小结
定义
病史和体格检查
关键诊断因素
- 有头部钝性创伤或加速力/减速力损伤病史
- 损伤后三十分钟或更长时间的格拉斯哥昏迷量表评分为 13-15 分，且出现一过性神经系统异常
- 危险因素
其他诊断因素
- 头痛
- 步态/平衡障碍或头晕
- 人格解体
- 疲劳
- 记忆障碍或失忆
- 呕吐/恶心
- 颈疼痛
- 神经系统体格检查正常
- 认知评估结果异常
危险因素
- 头部损伤
- 陈旧性颅脑创伤
- 酒精和药物滥用
诊断性检查
首要检查
- 临床诊断
需考虑的检查
- 头颅 CT
- 头部 MRI
- 凝血筛查
- 颅骨 x 线检查
- 酒精筛查（呼气和血液）
治疗流程
疑似创伤性脑损伤（任何严重程度）
确诊轻度创伤性脑损伤：在医院内
确诊轻度创伤性脑损伤：在社区中
撰稿人
专家顾问
Matthew Jones, MD, FRCP
Consultant Neurologist
Greater Manchester Neurosciences Centre
Salford Royal Foundation Trust
Manchester
UK
简介
MJ is an honorary senior lecturer at the University of Manchester.
利益声明
MJ is the chair of the Association of British Neurologists Education Committee (unpaid position). MJ is a faculty member of an MRCP revision course.
鸣谢
BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work is retained in parts of the content:
Luke C. Henry, PhD
Assistant Professor
Department of Neurological Surgery
Senior Clinical Neuropsychologist
University of Pittsburgh
Pittsburgh
PA
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
MT declares that she has no competing interests.
同行评议者
Alan Carson, MB ChB, MPhil, MD, FRCPsych, FRCP
Consultant Neuropsychiatrist
Honorary Professor of Neuropsychiatry
University of Edinburgh
Edinburgh
UK
利益声明
AC is treasurer to the Functional Neurological Disorders Society. He is associate editor of the Journal of Neurology, Neurosurgery and Psychiatry, and has contributed to the Scottish Intercollegiate Guidelines Network concussion guidelines. He developed a free-access, not-for-profit self-help website for patients after mild brain injury (http://www.headinjurysymptoms.org). He has received travel and accommodation expenses, but not payments, from professional organisations for speaking at their educational meetings including talks on concussion and brain injury. He gives independent testimony in court on a range of neuropsychiatric topics including brain injury. AC contributed content to a concussion application still in development.
编辑
Helena Delgado-Cohen
Section Editor, BMJ Best Practice
利益声明
HDC declares that she has no competing interests.
Anna Ellis
Head of Editorial, BMJ Best Practice
利益声明
AE declares that she has no competing interests.
Rachel Wheeler
Lead Section Editor, BMJ Best Practice
利益声明
RW declares that she has no competing interests.
Julie Costello
Comorbidities Editor, BMJ Best Practice
利益声明
JC declares that she has no competing interests.
Adam Mitchell
Drug Editor, BMJ Best Practice
利益声明
AM declares that he has no competing interests.
鉴别诊断
- 中度/重度创伤性脑损伤
- 抑郁
- 未累及头部的身体一般性外伤或损伤
更多 鉴别诊断指南
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格拉斯哥昏迷量表
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阿尔茨海默病和其他痴呆症
焦虑：是什么？
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