A Clinical Approach to the Diagnosis of Traumatic Encephalopathy Syndrome: A Review.
A Clinical Approach to the Diagnosis of Traumatic Encephalopathy Syndrome: A Review.
复制标题
诊断创伤性脑病综合征的临床方法：评论。
DOI：
10.1001/jamaneurol.2015.5015
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发表时间：
2016-06-01
期刊：
影响因子：
29
通讯作者：
Kutcher JS
中科院分区：
文献类型：
--
作者：
Reams N;Eckner JT;Almeida AA;Aagesen AL;Giordani B;Paulson H;Lorincz MT;Kutcher JS
慢性创伤性脑病（CTE）是指在一些有头部反复创伤性撞击史（以下简称头部创伤）的个体中发现的病理变化。在活体患者的临床评价期间无法评估这些变化。本文综述了CTE的神经病理学特征、分类、发展史、生物标志物在诊断中的作用以及现有的诊断标准。以前的标准已经提出了接近活的病人，但是，一个统一的，具体的做法是需要为执业临床医生。我们提出了一个新的诊断结构的临床综合征与反复暴露于头部创伤：创伤性脑病综合征。该临床范例将为可能的、可能的和不太可能的创伤性脑病综合征的诊断提供框架，包括关于最小暴露、临床过程的性质和诊断所需的其他临床特征的讨论。虽然前瞻性纵向研究正在进行中，以进一步阐明暴露于头部创伤，临床特征和病理变化的发展之间的关联，相应的临床诊断结构是必要的。
Chronic traumatic encephalopathy (CTE) refers to pathologic changes that have been found in some individuals with a history of repetitive traumatic impact to the head (hereinafter referred to as head trauma). These changes cannot be assessed during the clinical evaluation of a living patient. The neuropathologic features, taxonomy, history, role of biomarkers in diagnosis, and existing criteria of CTE are reviewed. Previous criteria have been proposed to approach the living patient; however, a unified, specific approach is needed for the practicing clinician. We propose a new diagnostic construct for the clinical syndrome associated with repetitive exposure to head trauma: traumatic encephalopathy syndrome. This clinical paradigm will provide the framework for a diagnosis of probable, possible, and unlikely traumatic encephalopathy syndrome, with included discussion regarding the minimum exposure, nature of the clinical course, and additional clinical features needed for diagnosis. While prospective longitudinal studies are ongoing to further elucidate the association of exposure to head trauma, clinical features, and the development of pathologic changes, a corresponding clinical construct for diagnosis is necessary.