Levin H S
University of Maryland, Baltimore.
Curr Opin Neurol. 1993 Dec;6(6):841-6. doi: 10.1097/00019052-199312000-00003.
Progress in research includes studies concerning the pathophysiology and outcome of pediatric head injury, the pathology of the hippocampus in fatal injury, and the use of multivariate statistics to predict outcome in survivors. Recent research has confirmed and extended findings regarding the differential effects of closed head injury, depending on the age of the individual. These studies indicate that the consequences of head injury are more severe in older adults and in children younger than 2 years. Neuroimaging findings include evidence for delayed brain injury as a major cause of mortality and disability. Functional brain imaging provides evidence for cerebral dysfunction that is not appreciated by structural brain imaging techniques and may have a stronger relationship to neurobehavioral sequelae. The neurobehavioral sequelae frequently implicate frontal dysfunction, even in the absence of structural findings on computed tomography or magnetic resonance imaging. Studies of mild head injury have expanded our knowledge concerning the pathogenesis of postconcussional symptoms, including a preinjury vulnerability based on recent life events. Persistent postconcussional symptoms after mild head injury are frequently associated with emotional disturbance of clinical proportions.
研究进展包括有关小儿头部损伤的病理生理学和预后、致命伤中海马体的病理学以及使用多变量统计来预测幸存者预后的研究。最近的研究证实并扩展了关于闭合性头部损伤的不同影响的研究结果，这取决于个体的年龄。这些研究表明，头部损伤在老年人和2岁以下儿童中的后果更为严重。神经影像学研究结果表明，迟发性脑损伤是死亡和残疾的主要原因。功能性脑成像为大脑功能障碍提供了证据，而这种功能障碍在结构性脑成像技术中并未被发现，并且可能与神经行为后遗症有更强的关联。即使在计算机断层扫描或磁共振成像未发现结构异常的情况下，神经行为后遗症也常常涉及额叶功能障碍。轻度头部损伤的研究扩展了我们对脑震荡后症状发病机制的认识，包括基于近期生活事件的伤前易感性。轻度头部损伤后持续的脑震荡后症状常常与临床程度的情绪障碍有关。
