Prognostic Influence and Magnetic Resonance Imaging Findings in Paroxysmal Sympathetic Hyperactivity after Severe Traumatic Brain Injury
Prognostic Influence and Magnetic Resonance Imaging Findings in Paroxysmal Sympathetic Hyperactivity after Severe Traumatic Brain Injury
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DOI：
10.1089/neu.2010.1391
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发表时间：
2010-11-01
影响因子：
4.2
通讯作者：
Lu, Yi-Cheng
中科院分区：
文献类型：
--
作者：
Lv, Li-Quan;Hou, Li-Jun;Lu, Yi-Cheng
阵发性交感神经功能亢进（PSH）是一种影响重型脑损伤幸存者的临床综合征。在这项研究中，PSH的患病率，磁共振成像（MRI）的表现，在重症监护病房（ICU）的临床过程中的影响，以及对神经功能恢复的影响进行了前瞻性调查，在87例严重创伤性脑损伤（TBI）患者。在损伤后的前30天内进行颅脑MRI。采用格拉斯哥预后量表（GOS）评定疗效。18.4%的患者发生PSH，年轻患者和格拉斯哥昏迷量表（GCS）评分较低的患者发生率更高。PSH患者的颅脑MRI显示病变更深，ICU住院时间明显延长，结局更差。PSH在患有严重TBI且伴有深部脑实质内病变的患者中很常见。PSH影响患者预后的机制尚未确定，但我们认为可能是间脑-中脑功能障碍或断开介导的。
Paroxysmal sympathetic hyperactivity (PSH) is a clinical syndrome affecting a subgroup of survivors of severe brain injury. In this study, the prevalence, magnetic resonance imaging (MRI) presentation, influence on the clinical course in the intensive care unit (ICU), and effect on neurological recovery of PSH were prospectively surveyed in 87 patients with severe traumatic brain injury (TBI). Cranial MRI was performed during the first 30 days after injury. The outcome was assessed according to the Glasgow Outcome Scale (GOS). PSH occurred in 18.4% of patients, with a greater incidence among younger patients and those with lower Glasgow Coma Scale (GCS) scores. Patients with PSH had more deep lesions as shown on cranial MRI, significantly longer ICU stays, and worse outcomes. PSH was shown to be common among patients with severe TBI who also had deep intraparenchymal lesions. The mechanism by which PSH influences patient outcomes has yet to be defined, but we believe that it may be mediated by diencephalic-mesencephalic dysfunction or disconnection.