Post-Traumatic Craniocervical Disorders From a Postural Control Perspective: A Narrative Review.
Post-Traumatic Craniocervical Disorders From a Postural Control Perspective: A Narrative Review.
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DOI：
10.12786/bn.2023.16.e15
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发表时间：
2023-07
期刊：
影响因子：
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通讯作者：
Cabaraux, Pierre
中科院分区：
文献类型：
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作者：
Belhassen, Serge;Mat, Quentin;Ferret, Claude;Clavel, Robert;Renaud, Bernard;Cabaraux, Pierre
轻度创伤性脑损伤 (mTBI) 和颈椎扭伤 (WI) 可能会导致长期致残后果，称为脑震荡后综合征 (PCS) 和颈椎扭伤相关疾病 (WAD)。 PCS 和 WAD 患者通常主诉头晕、眩晕、头痛、颈部疼痛、视觉不适、焦虑和神经认知功能障碍等症状。为了排除任何可治疗的急性后果，优先进行适当的医疗检查。然而，调查可能仍缺乏结论。聚集在头部和颈部结构中的眼部感觉运动系统、前庭系统和颈部本体感觉系统均涉及姿势控制，可能会因 mTBI 或 WI 而受损。它们的功能障碍与多种功能障碍相关，包括 PCS 和 WAD 患者报告的症状。此外，口颌系统需要进行专门评估，特别是与 WI 相关时。考虑 PCS 和 WAD 相关症状中这些系统的创伤后损伤的证据仍然缺乏，但似乎很有希望。此外，很少有研究从全面的角度考虑对这些广泛互连的系统的评估和/或处理。我们认为，为了带来新的治疗视角，有必要进一步研究 mTBI 和 WI 对涉及姿势控制的系统的影响。 • 脑震荡后综合征(PCS) 或颈椎扭伤相关疾病(WAD) 会影响头部和颈部姿势传感器，例如眼部感觉运动、前庭和颈部本体感觉系统。 • 在PCS 或WAD 中观察到的症状也出现在姿势传感器非创伤性损伤的情况下，表明需要仔细注意这些结构。 • 已经尝试了几种针对创伤性姿势传感器损伤的治疗干预措施，其中一些显示出有希望的结果
Mild traumatic brain injury (mTBI) and whiplash injury (WI) may lead to long-term disabling consequences known as post-concussive syndrome (PCS) and whiplash-associated disorders (WADs). PCS and WAD patients commonly complain of conditions encompassing dizziness, vertigo, headache, neck pain, visual complaints, anxiety, and neurocognitive dysfunctions. A proper medical work-up is a priority in order to rule out any acute treatable consequences. However investigations may remain poorly conclusive. Gathered in the head and neck structures, the ocular sensorimotor, the vestibular, and the cervical proprioceptive systems, all involved in postural control, may be damaged by mTBI or WI. Their dysfunctions are associated with a wide range of functional disorders including symptoms reported by PCS and WAD patients. In addition, the stomatognathic system needs to be specifically assessed particularly when associated to WI. Evidence for considering the post-traumatic impairment of these systems in PCS and WAD-related symptoms is still lacking but seems promising. Furthermore, few studies have considered the assessment and/or treatment of these widely interconnected systems from a comprehensive perspective. We argue that further research focusing on consequences of mTBI and WI on the systems involved in the postural control are necessary in order to bring new perspective of treatment. • Post-concussive syndrome (PCS) or whiplash-associated disorders (WAD) can affect head and neck postural sensors, such as the ocular sensorimotor, vestibular, and cervical proprioceptive systems. • Symptoms observed in PCS or WAD are also found in cases of non-traumatic impairment of postural sensors, indicating the need for careful attention to these structures. • Several therapeutic interventions targeting traumatic postural sensors impairment have been attempted, with some showing promising results