Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.
J Binocul Vis Ocul Motil. 2020 Oct-Dec;70(4):128-133. doi: 10.1080/2576117X.2020.1826289.
Concussion is a worldwide health concern among children and adolescents. Over the decades concussion has been gradually better recognized as an entity that accounts for a significant disability post head trauma in patients. Patients present with cognitive, somatic and oculo-vestibular symptoms that can be incapacitating. Most concussion symptoms are transient and resolve within 1-2 weeks but can persist for years. Concussion pathophysiology is complex and may not be fully understood but it involves numerous mechanisms including cellular metabolic derangements, cerebral blood inflow, and axonal disruption. With no associated objective biomarkers or visible pathologic brain changes, diagnosis of concussion can be challenging. Many organizations and collaborative groups have suggested numerous definitions and diagnostic criteria for concussion in an attempt to improve the evidence-based clinical assessments and therapies for concussion. Proper assessment and evaluation is crucial starting from counseling of the patient, gradual return to cognitive and physical activity in an individualized treatment plan to ensure a timely return to daily activities and full sport participation. This report provides a grasp over the current state of sport-related concussion knowledge, diagnosis, and clinical evaluation in children and adolescent, with a focus on the ocular symptoms and signs.
脑震荡是儿童和青少年的一个全球性健康问题。几十年来，脑震荡逐渐被更好地认识为一种实体，在头部创伤后，患者会出现显著的残疾。患者表现出认知、躯体和眼-前庭症状，可能导致残疾。大多数脑震荡症状是短暂的，在 1-2 周内会消失，但也可能持续数年。脑震荡的病理生理学很复杂，可能还不完全清楚，但它涉及许多机制，包括细胞代谢紊乱、脑血流和轴突中断。由于没有相关的客观生物标志物或可见的病理性脑改变，脑震荡的诊断具有挑战性。许多组织和合作团体已经提出了许多脑震荡的定义和诊断标准，试图改善基于证据的脑震荡临床评估和治疗。适当的评估和评估从对患者的咨询开始至关重要，然后逐渐恢复认知和身体活动，制定个体化的治疗计划，以确保及时恢复日常活动和全面参与体育运动。本报告概述了儿童和青少年运动相关性脑震荡的知识、诊断和临床评估现状，重点介绍了眼症状和体征。
