创伤性脑损伤和意识障碍的发生
Phoebe H Johnson-Black1, Julia M Carlson2, Paul M Vespa3
1Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
Handbook of clinical neurology
|February 22, 2025
概括
创伤性脑损伤 (TBI) 通过复杂的脑网络损伤导致意识障碍 (DOC). 恢复涉及网络重新出现,TBI患者的长期预后比非TBI病例更好.
科学领域:
- 神经科学是一个神经科学.
- 创伤研究 创伤研究
- 神经学 神经学
背景情况:
- 在全球范围内,创伤是导致意识障碍 (DOC) 的主要原因.
- 创伤性脑损伤 (TBI) 导致复杂的多焦点脑损伤,导致获得的网络障碍.
- 了解TBI诱导的DOC中的恢复机制至关重要.
研究的目的:
- 概述创伤性意识障碍 (TBI-DOC) 的诊断和预后考虑因素.
- 强调神经行为评估和TBI-DOC中的先进成像的重要性.
- 在TBI-DOC.中讨论恢复轨迹和未来的研究方向.
主要方法:
- 在急性,长期和慢性阶段进行标准化的神经行为评估.
- 使用结构和功能神经成像,曲谱和核医学研究.
- 采用电生理学技术进行DOC状态差异化和预测.
主要成果:
- 从TBI诱导的DOC中恢复的特点是动态皮层和皮下网络的重新出现.
- 对TBI-DOC的诊断评估可能比对非创伤性伤害更具挑战性.
- 与非TBI患者相比,TBI患者的康复预后更为有利,康复时间更长.
结论:
- 神经行为评估和多式神经成像对于管理TBI诱导的DOC至关重要.
- 虽然大多数改善发生在第一年内,但TBI-DOC的恢复可以延长到受伤后的5-10年.
- 药理疗法和神经调节疗法为TBI-DOC的未来研究提供了有希望的途径.
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