- Types of concussion of the brain
- Causes of concussion of the brain
- Symptoms of concussion of the brain
- Diagnosis of concussion of the brain
- Treatment of concussion of the brain
- Consequences and Forecast
Concussion of the brain is the easiest manifestation of craniocerebral trauma, which accounts for 30-40% of the total traumatological pathology. Especially often injuries of this kind are found in children who are highly mobile. It is important to remember that the presence of even minimal symptoms of concussion of the brain is the reason for seeking medical help. This will allow you to get rid of the manifestations of the disease much quicker and avoid the development of dangerous consequences.
Types of concussion of the brain
The place of brain concussion in the classification of craniocerebral trauma is as follows:
- TBI of mild degree - concussion of the brain;
- CWT of medium degree - a bruise of the brain;
- severe TBI - bruises of the brain, fractures of the base of the skull, intracerebral hematomas.
Causes of concussion of the brain
To the concussion of the brain can cause the following reasons:
- blow a heavy object over the head;
- sharp movements of the head, for example, when tipping it back in case of sudden braking of the car;
- falling from the height of his own body, for example, with fainting, epileptic seizure;
- head injuries in the home and in the workplace;
- jumping from height to foot;
- fall on the buttocks;
- "A syndrome of a shaken child" with rough handling, intensive motion sickness of an infant.
In order to understand the causes of concussion, it is necessary to recall the anatomy of the central nervous system and the skull. The spinal cord and hemispheres of the brain freely lie in the cavity of the skull and the spinal canal of the spine. With sudden movements or the application of force, it is possible for them to drastically shift in the opposite direction. In this case, damage to the brain tissue is observed according to the principle of a shock. Such a mechanical effect can be exposed directly to the substance of the brain, as well as blood vessels, intracerebral fluid.
The intensity of the effect on the central nervous system determines the degree of severity of the disturbances that arise. So, with concussion of the brain, only molecular changes in the brain substance, nervous synapses, vascular wall are revealed. In the case when a brain substance is destroyed during a trauma, it is said about a contusion or a concussion of the brain. With accumulation in the brain substance or under the cerebral membranes of the blood, intracranial hematoma develops.
Symptoms of concussion of the brain
The severity of clinical symptoms of concussion depends on the severity of the disease. For a light concussion, the following symptoms are characteristic:
- short-term loss of consciousness;
- the sensation of the appearance of "sparks from the eyes";
- blurred vision;
- flashing "flies" in front of the eyes;
- slight malaise;
- sleep disturbance;
- noise in ears;
- minor nausea.
With a shaking of moderate severity, these symptoms may appear:
- loss of consciousness after trauma;
- nausea and vomiting;
- violation of gait;
- Increased or slowed heart rate;
- increased blood pressure;
- the appearance of subcutaneous hematomas;
- a headache provoked by bright light, loud sounds;
- anterograde and retrograde amnesia.
In case of severe concussion, the patient's condition worsens. Vomiting becomes multiple and does not bring relief. Possible the appearance of hallucinations and delusions, paresis and paralysis, convulsive seizures. Dehydration of the body with disruption of the internal organs is developing. This condition requires immediate hospitalization in the intensive care unit and resuscitation.
Features of the clinical picture of concussion of the brain are determined by age factors:
- In infants - a concussion, as a rule, is not accompanied by loss of consciousness. Immediately after the trauma, paleness of the skin, drowsiness, lethargy, palpitations occur. Later, when feeding, frequent vomiting and regurgitation occur. Possible disturbance of sleep, expressed anxiety of the baby. Most often, with a favorable course, pathological manifestations come to naught within 2-3 days.
- Children of preschool age - concussion is also not accompanied by loss of consciousness. Perhaps mild indisposition, drowsiness or increased excitability, mild nausea. Sometimes there is a slight increase in body temperature. Occasionally, children have a symptom such as post-traumatic blindness. As a rule, it occurs either immediately after the injury, or after a few minutes. The visual impairment persists for several hours or tens of minutes, and then disappears on its own. Within 2-3 days the child's condition improves.
- in the elderly - in the first time after the trauma there is disorientation in time and space, memory disorders, dizziness. For people of age, headaches are localized in the occipital region and are pulsating in nature. Particularly severe headache occurs in elderly people suffering from hypertension. As a rule, during 3-7 days symptoms of concussion pass.
Diagnosis of concussion of the brain
In case of symptoms of concussion of the brain, you should immediately consult a doctor. When the patient is in a serious condition, it is better to call an ambulance team, which will provide transportation to the hospital. In case of concussion, a consultation with a traumatologist, neurologist, neurosurgeon, and therapist may be required. It is important to remember the so-called period of imaginary well-being, characterized by a temporary subsidence of trauma symptoms in a few hours or days. In this "bright" period, the patient's condition may worsen without apparent clinical symptoms, for example, in the formation of intracranial hematoma. That's why after getting any head injury you need to consult a specialist.
Diagnosis of brain concussion begins with a careful collection of complaints, anamnesis of the disease, a general and neurological examination. For additional examination of the patient the following instrumental techniques are used:
- Radiography is a simple study performed for most patients with CCT. The main purpose of radiography is to identify fractures of the skull bones. It is impossible to assess the state of the brain substance by X-ray, but identifying any fractures makes it possible to assign a moderate or severe status to the concussion, even with a favorable clinical picture.
- Neurosonography is an ultrasound study of the brain, which makes it possible to assess the state of the brain substance, the ventricles of the brain. With the help of neurosonography, it is possible to identify foci of bruises, signs of cerebral edema, development of intracranial hematomas. Ultrasound has no contraindications, is a painless and non-invasive method of investigation. Neurosonography allows you to visualize the structures of the brain through the unclosed large fontanel, thin temporal bones, eye socket, external auditory canal. In older people, the skull bones become thick, which makes it difficult to obtain reliable data.
- Echoencephalography is a method of ultrasound diagnosis, with which it is possible to determine the displacement of brain structures relative to the midline. Based on the data obtained, it can be concluded that there are such volumetric formations in the brain as hematomas or tumors. In addition, it is possible to obtain indirect information about the state of the ventricular system and the brain substance.
- CT is one of the most informative methods for diagnosing diseases and injuries of the central nervous system. The use of X-rays allows you to get a clear layered image of the brain and bones of the skull. CT provides opportunities for diagnosis of bruises, bruises, foreign bodies and damage to the bones of the arch and the base of the skull.
- MRI - refers to the most accurate and informative methods of studying the central nervous system. With its help, it is impossible to detect damage to the bones of the skull, which greatly limits the use of MRI in the diagnosis of craniocereberal trauma. When examining small children, anesthesia may be required.
- Electroencephalography - this study is aimed at studying the bioelectric activity of the brain. EEG makes it possible to determine the foci of the brain substance with a violation of the activity of neurons. The presence of such areas of epiaktivnosti can lead to the appearance of epileptic seizures.
- Lumbar puncture - this invasive study is aimed at obtaining cerebrospinal fluid from the spinal canal. The presence of blood can indicate a serious damage to the brain tissue. Lumbar puncture is performed according to strict indications, for example, if there is a suspicion of severe bleeding, an inflammatory or a tumor process.
Treatment of concussion of the brain
The tactics of treating concussion of the brain are determined by the degree of severity of the patient's condition. Treatment should be conducted in a hospital under the supervision of qualified specialists. Hospitalization allows you to monitor the patient's condition, the progression of clinical symptoms of the disease and conduct a full examination. In addition, staying in a hospital ensures the creation of psycho-emotional dormancy, which is a necessary condition for recovery.
- First aid - before arrival of physicians it is necessary to give the victim a horizontal position with an elevated head end. In the event that the patient does not regain consciousness, it is better to lay it on the right side with a slightly upturned and turned to the ground head. It is this position that ensures free breathing and prevents the ingress of vomit, saliva and mucus into the respiratory tract.
- Mode - patients who have suffered a brain concussion, it is necessary to comply with bed rest for 3-5 days. In addition, the patient should be gentle, with the exception of watching TV, listening to music, reading. The motor regimen expands in 2-5 days, after which the patient is discharged for outpatient treatment.
- Drug therapy - drug therapy with a concussion of the brain has several purposes. First of all, this is a reduction in intracerebral pressure with diuretics and potassium preparations. In addition, sedatives are used to relieve psychoemotional stress. In the case of severe headaches, mild analgesics may be indicated. The appointment of nootropic drugs is aimed at improving the processes of metabolism and nutrition of brain cells. In the case of severe nausea and vomiting, dehydration therapy is performed. Control of the effectiveness of treatment is carried out through repeated neurological examinations, instrumental research.
Consequences and Forecast
In case of adequate treatment and patient's compliance with the recommendations of doctors after concussion of the brain, in most cases, complete recovery and recovery of working capacity. However, in some patients there may be a decrease in memory, attention. There may be occasional dizziness, anxiety, irritability, headache, fatigue, insomnia. For some time, there may be increased sensitivity to bright light and loud sounds. However, in most cases, after 6-12 months, the effects of concussion gradually weaken.
About 3% of people have more severe consequences of concussion, most often due to non-compliance with the recommended regime. These patients can develop insomnia, vegetative-vascular dystonia, asthenic syndrome, epileptic seizures. Perhaps the emergence of the so-called postcommunism syndrome, characterized by the appearance of attacks of headaches, irritability, anxiety, insomnia. Such people have difficulty concentrating, which significantly reduces their ability to work.
Timely quality treatment will help to minimize the consequences of brain concussion.