Kontos Anthony P, Sufrinko Alicia, Sandel Natalie, Emami Kouros, Collins Michael W
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA.
UPMC Sports Medicine Concussion Program, Pittsburgh, PA.
Curr Sports Med Rep. 2019 Mar;18(3):82-92. doi: 10.1249/JSR.0000000000000573.
Sport-related concussion (SRC) is a heterogeneous injury that involves varied symptoms and impairment that presents a significant clinical challenge to sports medicine professionals. In response to this challenge, clinical researchers have proposed clinical profiles or subtype models for assessing and treating athletes with SRC. One such model emphasizes five concussion clinical profiles including cognitive/fatigue, vestibular, ocular, migraine, and anxiety/mood. Sleep is a common modifier that co-occurs across these clinical profiles. A combination of medical history, risk factors, injury information, clinical characteristics, and assessment outcomes can inform each clinical profile. Preliminary data involving 236 patients from a concussion specialty clinic indicate that the migraine (26%) and anxiety/mood (24%) profiles are the most common, with vestibular and ocular profiles combined representing more than one third (35%) of clinical profiles. Findings also support several relationships among different clinical profiles including vestibular and migraine, suggesting that many athletes present with multiple clinical profiles. Targeted, active treatments for each profile are discussed.
运动相关脑震荡（SRC）是一种异质性损伤，涉及多种症状和功能障碍，给运动医学专业人员带来了重大的临床挑战。为应对这一挑战，临床研究人员提出了用于评估和治疗SRC运动员的临床概况或亚型模型。其中一种模型强调了五种脑震荡临床概况，包括认知/疲劳、前庭、眼部、偏头痛和焦虑/情绪。睡眠是这些临床概况中共同出现的常见调节因素。病史、风险因素、损伤信息、临床特征和评估结果的综合可以为每种临床概况提供参考。来自一家脑震荡专科诊所的236名患者的初步数据表明，偏头痛（26%）和焦虑/情绪（24%）概况最为常见，前庭和眼部概况加起来占临床概况的三分之一以上（35%）。研究结果还支持了不同临床概况之间的几种关系，包括前庭和偏头痛，这表明许多运动员存在多种临床概况。文中还讨论了针对每种概况的针对性、积极治疗方法。
