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脑震荡症候群

脑震荡症候群(Post-concussion syndrome, PCS)为脑震荡(轻度的创伤性脑损伤, MTBI)后所产生的一系列症状[1][2][3],它可能持续几周、几个月或有时一年以上。PCS为创伤性脑损伤(TBI)最常发生的一种状况[2],38-80%的轻度头部创伤皆可能有此症状[4]。脑震荡症候群的判断标准可能为当症状持续超过3个月[5],也可能在一周内[6]或10天[7]就被判断为脑震荡症候群。持续性的脑震荡症候群(PPCS)的症状会持续超过6个月[6][8],或根据其他标准,3个月以上[9]

脑震荡症候群会导致各式各样的症状:在生理上的,如头痛;在认知上的,如注意力不易集中;以及在情绪及行为上的,如易怒以及爱乱幻想,有严重幻想症。因为很多脑震荡症候群的症状常见于其他疾病,或因其他疾病导致而加剧,因此有误诊的风险。虽然目前并没有针对PCS本身的治疗,但其症状可被治疗;目前有药物及物理/行为治疗可使用,病人也可获知其症状及一般的预后

目前并不清楚什么导致PCS的症状及该症状的持续[10],也不清楚为何有些人在轻度的创伤性脑损伤后会产生PCS、有些人则不会。其症候群的性质及诊断从19世纪以来一直被激烈探讨,不过,部分的风险因素已被确定;例如,已存在的身心状况、对于残疾的预期及年老皆会增加PPCS的可能性。病患脑部受伤前、受伤期间及复原后的身心因素皆被认为跟PCS的发展有关。[11]

征兆及症状

脑震荡症候群的英文缩写PCS亦可用来代表脑震荡后遗症[11]。该后遗症可能立即出现或在受伤后几个星期到几个月后才出现,其症状会随着时间慢慢缓解。[12]脑震荡症候群症状的性质有随着时间改变的倾向:受伤一开始大多为生理上的症状,但倾向后来改变为以心理上的症状为主。[13][14]征兆及症状如对于声音的敏感、注意力不集中及记忆的问题、易怒、沮丧、焦虑、疲劳及判断力差可被统称为"晚期症状",因为这些症状大多都不会在受伤后立即发生,而是会在几天或几个星期后才发生。[11]恶心及嗜睡的状况经常于脑震荡的二到四周后发生,并可能持续很久的时间。另外,头痛及头晕的现象会在受伤后立即发生,并且可能持续很久。[11]

参考文献

  1. ^ 存档副本. [2013-09-07]. (原始内容存档于2014-01-02). 
  2. ^ 2.0 2.1 Rao V, Lyketsos C (2000). "Neuropsychiatric sequelae of traumatic brain injury". Psychosomatics 41 (2): 95–103. doi:10.1176/appi.psy.41.2.95. PMID 10749946.
  3. ^ Mittenberg W, Strauman S (2000). "Diagnosis of mild head injury and the postconcussion syndrome". Journal of Head Trauma Rehabilitation 15 (2): 783–791. doi:10.1097/00001199-200004000-00003. PMID 10739967.
  4. ^ Hall RC, Hall RC, Chapman MJ (2005). "Definition, diagnosis, and forensic implications of postconcussional syndrome". Psychosomatics 46 (3): 195–202. doi:10.1176/appi.psy.46.3.195. PMID 15883140.
  5. ^ McHugh T, Laforce R, Gallagher P, Quinn S, Diggle P, Buchanan L (2006). "Natural history of the long-term cognitive, affective, and physical sequelae of mild traumatic brain injury". Brain and Cognition 60 (2): 209–11. PMID 16646125.
  6. ^ 6.0 6.1 Legome E. 2006. Postconcussive syndrome. eMedicine.com. Accessed January 1, 2007.
  7. ^ Schnadower D, Vazquez H, Lee J, Dayan P, Roskind CG (2007). "Controversies in the evaluation and management of minor blunt head trauma in children". Current Opinion in Pediatrics 19 (3): 258–264. doi:10.1097/MOP.0b013e3281084e85. PMID 17505183.
  8. ^ Evans RW (2004). "Post-traumatic headaches". Neurological Clinics 22 (1): 237–249. doi:10.1016/S0733-8619(03)00097-5. PMID 15062537.
  9. ^ Bigler ED (2008). "Neuropsychology and clinical neuroscience of persistent post-concussive syndrome". Journal of the International Neuropsychological Society 14 (1): 1–22. doi:10.1017/S135561770808017X. PMID 18078527.
  10. ^ Iverson GL, Lange RT (2003). "Examination of "postconcussion-like" symptoms in a healthy sample". Applied Neuropsychology 10 (3): 137–144. doi:10.1207/S15324826AN1003_02. PMID 12890639.
  11. ^ 11.0 11.1 11.2 11.3 Ryan LM, Warden DL (2003). "Post concussion syndrome". International Review of Psychiatry 15 (4): 310–6. doi:10.1080/09540260310001606692. PMID 15276952.
  12. ^ Kushner D (1998). "Mild traumatic brain injury: Toward understanding manifestations and treatment". Archives of Internal Medicine 158 (15): 1617–24. doi:10.1001/archinte.158.15.1617. PMID 9701095.
  13. ^ Weight DG (1998). "Minor head trauma". Psychiatric Clinics of North America 21 (3): 609–624. doi:10.1016/S0193-953X(05)70026-5. PMID 9774799.
  14. ^ Anderson T, Heitger M, Macleod AD (2006). "Concussion and mild head injury". Practical Neurology 6 (6): 342–357. doi:10.1136/jnnp.2006.106583.
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脑震荡症候群
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