995 May-Jun;9(4):405-12. doi: 10.3109/02699059509005780.
It has been widely assumed that patients who sustain mild traumatic brain injury (MTBI) or post-concussive syndrome develop post-traumatic stress disorder (PTSD) in response to their cognitive difficulties, diminished coping skills, or other losses. This study examined 70 patients who had previously been diagnosed as having either PTSD or MTBI. Each patient was asked to provide a highly detailed chronological history of the events which preceded, followed, and occurred during the traumatic event, to indicate whether they were rendered unconscious or had amnesia for the event, and to describe the various symptoms they developed. All (100.0%) of the PTSD patients were able to provide a highly detailed and emotionally charged recollection of the events which occurred within 15 minutes of the traumatic event in comparison to none (0.0%) of the MTBI patients. None of the MTBI patients reported symptoms such as intrusive recollections of the traumatic event, nightmares, hypervigilance, phobic or startle reactions, or became upset when they were asked to describe the traumatic event or were exposed to stimuli associated with it. These data suggest that PTSD and MTBI are two mutually exclusive disorders, and that it is highly unlikely that MTBI patients develop PTSD symptoms. Furthermore, these findings suggest that clinicians should exercise considerable caution in ruling out PTSD prior to making the diagnosis of MTBI.
人们普遍认为，遭受轻度创伤性脑损伤（MTBI）或脑震荡后综合征的患者会因认知困难、应对技能下降或其他损失而患上创伤后应激障碍（PTSD）。本研究调查了70名先前被诊断患有PTSD或MTBI的患者。每位患者都被要求提供一份关于创伤事件之前、之后以及期间所发生事件的非常详细的按时间顺序排列的病史，指出他们是否在事件中失去意识或出现失忆，并描述他们所出现的各种症状。与MTBI患者无一例（0.0%）能够做到相比，所有（100.0%）的PTSD患者都能够对创伤事件发生后15分钟内发生的事件提供非常详细且充满情感的回忆。没有一名MTBI患者报告有诸如对创伤事件的侵入性回忆、噩梦、过度警觉、恐惧或惊吓反应等症状，或者在被要求描述创伤事件或接触与之相关的刺激时感到不安。这些数据表明，PTSD和MTBI是两种相互排斥的疾病，MTBI患者极不可能出现PTSD症状。此外，这些发现表明，临床医生在诊断MTBI之前排除PTSD时应格外谨慎。
