Three types of nerve injury.
Three types of nerve injury.
复制标题
DOI：
10.1093/brain/66.4.237
复制
发表时间：
1943-01-01
期刊：
影响因子：
14.5
通讯作者：
Seddon, HJ
中科院分区：
文献类型：
--
作者：
Seddon, HJ
作者接受Henry Cohen对周围神经病变的分类：神经紊乱、轴索紊乱和神经失用症。在神经性损伤中，虽然通常神经纤维完全断裂，瘢痕组织生长在间隙中，但也有一些病例似乎保留了解剖学上的连续性。然而，没有完全的自然恢复是预期的。在轴索病中，神经纤维本身严重受损，但神经鞘和神经内膜鞘保存完好，可以引导出长的纤维到达正确的目的地，并期望完全自发恢复。神经失用症没有周围神经纤维变性。这种情况以前被归类为“暂时性阻塞”。讨论了功能恢复的预后（时间因素、完整性），并将其与解剖变化联系起来。作者强调的情况下，一部分神经可能已经经历了神经失调和另一部分轴索失调，这种情况使得预后非常困难。这三种类型的病变可以通过其临床方面来区分，而无需或术前探查。轴索痛的临床表现有时与单纯的功能性（心理）疾病非常相似。
The author accepts Henry Cohen''s classification of lesions of peripheral nerves into: neurot-mesis, axonotmesis and neurapraxia. In neurotmesis while there is, as a rule, a complete severance of the nerve fiber with scar tissue growing into the gap, yet there are some cases in which anatomical continuity is seemingly preserved. However, no complete spontaneous recovery is to be expected. In axonotmesis, the nerve fibers proper are gravely damaged, but neurilemma and endoneural sheaths are well preserved, to guide the out-growing fibers to their proper destination and a complete spontaneous recovery may be expected. In neurapraxia there is no peripheral degeneration of nerve fibers. Such cases were formerly grouped as "transient block." The prognosis of functional restoration (time factor, completeness) is discussed and correlated to the anatomical changes. The author stresses the cases where a part of the nerve may have undergone neurotmesis and another part axonotmesis, a condition which renders a prognosis very difficult. The 3 types of lesions may be distinguished by their clinical aspects without or before surgical exploration. The clinical picture of axonotmesis may be at times very similar to mere functional (psychogenic) disorders.