创伤性脑损伤(TBI)仍然是发病率和死亡率的主要原因,全球每年约有6900万人受到影响,特别是在神经外科资源有限的低收入和中等收入国家(LMICs)。TBI的神经认知后果范围从危及生命的条件到更微妙的损伤,如认知缺陷,冲动,和行为的变化,显著影响患者重返社会。低收入国家承担着全球约70%的创伤负担,TBI的原因与高收入国家(HIC)不同。低收入国家缺乏公平的神经外科护理加剧了这些挑战。改善低收入国家的TBI护理需要有针对性的资源分配,神经创伤登记处,加强教育,创伤中心内的多学科方法。来自低资源环境中成功的神经创伤计划的报告提供了对安全、当“黄金标准”协议不可行时,管理TBI的可适应策略。这篇综述讨论了LMICs中常见的TBI场景,突出关键的流行病学因素,诊断挑战,和适用于资源有限环境的手术技术。具体案例,包括硬膜外血肿,硬膜下血肿,蛛网膜下腔出血,脑脊液漏,旨在为改善LMIC的神经外科手术结果提供可行的见解。
Traumatic brain injury (TBI) remains a leading cause of morbidity and mortality, with approximately 69 million individuals affected globally each year, particularly in low- and middle-income countries (LMICs) where neurosurgical resources are limited. The neurocognitive consequences of TBI range from life-threatening conditions to more subtle impairments such as cognitive deficits, impulsivity, and behavioral changes, significantly impacting patients\' reintegration into society. LMICs bear about 70% of the global trauma burden, with causes of TBI differing from high-income countries (HICs). The lack of equitable neurosurgical care in LMICs exacerbates these challenges. Improving TBI care in LMICs requires targeted resource allocation, neurotrauma registries, increased education, and multidisciplinary approaches within trauma centers. Reports from successful neurotrauma initiatives in low-resource settings provide valuable insights into safe, adaptable strategies for managing TBI when \"gold standard\" protocols are unfeasible. This review discusses common TBI scenarios in LMICs, highlighting key epidemiological factors, diagnostic challenges, and surgical techniques applicable to resource-limited settings. Specific cases, including epidural hematoma, subdural hematoma, subarachnoid hemorrhage, and cerebrospinal fluid leaks, are explored to provide actionable insights for improving neurosurgical outcomes in LMICs.