Feddermann-Demont Nina, Straumann Dominik, Dvořák Jiří
a Department of Neurology , University Hospital Zurich , Zurich , Switzerland.
J Sports Sci. 2014;32(13):1217-28. doi: 10.1080/02640414.2014.918273. Epub 2014 Jun 6.
A concussion is a rare but potentially serious injury of football players. Thus, an immediate and valid diagnosis, estimate of severity and therapeutic management is required. To summarise the published information on management of concussion with respect to a safe return to play (RTP), a literature search was conducted. Current guidelines on concussion in sports and significant studies on concussion in football were analysed. After concussion, management and RTP decision should remain in the area of clinical judgement on an individualised basis according to the current international guidelines. If a concussion is suspected, the player should not be allowed to RTP the same day. The RTP programme should follow a gradual step-wise procedure. A concussed player should not RTP unless he/she is asymptomatic and the neurological and neuropsychological examinations are normal. Untimely RTP bears an increased risk of sustaining another more severe brain injury and repetitive brain injury of long-term sequelae. In football, the management of concussion should primarily follow the recommendations proposed by the Concussion in Sports Group. Information and education of players and their medical and coaching team help to protect the players' health. Future studies on concussion should include validated and detailed information on RTP protocols.
脑震荡是足球运动员中一种罕见但可能严重的损伤。因此，需要进行即时且有效的诊断、严重程度评估及治疗管理。为总结已发表的关于脑震荡管理及安全重返比赛（RTP）的信息，进行了文献检索。分析了当前关于运动中脑震荡的指南以及足球运动中脑震荡的重要研究。脑震荡后，管理及RTP决策应根据当前国际指南，基于个体化的临床判断。如果怀疑有脑震荡，当天不应允许运动员重返比赛。RTP计划应遵循逐步的程序。脑震荡的运动员除非无症状且神经及神经心理学检查正常，否则不应重返比赛。过早重返比赛会增加遭受另一次更严重脑损伤及长期后遗症的重复性脑损伤的风险。在足球运动中，脑震荡的管理应主要遵循运动中脑震荡小组提出的建议。对运动员及其医疗和教练团队进行信息和教育有助于保护运动员的健康。未来关于脑震荡的研究应包括关于RTP方案的有效且详细的信息。
