Mild traumatic brain injury

Обзор 
Теория 
Диагноз 
Лечение 
Последующее наблюдение 
Источники 

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Последний просмотренный: 8 Feb 2026

Last updated: 03 Jul 2025

Mild traumatic brain injury (TBI) is a closed head injury due to a direct blow to the head or deceleration of the head from an impulsive force, resulting in a transient change in mental status.

The most common causes are motor vehicle accidents, sports, assaults, and falls.

Diagnosing mild TBI is difficult based on acute injury characteristics and presenting signs and symptoms.

Headache, mental slowing and fogginess, and memory difficulties are typical symptoms. Symptoms may fluctuate, but typically subside after 1 week to 1 month. Loss of consciousness is not necessary for a positive diagnosis.

Computed tomography scan and magnetic resonance imaging are typically normal in mild TBI.

For uncomplicated cases, physical and cognitive rest is usually sufficient.

Определение

TBI is a closed head injury due to a direct blow to the head or deceleration of the head from an impulsive force that results in a change in mental status.[1] The Glasgow Coma Scale (GCS) remains the main instrument for classifying the severity of TBI as mild (GCS 13–15), moderate (GCS 9–12), or severe (GCS ≤8).[2] However, the GCS is confounded by several factors, including drug and alcohol use, prescription or nonprescription drugs, and tracheal intubation.[2] Concussion and mild TBI are overlapping but distinct terms; concussion can be considered a subset of mild TBI, which comprises a range of injury types at the less severe end of the brain injury spectrum (which includes concussion with other features).[3][4] Currently there are no distinct symptom profiles, diagnostic criteria, or objective biomarkers that distinguish concussion from mild TBI.[4] Centers for Disease Control and Prevention: HEADSUP Opens in new window

Анамнез и осмотр

Ключевые диагностические факторы

direct blow to the head or deceleration of the head from an impulsive force
previous brain trauma, substance use, or alcohol misuse

Полная информация

Другие диагностические факторы

headache
feeling foggy/slow
dizziness/balance problems
memory difficulties
vomiting/nausea
neck pain
normal physical neurologic exam
abnormalities on neuropsychological testing

Полная информация

Факторы риска

head injury
previous brain trauma
alcohol and drug misuse
poor neck strength

Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

clinical diagnosis

Полная информация

Исследования, проведение которых нужно рассмотреть

CT head
MRI head

Полная информация

Неотложные исследования

PET, single-photon emission CT (SPECT) of head
multimodal MRI technologies

Полная информация

Алгоритм лечения

Острый

confirmed mild traumatic brain injury

Составители

Эксперты-консультанты

Luke C. Henry, PhD

Assistant Professor

Department of Neurological Surgery

Senior Clinical Neuropsychologist

University of Pittsburgh

Pittsburgh

Раскрытие информации

LCH declares that he has no competing interests.

Maria Twichell, MD

Assistant Clinical Professor

Director

General Rehabilitation Unit

UPMC Physical Medicine and Rehabilitation

University of Pittsburgh Medical Center

Pittsburgh

Раскрытие информации

MT declares that she has no competing interests.

Выражение благодарностей

Dr Luke C. Henry and Dr Maria Twichell would like to gratefully acknowledge Dr Jeffrey Bazarian and Dr Maryse Lassonde, previous contributors to this topic.

Раскрытие информации

JB has been reimbursed by Roche, the manufacturer of an automated assay for serum S-100B, to attend a conference, and has been reimbursed by Banyan Biomarkers and Neuren Pharmaceuticals to help develop their research protocols. JB is also an author of a reference cited in this topic. ML is an author of several references cited in this topic.

Рецензенты

Eirik Helseth, MD, PhD

Professor and Consultant

Department of Neurosurgery

Ulleval University Hospital

Oslo

Norway

Раскрытие информации

EH declares that he has no competing interests.

Margot Putukian, MD

Director of Athletic Medicine

Princeton University

Princeton

Раскрытие информации

MP is an author of a reference cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

Maas AIR, Menon DK, Manley GT, et al. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol. 2022 Nov;21(11):1004-60.Полный текст Аннотация

Harmon KG, Clugston JR, Dec K, et al. American Medical Society for Sports Medicine position statement on concussion in sport. Br J Sports Med. 2019 Feb;53(4):213-25.Полный текст Аннотация

Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on concussion in sport-Amsterdam, October 2022. Br J Sports Med. 2023 Jun;57(11):695-711.Полный текст Аннотация

American College of Emergency Physicians Clinical Policies Subcommittee (Writing Committee) on Mild Traumatic Brain Injury; Valente JH, Anderson JD, Paolo WF, et al. Clinical policy: critical issues in the management of adult patients presenting to the emergency department with mild traumatic brain injury - approved by ACEP Board of Directors, February 1, 2023, clinical policy endorsed by the Emergency Nurses Association (April 5, 2023). Ann Emerg Med. 2023 May;81(5):e63-105.Полный текст Аннотация

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия
- Moderate/severe traumatic brain injury (TBI)
- Depression
- General trauma or injury to the body not involving the head
Больше Отличия
Рекомендации
- Living guideline for pediatric concussion
- Living concussion guidelines: guideline for concussion and prolonged symptoms for adults 18 years of age or older
Больше Рекомендации
Калькуляторы
Glasgow Coma Scale
Canadian Head CT Rule for Minor Head Injury
Больше Калькуляторы
Лифлеты для пациента
Concussion (mild traumatic brain injury)
Больше Лифлеты для пациента
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Использование этого контента попадает под действие нашего заявления об отказе от ответственности

Mild traumatic brain injury

Резюме

Определение

Анамнез и осмотр

Ключевые диагностические факторы

Другие диагностические факторы

Факторы риска

Диагностические исследования

Исследования, которые показаны в первую очередь

Исследования, проведение которых нужно рассмотреть

Неотложные исследования

Алгоритм лечения

confirmed mild traumatic brain injury

Составители

Эксперты-консультанты

Luke C. Henry, PhD

Раскрытие информации

Maria Twichell, MD

Раскрытие информации

Выражение благодарностей

Раскрытие информации

Рецензенты

Eirik Helseth, MD, PhD

Раскрытие информации

Margot Putukian, MD

Раскрытие информации

Peer reviewer acknowledgements

Disclosures

Список литературы

Основные статьи

Статьи, указанные как источники

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

Отличия

Рекомендации

Калькуляторы

Лифлеты для пациента

Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Войдите в учетную запись или оформите подписку, чтобы получить полноценный доступ к BMJ Best Practice

Войдите в учетную запись, чтобы получить полноценный доступ к BMJ Best Practice