J Orthop Sports Phys Ther. 2019 Nov;49(11):787-798. doi: 10.2519/jospt.2019.8855. Epub 2019 Oct 9.
Concussion is an ongoing concern for health care providers. The incidence rates continue to be high and the rate of recovery is variable due to potential risk factors. With no valid biomarkers, diagnosis and assessment of concussion remain a clinical challenge. The heterogeneity in presentation following injury provides an additional level of complexity, requiring the screening and evaluation of diverse body systems, including oculomotor, vestibular, autonomic, psychiatric, cervical, and cognitive symptoms. While a few tools, such as the Vestibular/Ocular Motor Screening and Balance Error Scoring System, have been developed specifically for concussion, the vast majority of tests are adapted from other conditions. Further complicating the process is the overlapping and interactive nature of the multiple domains of postconcussion presentation. This commentary illustrates how clinicians can conceptualize the multiple profiles that present following concussion and describes tools that are available to assist with screening and evaluation of each area. The multifaceted nature of concussion warrants broad clinical screening skills and an interdisciplinary approach to management. .
脑震荡一直是医疗保健提供者关注的问题。由于潜在的风险因素，其发病率仍然很高，且恢复速度也各不相同。由于没有有效的生物标志物，脑震荡的诊断和评估仍然是一个临床挑战。受伤后表现的异质性增加了复杂性，需要对包括眼球运动、前庭、自主神经、精神、颈椎和认知症状在内的多种身体系统进行筛查和评估。虽然已经开发了一些专门用于脑震荡的工具，如前庭/眼动筛查和平衡错误评分系统，但绝大多数测试都是从其他疾病改编而来的。进一步使这一过程复杂化的是，脑震荡后多个表现领域的重叠和相互作用性质。本评论说明了临床医生如何理解脑震荡后出现的多种表现，并描述了可用于筛查和评估每个领域的工具。脑震荡的多方面性质需要广泛的临床筛查技能和跨学科的管理方法。
