Lee S T, Liu T N, Wong C W, Yeh Y S, Tzaan W C
Department of Neurosurgery, Chang Gung Medical College, Taipei, Taiwan, Republic of China.
Acta Neurochir (Wien). 1995;135(3-4):136-40. doi: 10.1007/BF02187757.
In this prospective study, a series of 1812 consecutive mild head injured adult patients who visited the hospital emergency department were assessed. Twenty-eight patients (1.5%) deteriorated after head injury; 23 of these (1.3% of the series) required surgical intervention. Five patients (0.3%) deteriorated due to non-surgical causes [post-traumatic seizure 2, syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 3]. Most of the deterioration occurred within the first 24 hours (57%). Post-traumatic headache was found in 280 patients (15.5%) and 84 patients (4.6%) suffered post-traumatic vomiting. The relative risk is calculated. Age over 60, presence of drowsiness, focal motor weakness, post-traumatic headache and vomiting has increased risk of deterioration (p < 0.001). This study suggests that post-traumatic headache and vomiting deserve more clinical attention rather than being considered as post-traumatic syndrome only.
在这项前瞻性研究中，对连续就诊于医院急诊科的1812例轻度颅脑损伤成年患者进行了评估。28例患者（1.5%）在颅脑损伤后病情恶化；其中23例（占该系列的1.3%）需要手术干预。5例患者（0.3%）因非手术原因病情恶化[创伤后癫痫2例，抗利尿激素分泌不当综合征（SIADH）3例]。大多数病情恶化发生在最初24小时内（57%）。280例患者（15.5%）出现创伤后头痛，84例患者（4.6%）出现创伤后呕吐。计算了相对风险。60岁以上、嗜睡、局灶性运动无力、创伤后头痛和呕吐会增加病情恶化的风险（p<0.001）。本研究表明，创伤后头痛和呕吐值得更多临床关注，而不应仅被视为创伤后综合征。
