脑震荡后综合症

脑震荡后综合症(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]。脑震荡综合症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]就被判断为脑震荡综合症。持续性的脑震荡综合症(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]。

脑震荡综合症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。因为很多脑震荡综合症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。其综合症的性质及诊断从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

脑震荡综合症的英文缩写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]脑震荡综合症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]
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]. （原始内容存档于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.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]