Macciocchi S N, Barth J T, Littlefield L M
Department of Physical Medicine, University of Virginia Medical School, Charlottesville, USA.
Clin Sports Med. 1998 Jan;17(1):27-36. doi: 10.1016/s0278-5919(05)70058-2.
Although concern about mild sports head injury has significantly increased in the past decade, few well-controlled studies exist. As such, we are not able to definitively specify the effect of injury biomechanics, severity, frequency, and complications on outcome. Until more definitive research is completed, management of mild head injury will have to be based on clinical judgment rather than empiric fact. Despite present empiric limitations, several tentative conclusions appear appropriate. First, head injury is a relatively frequent occurrence in sports. Second, the overwhelming majority of single, grade 1 injuries have few persisting symptoms, and morbidity in the short-term appears low. Third, multiple injuries (> 3), especially grade 2 or grade 3, may have long-term irreversible consequences. Fourth, as best as we can tell, athletes with apparently equivalent injuries by clinical standards may have different outcomes. Finally, outcome in mild sports head injury must receive increased research attention, and some symmetry and coordination of efforts should be encouraged.
尽管在过去十年中,人们对轻度运动性头部损伤的关注显著增加,但相关的严格对照研究却很少。因此,我们无法确切说明损伤的生物力学、严重程度、发生频率和并发症对预后的影响。在完成更确切的研究之前,轻度头部损伤的处理将不得不基于临床判断而非实证依据。尽管目前存在实证方面的局限性,但仍可得出一些初步结论。首先,头部损伤在体育运动中较为常见。其次,绝大多数单次的1级损伤几乎没有持续症状,短期发病率似乎较低。第三,多次损伤(>3次),尤其是2级或3级损伤,可能会产生长期不可逆的后果。第四,就目前所知,按照临床标准看似损伤程度相当的运动员,其预后可能不同。最后,轻度运动性头部损伤的预后必须得到更多的研究关注,并且应鼓励在研究工作上保持一定的对称性和协调性。