腦震盪後綜合症

腦震盪後綜合症(Post-concussion syndrome, PCS)為腦震盪(輕度的創傷性腦損傷, MTBI)後所產生的一系列徵狀^[1]^[2]^[3]，它可能持續幾週、幾個月或有時一年以上。PCS為創傷性腦損傷(TBI)最常發生的一種狀況^[2]，38-80%的輕度頭部創傷皆可能有此徵狀^[4]。腦震盪綜合症的判斷標準可能為當徵狀持續超過3個月^[5]，也可能在一週內^[6]或10天^[7]就被判斷為腦震盪綜合症。持續性的腦震盪綜合症(PPCS)的徵狀會持續超過6個月^[6]^[8]，或根據其他標準，3個月以上^[9]。

腦震盪綜合症會導致各式各樣的徵狀：在生理上的，如頭痛；在認知上的，如注意力不易集中；以及在情緒及行為上的，如易怒以及愛亂幻想，有嚴重幻想症。因為很多腦震盪綜合症的徵狀常見於其他疾病，或因其他疾病導致而加劇，因此有誤診的風險。雖然目前並沒有針對PCS本身的治療，但其徵狀可被治療；目前有藥物及物理/行為治療可使用，病人也可獲知其徵狀及一般的預後。

目前並不清楚什麼導致PCS的徵狀及該徵狀的持續^[10]，也不清楚為何有些人在輕度的創傷性腦損傷後會產生PCS、有些人則不會。其綜合症的性質及診斷從19世紀以來一直被激烈探討，不過，部分的風險因素已被確定;例如，已存在的身心狀況、對於殘疾的預期及年老皆會增加PPCS的可能性。病患腦部受傷前、受傷期間及復原後的身心因素皆被認為跟PCS的發展有關。^[11]

徵兆及徵狀

腦震盪綜合症的英文縮寫PCS亦可用來代表腦震盪後遺症^[11]。該後遺症可能立即出現或在受傷後幾個星期到幾個月後才出現，其徵狀會隨着時間慢慢緩解。^[12]腦震盪綜合症徵狀的性質有隨着時間改變的傾向：受傷一開始大多為生理上的徵狀，但傾向後來改變為以心理上的徵狀為主。^[13]^[14]徵兆及徵狀如對於聲音的敏感、注意力不集中及記憶的問題、易怒、沮喪、焦慮、疲勞及判斷力差可被統稱為"晚期徵狀"，因為這些徵狀大多都不會在受傷後立即發生，而是會在幾天或幾個星期後才發生。^[11]噁心及嗜睡的狀況經常於腦震盪的二到四週後發生，並可能持續很久的時間。另外，頭痛及頭暈的現象會在受傷後立即發生，並且可能持續很久。^[11]

參考文獻

[1]
存档副本. [2013-09-07]. （原始內容存檔於2014-01-02）.
[2]
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]
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]
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.

[1] [1]
存档副本. [2013-09-07]. （原始內容存檔於2014-01-02）.

[raov-2] [2]
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] [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] [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] [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.

[#1-6] [6]
Legome E. 2006. Postconcussive syndrome. eMedicine.com. Accessed January 1, 2007.

[7] [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] [8]
Evans RW (2004). "Post-traumatic headaches". Neurological Clinics 22 (1): 237–249. doi:10.1016/S0733-8619(03)00097-5. PMID 15062537.

[9] [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] [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.

[ryanlm-11] [11]
Ryan LM, Warden DL (2003). "Post concussion syndrome". International Review of Psychiatry 15 (4): 310–6. doi:10.1080/09540260310001606692. PMID 15276952.

[12] [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] [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] [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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