Mild traumatic brain injury
小结
定义
病史和体格检查
关键诊断因素
- direct blow to the head or deceleration of the head from an impulsive force
- previous brain trauma, substance use, or alcohol misuse
其他诊断因素
- headache
- feeling foggy/slow
- dizziness/balance problems
- memory difficulties
- vomiting/nausea
- neck pain
- normal physical neurologic exam
- abnormalities on neuropsychological testing
危险因素
- head injury
- previous brain trauma
- alcohol and drug misuse
- poor neck strength
诊断性检查
首要检查
- clinical diagnosis
需考虑的检查
- CT head
- MRI head
新兴检查
- PET, single-photon emission CT (SPECT) of head
- multimodal MRI technologies
治疗流程
confirmed mild traumatic brain injury
撰稿人
专家顾问
Luke C. Henry, PhD
Assistant Professor
Department of Neurological Surgery
Senior Clinical Neuropsychologist
University of Pittsburgh
Pittsburgh
PA
利益声明
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
PA
利益声明
MT declares that she has no competing interests.
鸣谢
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.
利益声明
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.
同行评议者
Eirik Helseth, MD, PhD
Professor and Consultant
Department of Neurosurgery
Ulleval University Hospital
Oslo
Norway
利益声明
EH declares that he has no competing interests.
Margot Putukian, MD
Director of Athletic Medicine
Princeton University
Princeton
NJ
利益声明
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.
参考文献
关键文献
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.全文 摘要
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.全文 摘要
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.全文 摘要
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.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Moderate/severe traumatic brain injury (TBI)
- Depression
- General trauma or injury to the body not involving the head
更多 鉴别诊断指南
- Living guideline for pediatric concussion
- Living concussion guidelines: guideline for concussion and prolonged symptoms for adults 18 years of age or older
更多 指南医学计算器
Glasgow Coma Scale
Canadian Head CT Rule for Minor Head Injury
更多 医学计算器患者教育信息
Concussion (mild traumatic brain injury)
更多 患者教育信息
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明