Kaufman Matthew W, Su Charles A, Trivedi Nikunj N, Lee Michelle K, Nelson Grant B, Cupp Sean A, Voos James E
Case Western Reserve University School of Medicine, Cleveland, Ohio.
Departments of Orthopaedic Surgery (C.A.S., N.N.T., G.B.N., S.A.C., and J.E.V.) and Family Medicine (S.A.C.), University Hospitals Cleveland Medical Center, Cleveland, Ohio.
JBJS Rev. 2021 Jun 8;9(6):01874474-202106000-00001. doi: e20.00108.
»: Concussion is a complex pathophysiologic process that affects the brain; it is induced by biomechanical forces, with alteration in mental status with or without loss of consciousness.
»: Concussion assessment tools may be broadly categorized into (1) screening tests such as the SAC (Standardized Assessment of Concussion), the BESS (Balance Error Scoring System), and the King-Devick (KD) test; (2) confirmatory tests including the SCAT (Sport Concussion Assessment Tool), the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing), and the VOMS (Vestibular Oculomotor Screening); and (3) objective examinations such as brain network activation (BNA) analysis, imaging studies, and physiologic markers.
»: The KD, child SCAT3 (cSCAT3), child ImPACT (cImPACT), and VOMS tests may be used to evaluate for concussion in the pediatric athlete.
»: Future work with BNA, functional magnetic resonance imaging, diffusion tensor imaging, and serum biomarkers may provide more objective assessment of concussion, neurologic injury, and subsequent recovery.
脑震荡是一种影响大脑的复杂病理生理过程；它由生物力学力诱发，可伴有或不伴有意识丧失的精神状态改变。
（1）筛查测试，如SAC（脑震荡标准化评估）、BESS（平衡误差评分系统）和King-Devick（KD）测试；（2）确认性测试，包括SCAT（运动性脑震荡评估工具）、ImPACT（脑震荡后即刻评估和认知测试）和VOMS（前庭动眼筛查）；以及（3）客观检查，如脑网络激活（BNA）分析、影像学研究和生理标志物。
KD测试、儿童SCAT3（cSCAT3）、儿童ImPACT（cImPACT）和VOMS测试可用于评估儿科运动员的脑震荡情况。
未来关于BNA、功能磁共振成像、扩散张量成像和血清生物标志物的研究可能会为脑震荡、神经损伤及后续恢复提供更客观的评估。
