In response to the need to better define the natural history of emerging consciousness after traumatic brain injury (TBI) and to better describe the characteristics of the condition commonly labeled Post-traumatic Amnesia, a case definition and diagnostic criteria for the Post- traumatic Confusional State (PTCS) were developed. This project was completed by the Confusion Workgroup of the American Congress of Rehabilitation Medicine Brain Injury Interdisciplinary Special Interest group. The case definition was informed by an exhaustive literature review and expert opinion of workgroup members from multiple disciplines. The workgroup reviewed 2,466 abstracts and extracted evidence from 44 articles. Consensus was reached through teleconferences, face-to-face meetings, and three rounds of modified Delphi voting. The case definition provides detailed description of PTCS (1) core neurobehavioral features, (2) associated neurobehavioral features, (3) functional implications, (4) exclusion criteria, (5) lower boundary, and (6) criteria for emergence. Core neurobehavioral features include disturbances of attention, orientation, and memory as well as excessive fluctuation. Associated neurobehavioral features include emotional and behavioral disturbances, sleep-wake cycle disturbance, delusions, perceptual disturbances and confabulation. The lower boundary distinguishes PTCS from the minimally conscious state while upper boundary is marked by significant improvement in the four core and five associated features. Key research goals are establishment of cut-offs on assessment instruments and determination of levels of behavioral function that distinguish persons in PTCS from those who have emerged to the period of continued recovery.

中文翻译：

---

创伤后混乱状态：病例定义和诊断标准

为了更好地定义创伤性脑损伤 (TBI) 后出现意识的自然史并更好地描述通常标记为创伤后遗忘症的特征，创伤后意识模糊状态的病例定义和诊断标准(PTCS) 开发。该项目由美国康复医学大会脑损伤跨学科特别兴趣小组的混淆工作组完成。病例定义是通过详尽的文献综述和来自多个学科的工作组成员的专家意见得出的。工作组审查了 2,466 篇摘要并从 44 篇文章中提取了证据。通过电话会议、面对面会议和三轮修改后的德尔福投票达成共识。病例定义提供了 PTCS (1) 核心神经行为特征、(2) 相关神经行为特征、(3) 功能影响、(4) 排除标准、(5) 下限和 (6) 出现标准的详细描述。核心神经行为特征包括注意力、方向和记忆障碍以及过度波动。相关的神经行为特征包括情绪和行为障碍、睡眠-觉醒周期障碍、妄想、知觉障碍和虚构。下边界将 PTCS 与最低意识状态区分开来，而上边界的标志是四个核心和五个相关特征的显着改善。