Burke Rehabilitation Hospital, 785 Mamaroneck Avenue, White Plains, New York, 10605 NY, USA.
Nat Rev Neurol. 2013 Apr;9(4):222-30. doi: 10.1038/nrneurol.2013.33. Epub 2013 Mar 12.
Acute and chronic sports-related traumatic brain injuries (TBIs) are a substantial public health concern. Various types of acute TBI can occur in sport, but detection and management of cerebral concussion is of greatest importance as mismanagement of this syndrome can lead to persistent or chronic postconcussion syndrome (CPCS) or diffuse cerebral swelling. Chronic TBI encompasses a spectrum of disorders that are associated with long-term consequences of brain injury, including chronic traumatic encephalopathy (CTE), dementia pugilistica, post-traumatic parkinsonism, post-traumatic dementia and CPCS. CTE is the prototype of chronic TBI, but can only be definitively diagnosed at autopsy as no reliable biomarkers of this disorder are available. Whether CTE shares neuropathological features with CPCS is unknown. Evidence suggests that participation in contact-collision sports may increase the risk of neurodegenerative disorders such as Alzheimer disease, but the data are conflicting. In this Review, the spectrum of acute and chronic sport-related TBI is discussed, highlighting how examination of athletes involved in high-impact sports has advanced our understanding of pathology of brain injury and enabled improvements in detection and diagnosis of sport-related TBI.
急性和慢性与运动相关的创伤性脑损伤（TBI）是一个重大的公共卫生问题。运动中可能发生各种类型的急性 TBI，但脑震荡的检测和管理最为重要，因为这种综合征的管理不当可能导致持续性或慢性脑震荡后综合征（CPCS）或弥漫性脑肿胀。慢性 TBI 包括一系列与脑损伤长期后果相关的疾病，包括慢性创伤性脑病（CTE）、拳击痴呆、创伤后帕金森病、创伤后痴呆和 CPCS。CTE 是慢性 TBI 的典型代表，但由于没有可靠的这种疾病的生物标志物，只能在尸检中确诊。CTE 是否与 CPCS 具有相同的神经病理学特征尚不清楚。有证据表明，参与接触性碰撞运动可能会增加阿尔茨海默病等神经退行性疾病的风险，但数据存在矛盾。在这篇综述中，讨论了急性和慢性与运动相关的 TBI 谱，强调了对参与高冲击运动的运动员的检查如何提高了我们对脑损伤病理的理解，并促进了运动相关 TBI 的检测和诊断的改进。
