In fact, many diagnoses are very irregular. For example, some patients who are admitted to the hospital one day after traumatic brain injury do not see any obvious abnormality in the cranial CT, and many doctors make the diagnosis of post-traumatic brain injury syndrome at the time of admission, which is actually wrong. The following is a summary of post-traumatic brain injury syndrome, which can be used to standardize the diagnosis and treatment.
Standardized diagnostic criteria for post-traumatic brain injury syndrome.
Traumatic brain injury syndrome can be diagnosed with the following 3 conditions: Yunyun Liu, Department of Neurology, The Sixth Hospital of Sun Yat-sen University
More than 3 months after craniocerebral trauma, there are still symptoms of headache, dizziness, fatigue, vertigo, memory loss, inattention, palpitations, insomnia, excessive dreaming, excessive sweating, emotional instability and other symptoms of brain function, plant nerve dysfunction and psychological disorders.
No positive neurological signs were found.
There was no abnormality in cranial CT and cerebrospinal fluid examination.
From the above diagnostic criteria, we can see why it is wrong for many doctors to make the diagnosis of traumatic brain injury syndrome on the basis of normal CT on admission.
Etiology and pathogenesis of post-traumatic brain injury syndrome.
The etiology is closely related to traumatic brain injury in time. The pathogenesis is not fully understood, and there is no definite conclusion whether it is an organic or functional lesion. However, there is evidence that the disease has a histomorphological basis, with punctate hemorrhage and edema in the brain tissue, followed by small foci of softening and degenerative lesions; abnormal changes in nerve cells are seen microscopically, such as axonal degeneration and myelin degeneration and necrosis neuroradiological examination with mild widening of the cerebral sulcus and dilatation of the ventricles; however, some patients are also associated with social and self-psychological factors.
Ancillary tests for traumatic brain injury syndrome.
1. blood biochemical examination, with attention to exclude post-traumatic brain injury brain salt depletion syndrome.
2. Cerebrospinal fluid examination.
3. Neurophysiological examination: electroencephalography. Brainstem auditory evoked potentials.
EEG may show normal or abnormal. Some studies have shown that EEG abnormalities in patients with traumatic brain injury syndrome are caused by organic causes of brain function damage, and the EEG positivity rate is 81.8% during the treatment period, with mild abnormalities mainly in theta waves and moderate abnormalities in theta and delta waves, suggesting that the cortical function of the patient is disturbed, reflecting the clinical situation of cortical function in accordance with the degree of clinical diagnosis of damage.
Brainstem auditory evoked potentials may be normal or abnormal. The presence of damage to the high brainstem in the central segment of the auditory conduction pathway may be related to the different degrees of intracranial displacement of brain tissue during traumatic brain injury, causing brainstem and interstitial brainstem damage.
It is possible that the brain tissue was displaced to different degrees within the skull during traumatic brain injury, causing damage to the brainstem and mesencephalon and forcing vegetative dysfunction. Some scholars suggest that it may be related to abnormal neurotransmitter function, while others suggest that it is related to reduced cerebral blood flow.
4. Cephalometric imaging: cranial CT, cranial MRI examination.
5. Neuropsychological examination.
Treatment of post-traumatic brain injury syndrome.
1. psychotherapy
2. Drug therapy.
Sedative drugs
Anti-anxiety and depression drugs
Drugs for regulating vegetative nerves
Calcium antagonists
Other symptomatic support drugs
3. Other treatment