Etiology of the post-concussion syndrome: Physiogenesis and psychogenesis revisited

摘要

In his seminal article, Physiogenesis and Psychogenesis in the ‘Post-Concussional Syndrome,’ Lishman (1988) proposednthat neurobiological factors account for the development of the post-concussion syndrome and psychological factors becomenprimarily responsible for maintaining it in the chronic phase. Over the 20 years that followed, researchers have advanced ournunderstanding of the etiology of the post-concussion syndrome. Our review of this evidence suggests that neurobiological andnpsychological factors play a causal role in post-concussion symptoms from the outset, and thus, Lishman’s causal model shouldnbe updated. If we can clinically identify individuals on a trajectory of poor recovery in the acute post-injury stage, then we canndirect secondary prevention towards modifiable risk factors.