神経外傷
Online ISSN : 2434-3900
特別寄稿
スポーツ頭部外傷における脳神経外科医の対応
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永廣 信治谷 諭荻野 雅宏川又 達朗前田 剛野地 雅人成相 直中山 晴雄福田 修阿部 俊昭鈴木 倫保山田 和雄片山 容一
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ジャーナル フリー

2013 年 36 巻 2 号 p. 119-128

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Judo-related severe head injury in children and adolescents is a hot topic in the media and in society. Neurosurgeons are often involved in many other sports-related head injuries. The Committee of Sport Head Injury in the Japan Society of Neurotraumatology has studied to develop guideline for neuro­surgeons how to manage the athletes with sports-related concussion or an intracranial structural lesion, and how to allow them to return to play.

Sports-related concussion includes not only transient uncon­sciousness and amnesia but also various somatic (e.g. head­ache), cognitive and emotional symptoms. The most con­cussions typically resolve in a short time, although the recovery may be longer over a week in children and adolescents. The Sports Concussion Assessment Tool (SCAT) is the standard method for evaluation of concussion. Repeated con­cussions may produce rapid catastrophic deterioration (sec­ond impact syndrome) or chronic traumatic encephalo­pathy presenting with cognitive dysfunction. Second impact syn­drome may occur in association with acute subdural hematoma. In concussion patients with prolonged symptoms (e.g. headache), brain CT or MRI should be recommended to exclude an intracranial structural lesion such as thin subdural hematoma. Once concussion is diagnosed, an athlete should not be return to play in the same day. An athlete must be asymptomatic prior to return to play, and should take a graduated return to play protocol lasting around one week. Once an intracranial structural lesion (e.g. subdural hematoma) has been found after sport head injury, the athlete should not be allowed principally to return to play contact sports.

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© 2013 日本脳神経外傷学会
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