Outcome from mild traumatic brain injury

被引:464
作者
Iverson, GL [1 ]
机构
[1] Univ British Columbia, Riverview Hosp, Dept Psychiat, Neuropsychiat Program, Vancouver, BC V6T 2A1, Canada
关键词
concussion; memory; mild traumatic brain injury; outcome; pathophysiology;
D O I
10.1097/01.yco.0000165601.29047.ae
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Purpose of review The focus of this review is outcome from mild traumatic brain injury. Recent literature relating to pathophysiology, neuropsychological outcome, and the persistent postconcussion syndrome will be integrated into the existing literature. Recent findings The MTBI literature is enormous, complex, methodologically flawed, and controversial. There have been dozens of studies relating to pathophysiology, neuropsychological outcome, and the postconcussion syndrome during the past year. Two major reviews have been published. Some of the most interesting prospective research has been done with athletes. Summary The cognitive and neurobehavioral sequelae are self-limiting and reasonably predictable. Mild traumatic brain injuries are characterized by immediate physiological changes conceptualized as a multilayered neurometabolic cascade in which affected cells typically recover, although under certain circumstances a small number might degenerate and die. The primary pathophysiologies include ionic shifts, abnormal energy metabolism, diminished cerebral blood flow, and impaired neurotransmission. During the first week after injury the brain undergoes a dynamic restorative process. Athletes typically return to pre-injury functioning (assessed using symptom ratings or brief neuropsychological measures) within 2-14 days. Trauma patients usually take longer to return to their pre-injury functioning. In these patients recovery can be incomplete and can be complicated by preexisting psychiatric or substance abuse problems, poor general health, concurrent orthopedic injuries, or comorbid problems (e.g. chronic pain, depression, substance abuse, life stress, unemployment, and protracted litigation).
引用
收藏
页码:301 / 317
页数:17
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