Makdissi Michael, Davis Gavin, McCrory Paul
BSc (Hons), MBBS, PhD, FACSP, Research Fellow, Florey Institute of Neuroscience and Mental Health, Austin Campus, Melbourne Brain Centre, Heidelberg, Australasian College of Sports Physicians, Olympic Park Sports Medicine Centre, Melbourne, Victoria.
Aust Fam Physician. 2014 Mar;43(3):94-9.
Concussion is common in many sports and recreational activities. It is thought to reflect a functional rather than structural injury to the brain. The clinical features are typically short-lived and usually resolve spontaneously. Complications, however, can occur and may include prolonged symptoms and/or cognitive deficits in the short term, as well as depression and cumulative deterioration in brain function in the longer term.
This article will provide an updated clinical review of concussion in sport, with an emphasis on assessment and management in general practice.
The critical issues in the clinical management of concussion in sport include making a diagnosis, differentiating between concussion and other pathologies (particularly structural head injury), recognising the presence of any modifying factors (which may increase the risk of complications) and determining when the patient can safely return to competition. The key components of safe return-to-play decisions include rest, neuropsychological testing and a graded program of exertion before return to sport.
脑震荡在许多体育和娱乐活动中很常见。人们认为它反映的是大脑的功能性损伤而非结构性损伤。其临床症状通常持续时间较短，且通常会自行缓解。然而，并发症可能会出现，短期可能包括症状延长和/或认知缺陷，长期还可能包括抑郁和脑功能的累积衰退。
本文将对运动性脑震荡进行最新的临床综述，重点关注全科医疗中的评估和管理。
运动性脑震荡临床管理中的关键问题包括做出诊断、区分脑震荡与其他病症（尤其是结构性头部损伤）、识别任何可能增加并发症风险的调节因素，以及确定患者何时能够安全重返比赛。安全重返比赛决策的关键要素包括休息、神经心理学测试以及在重返运动前进行分级运动计划。
