Smith Aynsley M, Stuart Michael J, Roberts William O, Dodick David W, Finnoff Jonathan T, Jorgensen Janelle K, Krause David A
*Department of Orthopedic Surgery and Physical Medicine and Rehabilitation, Sports Medicine Center, Mayo Clinic, Rochester, Minnesota; †Department of Orthopedic Surgery, Mayo Clinic Sports Medicine Center, Mayo Clinic, Rochester, Minnesota; ‡Department of Family Medicine and Community Health, University of Minnesota-Twin Cities, Minneapolis, Minnesota; §Department of Neurology, Mayo Clinic, Scottsdale, Arizona; ¶Department of Physical Medicine and Rehabilitation, Mayo Clinic Sports Medicine Center, Minneapolis, Minnesota; ‖Sports Medicine Center, Mayo Clinic, Rochester, Minnesota; and **Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota.
Clin J Sport Med. 2017 Sep;27(5):503-509. doi: 10.1097/JSM.0000000000000412.
This review provides an update on sport-related concussion (SRC) in ice hockey and makes a case for changes in clinical concussion evaluation. Standard practice should require that concussions be objectively diagnosed and provide quantitative measures of the concussion injury that will serve as a platform for future evidence-based treatment.
The literature was surveyed to address several concussion-related topics: research in ice hockey-related head trauma, current subjective diagnosis, promising components of an objective diagnosis, and current and potential treatments.
Sport-related head trauma has marked physiologic, pathologic, and psychological consequences for athletes. Although animal models have been used to simulate head trauma for pharmacologic testing, the current diagnosis and subsequent treatment in athletes still rely on an athlete's motivation to report or deny symptoms. Bias-free, objective diagnostic measures are needed to guide quantification of concussion severity and assessment of treatment effects. Most of the knowledge and management guidelines of concussion in ice hockey are generalizable to other contact sports.
There is a need for an objective diagnosis of SRC that will quantify severity, establish a prognosis, and provide effective evidence-based treatment. Potential methods to improve concussion diagnosis by health care providers include a standardized concussion survey, the King-Devick test, a quantified electroencephalogram, and blood analysis for brain cell-specific biomarkers.
本综述提供了冰球运动相关脑震荡（SRC）的最新情况，并提出了临床脑震荡评估变革的理由。标准做法应要求对脑震荡进行客观诊断，并提供脑震荡损伤的量化指标，这将为未来基于证据的治疗提供平台。
对文献进行了调研，以探讨几个与脑震荡相关的主题：冰球相关头部创伤的研究、当前的主观诊断、客观诊断的有前景的组成部分以及当前和潜在的治疗方法。
运动相关头部创伤对运动员有显著的生理、病理和心理影响。虽然动物模型已被用于模拟头部创伤以进行药物测试，但目前对运动员的诊断和后续治疗仍依赖于运动员报告或否认症状的意愿。需要无偏差的客观诊断措施来指导脑震荡严重程度的量化和治疗效果的评估。冰球脑震荡的大多数知识和管理指南可推广到其他接触性运动。
需要对运动相关脑震荡进行客观诊断，以量化严重程度、确定预后并提供有效的循证治疗。医疗保健提供者改善脑震荡诊断的潜在方法包括标准化脑震荡调查问卷、King-Devick测试、量化脑电图以及针对脑细胞特异性生物标志物的血液分析。
