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与运动相关的头部损伤的当前主题:综述

Current topics in sports-related head injuries: a review.

作者信息

Nagahiro Shinji, Mizobuchi Yoshifumi

机构信息

Department of Neurosurgery, Institute of Health Biosciences, The University of Tokushima Graduate School.

出版信息

Neurol Med Chir (Tokyo). 2014;54(11):878-86. doi: 10.2176/nmc.ra.2014-0224. Epub 2014 Oct 31.

Abstract

We review the current topic in sports-related head injuries including acute subdural hematoma (ASDH), concussion, and chronic traumatic encephalopathy (CTE). Sports-related ASDH is a leading cause of death and severe morbidity in popular contact sports like American football in the USA and judo in Japan. It is thought that rotational acceleration is most likely to produce not only cerebral concussion but also ASDH due to the rupture of a parasagittal bridging vein, depending on the severity of the rotational acceleration injury. Repeated sports head injuries increase the risk for future concussion, cerebral swelling, ASDH or CTE. To avoid fatal consequences or CTE resulting from repeated concussions, an understanding of the criteria for a safe post-concussion return to play (RTP) is essential. Once diagnosed with a concussion, the athlete must not be allowed to RTP the same day and should not resume play before the concussion symptoms have completely resolved. If brain damage has been confirmed or a subdural hematoma is present, the athlete should not be allowed to participate in any contact sports. As much remains unknown regarding the pathogenesis and pathophysiology of sports-related concussion, ASDH, and CTE, basic and clinical studies are necessary to elucidate the crucial issues in sports-related head injuries.

摘要

我们回顾了与运动相关的头部损伤的当前主题,包括急性硬膜下血肿(ASDH)、脑震荡和慢性创伤性脑病(CTE)。与运动相关的ASDH是美国美式橄榄球和日本柔道等流行接触性运动中死亡和严重发病的主要原因。据认为,旋转加速度不仅最有可能导致脑震荡,还会因矢状窦旁桥静脉破裂而导致ASDH,这取决于旋转加速度损伤的严重程度。反复的运动头部损伤会增加未来发生脑震荡、脑肿胀、ASDH或CTE的风险。为避免因反复脑震荡导致致命后果或CTE,了解安全的脑震荡后恢复比赛(RTP)标准至关重要。一旦被诊断为脑震荡,运动员当天不得恢复比赛,在脑震荡症状完全消失之前不应恢复比赛。如果已确认有脑损伤或存在硬膜下血肿,则不应允许运动员参加任何接触性运动。由于关于与运动相关的脑震荡、ASDH和CTE的发病机制和病理生理学仍有许多未知之处,因此需要进行基础和临床研究来阐明与运动相关的头部损伤中的关键问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c9c/4533345/0c5aa8b159b8/nmc-54-878-g1.jpg

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