Rivera Robin G, Roberson Susan P, Whelan Margaret, Rohan Annie
Robin G. Rivera is a Nurse Practitioner, Division of Pediatric-Adolescent Medicine, Cohen Children's Medical Center of the North Shore-LIJ Health System, New Hyde Park, NY. Susan P. Roberson is a Nurse Practitioner, Division of Pediatric-Adolescent Medicine, Cohen Children's Medical Center of the North Shore-LIJ Health System, New Hyde Park, NY. Margaret Whelan is a Coordinator, Family Nurse Practitioner Track, Molloy College, Division of Nursing, Rockville Centre, NY. Annie Rohan is Director of Pediatric Research, Stony Brook University, School of Nursing, Stony Brook, NY, and a Nurse Practitioner, Neonatal Intensive Care Unit, Cohen Children's Medical Center of the North Shore-LIJ Health System, New Hyde Park, NY. She can be reached via e-mail at
MCN Am J Matern Child Nurs. 2015 Mar-Apr;40(2):76-86; quiz E5-6. doi: 10.1097/NMC.0000000000000114.
Concussions are among the most complex injuries to assess and manage in sports medicine and primary care. Sports concussion in youth has received much attention in recent years because research shows that improperly managed concussion can lead to long-term cognitive deficits and mental health problems. There are several notable risk factors affecting the incidence and severity of concussion in school-age children and adolescents, including a history of a previous concussion. A more conservative approach for return to activities following concussion has been proposed for children and adolescents. Programs of individualized, stepwise increases in physical activity have largely replaced use of algorithms for assigning a grade and activity expectations to concussions. Although validity and reliability testing is ongoing to support use of concussion assessment instruments in pediatric patients, it is practical and appropriate that clinicians incorporate symptom checklists, sideline and balance assessment tools, and neurocognitive assessment instruments into their practice in accordance with evidence-based guidelines.
脑震荡是运动医学和初级保健中最难评估和处理的损伤之一。近年来，青少年运动性脑震荡备受关注，因为研究表明，脑震荡处理不当会导致长期认知缺陷和心理健康问题。有几个显著的风险因素会影响学龄儿童和青少年脑震荡的发生率和严重程度，包括既往有脑震荡史。针对儿童和青少年，已提出一种更保守的脑震荡后恢复活动的方法。个体化、逐步增加身体活动的方案已在很大程度上取代了为脑震荡评定等级和设定活动预期的算法。尽管目前正在进行效度和信度测试以支持在儿科患者中使用脑震荡评估工具，但临床医生根据循证指南将症状清单、场边和平衡评估工具以及神经认知评估工具纳入其诊疗实践既切实可行又恰当。
