Intracranial pressure changes after mild traumatic brain injury: a systematic review.

Intracranial pressure changes after mild traumatic brain injury: a systematic review.
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轻度创伤性脑损伤后颅内压发生变化:系统评价。

DOI:
10.1080/02699052.2018.1469045
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发表时间:
2018
期刊:
影响因子:
1.9
通讯作者:
Willer BS
Willer BS
中科院分区:
医学4区
文献类型:
--
作者:
Haider MN;Leddy JJ;Hinds AL;Aronoff N;Rein D;Poulsen D;Willer BS

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由于缺乏敏感的非侵入性方法,轻度创伤性脑损伤(mTBI)后颅内压(ICP)的研究很少。本综述的目的是总结mTBI后ICP变化的现有知识。截至2016年12月,由3名评价者独立检索了PubMed、Embase、CINAHL和Scopus。纳入标准:测量mTBI后ICP和脑水肿的动物和人体研究。排除标准:中度和重度创伤性脑损伤,重复样本,以及在撞击时测量ICP而不是之后测量ICP的研究。采用唐斯和布莱克标准评估研究质量。在1067篇论文中,纳入了9项研究。在人体研究中,1例提供了ICP升高的直接证据,1例提供了ICP升高的间接证据,2例提供了ICP降低的间接证据。在动物研究中,3项研究提供了ICP升高的直接证据,1项提供了ICP升高的间接证据,1项提供了ICP无变化的间接证据。现有的研究表明,mTBI后可能会出现ICP升高,动物研究表明,ICP升高数天后会恢复到基线水平,这与功能和症状恢复相对应。未来的人类研究需要使用敏感的间接方法来测量颅内压纵向后mTBI。
Intra-cranial pressure (ICP) after mild traumatic brain injury (mTBI) is poorly studied due to lack of sensitive non-invasive methods. The purpose of this review was to summarize the existing knowledge of changes in ICP after mTBI. PubMed, Embase, CINAHL, and Scopus were searched by 3 reviewers independently up to December 2016. Inclusion criteria: animal and human studies measuring ICP and brain oedema after an mTBI. Exclusion criteria: Moderate and severe forms of traumatic brain injury, repeat samples, and studies that measured ICP at the time of impact but not after. Study quality was assessed using Downs and Black criteria. Of 1067 papers, 9 studies were included. In human studies, 1 provided direct evidence on increased, 1 provided indirect evidence of increased, and 2 provided indirect evidence of decreased ICP. In animal studies, 3 studies provided direct evidence of increased, 1 provided indirect evidence of increased, and 1 provided indirect evidence of no change in ICP. The existing research suggests that there may be increased ICP after mTBI and animal studies suggest an elevation for days which returns to baseline, which corresponds with functional and symptomatic recovery. Future human studies using sensitive indirect methods to measure ICP longitudinally after mTBI are needed.
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