预测和改善严重小儿脑外伤的预后。

IF 3.4 2区 医学 Q2 CLINICAL NEUROLOGY Expert Review of Neurotherapeutics Pub Date : 2024-10-01 Epub Date: 2024-08-14 DOI:10.1080/14737175.2024.2389921
Mathilde Chevignard, Hugo Câmara-Costa, Georges Dellatolas
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引用次数: 0

摘要

导言:严重的小儿创伤性脑损伤(spTBI),包括幼儿的虐待性头部创伤(AHT),是一个重大的公共卫生问题。严重创伤性脑损伤的长期后果包括各种身体、神经、生物、认知、行为和社会功能障碍:本叙事性综述概述了 2019 年 1 月至 2024 年 2 月期间发表的有关 spTBI 的研究和综述。2019年之前发表的重要文献也包括在内。文章涵盖了脊髓创伤性脑损伤的原因、流行病学和死亡率;差异、不平等和社会经济因素;重症监护;结果和干预措施:专家观点:在创伤性脑损伤的病因、治疗和结果方面,不同国家之间以及社会经济因素之间存在差异。创伤性脑损伤的总体预后较差。重症监护指南的遵守情况并不完善,指南的证据基础需要进一步调查。神经影像学和生物标志物对预后的预测是一个快速发展的领域。长期的认知、行为和社会心理障碍是最常见的致残因素。他们的调查应明确区分客观测量(临床检查、认知测试、事实)和主观测量(使用患者和委托人报告的问卷进行估计),同时考虑到报告的困难可能存在共同来源偏差。建议采取以家庭/护理者为中心的干预措施、生态学方法以及在提供干预措施时使用技术,以改善创伤后应激障碍后的长期困难。
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Predicting and improving outcome in severe pediatric traumatic brain injury.

Introduction: Severe pediatric traumatic brain injury (spTBI), including abusive head trauma (AHT) in young children, is a major public health problem. Long-term consequences of spTBI include a large variety of physical, neurological, biological, cognitive, behavioral and social deficits and impairments.

Areas covered: The present narrative review summarizes studies and reviews published from January 2019 to February 2024 on spTBI. Significant papers published before 2019 were also included. The article gives coverage to the causes of spTBI, its epidemiology and fatality rates; disparities, inequalities, and socioeconomic factors; critical care; outcomes; and interventions.

Expert opinion: There are disparities between countries and according to socio-economic factors regarding causes, treatments and outcomes of spTBI. AHT has an overall poor outcome. Adherence to critical care guidelines is imperfect and the evidence-base of guidelines needs further investigations. Neuroimaging and biomarker predictors of outcomes is a rapidly evolving domain. Long-term cognitive, behavioral and psychosocial difficulties are the most prevalent and disabling. Their investigation should make a clear distinction between objective (clinical examination, cognitive tests, facts) and subjective measures (estimations using patient- and proxy-reported questionnaires), considering possible common source bias in reported difficulties. Family/caregiver-focused interventions, ecological approaches, and use of technology in delivery of interventions are recommended to improve long-term difficulties after spTBI.

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来源期刊
Expert Review of Neurotherapeutics
Expert Review of Neurotherapeutics Medicine-Neurology (clinical)
CiteScore
7.00
自引率
2.30%
发文量
61
审稿时长
4-8 weeks
期刊介绍: Expert Review of Neurotherapeutics (ISSN 1473-7175) provides expert reviews on the use of drugs and medicines in clinical neurology and neuropsychiatry. Coverage includes disease management, new medicines and drugs in neurology, therapeutic indications, diagnostics, medical treatment guidelines and neurological diseases such as stroke, epilepsy, Alzheimer''s and Parkinson''s. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points
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