Characterizing and treating dizziness after mild head trauma
Characterizing and treating dizziness after mild head trauma
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DOI：
10.1097/00129492-200403000-00009
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发表时间：
2004-03-01
影响因子：
2.1
通讯作者：
Wester, D
中科院分区：
文献类型：
--
作者：
Hoffer, ME;Gottshall, KR;Wester, D
目的：本研究的目的是描述轻度头部创伤后出现头晕的模式，并检查这种疾病的诊断和治疗。研究设计：前瞻性患者登记。设置：三级转诊中心。患者：58例现役和退役军人，他们持续轻度头部创伤并因此出现头晕。干预措施：前庭评估、分组表征和治疗。主要结果测量：结果测量包括诊断类型的表征、诊断类型的患者分布和患者结果。结果：轻度头部损伤后头晕的患者被分为三个诊断组。41%的人患有创伤后前庭偏头痛，28%的人患有创伤后位置性眩晕，19%的人被归类为创伤后空间定向障碍。其余12%的患者无法进行表征。体位组有客观的体格检查结果，所有病例均经治疗清除。偏头痛组和定向障碍组患者的前庭眼反射（VOR）和前庭脊髓反射（VSR）明显异常。偏头痛组中有84%的人表现出这些测试结果的改善，而定向障碍组中只有27%。平均时间回到工作岗位是不到1周的位置组，3.8周的偏头痛组，和大于3个月的定向障碍group.Conclusions：使用我们的患者登记处的个人患有头晕后，轻度头部外伤，我们能够描述这些病例中的大多数到三个更具体的诊断组之一。我们目前的诊断标准，建议的治疗方针，我们的预后数据。
Objective: The objectives of this study were to characterize patterns of dizziness seen after mild head trauma and to examine the diagnosis and treatment of this disorder.Study Design: Prospective patient registry.Setting: Tertiary referral center.Patients: Fifty-eight cases of active duty and retired military personnel who sustained mild head trauma and had resultant dizziness.Interventions: Vestibular evaluation, characterization by group, and treatment.Main Outcome Measures: Outcome measures include characterization of diagnosis types, patient distribution by diagnosis type, and patient outcome.Results: Individuals suffering from dizziness after mild head injury were divided into three diagnostic groups. Forty-one percent of the individuals suffered from posttraumatic vestibular migraines, 28% of the individuals had posttraumatic positional vertigo, and 19% of the individuals were classified as posttraumatic spatial disorientation. The remaining 12% of the patients could not be characterized. The positional group had objective physical examination findings, which cleared with treatment in all cases. The migraine group of patients and the disorientation group of patients had distinct abnormalities of the vestibulo-ocular reflex (VOR) and the vestibulo-spinal reflex (VSR). Eighty-four percent of the migraine group demonstrated an improvement of these test results as compared with 27% of the disorientation group. Mean time to return to work was less than 1 week for the positional group, 3.8 weeks for the migraine group, and greater than 3 months for the disorientation group.Conclusions: Using our patient registry of individuals suffering from dizziness after mild head trauma, we were able to characterize the majority of these cases into one of three more specific diagnostic groups. We present diagnostic criteria, suggested treatment guidelines, and our prognostic data.