- Types of brain concussion
- Causes of brain concussion
- Symptoms of brain concussion
- Diagnosis of brain concussion
- Treatment of brain concussion
- Consequences and prognosis
Concussion of the brain is the easiest manifestation of traumatic brain injury, which accounts for 30-40% of the total trauma. Especially often injuries of this kind are found in children with high mobility. It is important to remember that the presence of even minimal symptoms of concussion is a pretext for seeking medical help. This will allow much faster to get rid of the manifestations of the disease and avoid the development of dangerous consequences.
Types of brain concussion
The place of brain concussion in the classification of traumatic brain injury is as follows:
- Mild TBI - concussion;
- Chmt of moderate degree - brain contusion;
- severe TBI - brain contusions, skull base fractures, intracerebral hematomas.
Causes of brain concussion
The following reasons may lead to concussion of the brain:
- hit a heavy object on the head;
- sharp head movements, for example, when it is tilted back in the event of a sudden braking of the car;
- a fall from a height of one's own body, for example, when fainting, an epileptic seizure
- head bruises in living conditions and at work;
- jumping from height to foot;
- falling on the buttocks;
- “Shaken child syndrome” with mistreatment, intense rocking of the baby.
In order to understand the causes of the development of a concussion, it is necessary to recall the anatomy of the central nervous system and the skull. The spinal cord and cerebral hemispheres freely lie in the cranial cavity and spinal canal. In case of sudden movements or application of force, they can be dramatically shifted in the opposite direction. In this case, there is damage to the brain tissue on the principle of anti-impact. Such a mechanical effect can be directly affected by the substance of the brain, as well as blood vessels, intracerebral fluid.
The intensity of the impact on the central nervous system determines the severity of the resulting disorders. So with a concussion of the brain, only molecular changes in the medulla, nerve synapses, vascular wall are detected. In the case when the injury causes the destruction of the medulla, talking about contusion or contusion of the brain. With accumulation in the substance of the brain or under the meninges of blood, an intracranial hematoma develops.
Symptoms of brain concussion
The severity of the clinical symptoms of concussion depends on the severity of the disease. The following symptoms are characteristic of mild tremors:
- short-term loss of consciousness;
- sensation of the appearance of "sparks from the eyes"
- blurred vision;
- flashing "fly" before my eyes;
- mild malaise;
- sleep disturbance;
- noise in ears;
- slight nausea.
When moderate concussion may appear such symptoms:
- loss of consciousness after injury;
- nausea and vomiting;
- gait disturbance;
- increased or slow pulse;
- high blood pressure;
- the appearance of subcutaneous hematomas;
- headache, provoked by bright light, loud sounds;
- anterograde and retrograde amnesia.
In case of severe shaking, the patient's condition worsens. Vomiting becomes multiple and does not bring relief. Perhaps the appearance of hallucinations and delusions, paresis and paralysis, convulsive seizures. Dehydration of the body with a violation of the internal organs. This condition requires immediate hospitalization in the intensive care unit and resuscitation.
Features of the clinical picture of brain concussion are determined by age factors:
- In infants - concussion, as a rule, is not accompanied by loss of consciousness. Immediately after the injury, paleness of the skin, drowsiness, lethargy, and rapid heartbeat are observed. In the subsequent feeding, frequent regurgitations and vomiting appear. Perhaps sleep disturbance, expressed anxiety baby. Most often, with a favorable course of pathological manifestations come to naught within 2-3 days.
- In preschool children, concussion is also not accompanied by loss of consciousness. Perhaps slight indisposition, drowsiness or irritability, mild nausea. Sometimes there is a slight increase in body temperature. Occasionally, children develop a symptom of post-traumatic blindness. As a rule, it occurs either immediately after the injury, or a few minutes later. 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 - at first after injury there is disorientation in time and space, memory impairment, dizziness. For people in age are characterized by headaches, localized in the occipital region and wearing a pulsating character. Especially severe headache appears in older people suffering from hypertension. As a rule, within 3-7 days the symptoms of concussion disappear.
Diagnosis of brain concussion
In the event of symptoms of concussion, you should immediately consult a doctor. In case of a serious condition of the patient, it is better to call the ambulance team, which will provide transportation to the hospital. In the event of a concussion, it may be necessary to consult a traumatologist, a neuropathologist, a neurosurgeon, a therapist. It is important to keep in mind the so-called period of imaginary well-being, characterized by temporarily subsiding of the symptoms of injury after a few hours or days. In this “light” period, the patient’s condition may deteriorate without visible clinical symptoms, for example, during the formation of an intracranial hematoma. That is why after receiving any head injury, you should consult with a specialist.
Diagnosis of concussion begins with a thorough 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 that is performed for most patients with TBI. The main purpose of radiography is to identify fractures of the skull bones. It is impossible to assess the state of the substance of the brain by radiographs, but identifying any fractures makes it possible to assign the status of moderate or severe to a shake, even with a successful clinical picture.
- Neurosonography is an ultrasound examination of the brain that allows you to assess the state of the medulla and ventricles of the brain. With the help of neurosonography, it is possible to identify foci of contusions, signs of swelling of the brain, the development of intracranial hematomas. Ultrasound has no contraindications, is a painless and non-invasive method of research. Neurosonography allows visualization of the brain structure through an unclosed large spring, thin temporal bones, eye socket, external auditory canal. In older people, the bones of the skull 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. On the basis of the data obtained, it is possible to conclude that there are such large formations as hematomas or tumors in the brain. In addition, it is possible to obtain indirect information about the state of the ventricular system and the medulla.
- CT scan is one of the most informative methods for diagnosing diseases and injuries of the central nervous system. The use of X-rays allows to obtain a clear layer-by-layer image of the brain and bones of the skull. CT provides opportunities for the diagnosis of hematomas, bruises, foreign bodies and damage to the bones of the fornix and base of the skull.
- MRI - refers to the most accurate and informative methods of studying the central nervous system. With it, it is impossible to determine damage to the bones of the skull, which significantly limits the use of MRI in the diagnosis of traumatic brain injuries. When examining young children, anesthesia may be necessary.
- Electroencephalography - this study aims to study the bioelectric activity of the brain. EEG makes it possible to determine the foci of the medulla in violation of the activity of neurons. The presence of such epi-activity sites can lead to epileptic seizures.
- Lumbar puncture is an invasive study aimed at obtaining CSF from the cerebral spinal canal. The presence of blood may indicate serious damage to the brain tissue. Lumbar puncture is performed according to strict indications, for example, in case of suspected severe bleeding, inflammatory or neoplastic process.
Treatment of brain concussion
The tactics of treating concussion of the brain is determined by the severity of the patient's condition. Treatment should be carried out in the hospital under the supervision of qualified professionals. Hospitalization allows you to monitor the patient's condition, the progression of the clinical symptoms of the disease and conduct a full examination. In addition, the stay in the hospital provides for the creation of psycho-emotional peace, which is a prerequisite for recovery.
- First aid - before the arrival of the physicians it is necessary to give the victim a horizontal position with a raised head end. In the event that the patient does not regain consciousness, it is better to lay him on his right side with his head slightly thrown back and turned to the ground. This is the position that provides free breathing and prevents vomit, saliva and mucus from entering the respiratory tract.
- Regimen - patients suffering a concussion should be kept in bed for 3-5 days. In addition, the patient must observe a gentle mode with the exception of watching TV, listening to music, reading. The motor mode is extended for 2-5 days, after which the patient is discharged for outpatient treatment.
- Drug therapy - drug therapy for concussion of the brain has several goals. First of all, this reduction in intracerebral pressure with the help of diuretics and potassium preparations. In addition, sedative drugs are used to relieve emotional stress. In case of severe headaches, light painkillers may be indicated. The purpose of nootropic drugs is aimed at improving the metabolic processes and nutrition of brain cells. In the case of severe nausea and vomiting, dehydration therapy is performed. Monitoring the effectiveness of treatment is carried out using repeated neurological examinations, instrumental studies.
Consequences and prognosis
In the case of adequate treatment and compliance by the patient with the recommendations of the doctors after a concussion of the brain, in most cases there is a full recovery and restoration of working capacity. However, in some patients there may be a decrease in memory, attention. Recurrent dizziness, anxiety, irritability, headache, fatigue, insomnia may occur. For some time, hypersensitivity to bright light and loud sounds may persist. However, in most cases, after 6-12 months, the effects of brain concussion gradually subside.
About 3% of people have more pronounced effects of tremors, most often due to non-compliance with the recommended regimen. These patients may develop insomnia, vegetative-vascular dystonia, asthenic syndrome, and epileptic seizures. Perhaps the emergence of the so-called post-syndrome syndrome, characterized by the appearance of headaches, irritability, anxiety, insomnia. Such people have difficulty concentrating, which significantly reduces their ability to work.
A timely, high-quality treatment will help minimize the effects of a concussion.