スポーツ脳神経外科—脳振盪への対応

Sports-Related Concussion:Update beyond the Japanese Guidelines for the Treatment and Management of Head Trauma

Point

・脳振盪はあくまで症状から診断され，背景にある病態生理は単一ではなく，簡便な診断方法も見出されていない．

・段階的に復帰すべきことは広く認識されつつあるが，効果的な治療法やリハビリテーションも今後の課題である．

・反復受傷の結果とされる慢性外傷性脳症（CTE）の病理学的所見は解明されつつあるが，臨床診断や検査法の確立にはさらなる研究が必要である．

　All the statements regarding sports-related concussion（SRC）in our guidelines are generally simple but somewhat unfavorable. SRC is diagnosed solely by symptoms, without any definitive diagnostic measures. Various pathophysiologies are suspected to underlie SRC, making single diagnostic biomarker or neuroimaging unreliable. It is widely acknowledged that casualties of SRC should return to play gradually in a stepwise fashion; however, effective treatment and rehabilitation need to be determined. Although the pathological findings of chronic traumatic encephalopathy（CTE）, possibly the result of repetitive injuries, have been elucidated, further research is needed to establish a clinical diagnosis and testing modalities for CTE.