concussion of the brain - it's easy to reversible brain damage functions arising from the traumatic impact. It is believed that a concussion-based displays is a violation of connections between nerve cells, advantageously functional.
concussion frequency of occurrence ranks first in the structure of the cranial traumatism. The causes of concussions are like car accidents and domestic, industrial and sports injuries; play a significant role and criminal circumstances.
manifestations of tremors
The main symptom of concussion is a loss of consciousness at the time of injury. An exception may be only children and the elderly. Immediately after a concussion can also be observed
- single vomiting,
- some shortness of breath,
- fast or slow pulse,
- memory impairment in the current or preceding events,
but these figures will soon be normalized. Blood pressure returns quickly to normal limits, but in some cases may increase firmness - this is due to not only the trauma, but also its accompanying stress factors. Body temperature at concussion remains normal.
For the restoration of consciousness typical complaints
- headache,
- nausea,
- dizziness,
- weakness,
- noise in ears,
- flushing,
- sweating,
- feeling of discomfort,
- sleep disturbance.
When concussion general condition of the victims usually improve rapidly during the first, at least - the second week. It should however be borne in mind that headaches and other subjective symptoms can be kept much longer due to various reasons.
Features manifestations in children and the elderly
Picture concussion is largely determined by age factors.
In infants and young children concussion often occurs without impairment of consciousness. At the time of the injury - sudden pallor of the skin (especially face), heart palpitations, then lethargy, drowsiness. Arise regurgitation during feeding, vomiting, marked anxiety, sleep disorders. All manifestations are held in 2-3 days.
In young (preschool) age of concussion can occur without loss of consciousness. The general condition is improved in 2-3 days.
In elderly and elderly primary loss of consciousness with brain concussion occurs much less frequently than in the young and middle age. However, often it manifests severe disorientation to time and place. Headaches are often pulsating character and are localized in the occipital region; They last from 3 to 7 days, to differ materially intensity in patients suffering hypertensive disease. Frequent dizziness.
Diagnostics
In the diagnosis of concussion it is particularly important to consider the circumstances of the injury and the incident information of witnesses. Dual role may be played by the following injuries to the head and factors such as alcohol intoxication, the psychological condition of the victim, etc.
concussion is often no objective diagnostic features. In the first minutes and hours of the doctor and other witnesses can see the loss of consciousness (a few minutes), twitching during abduction of the eyeballs gaze to the side (nystagmus), impaired balance and coordination, double eyes.
Laboratory and instrumental signs of concussion diagnosis does not exist.
- When you shake the skull fractures are absent.
- The pressure and composition of the cerebrospinal fluid without deviation.
- Ultrasonography (M-echoscopy) displacement and extension of medial cerebral structures is not revealed.
- Computed tomography in patients with traumatic concussion does not detect abnormalities in the material condition of the brain and other intracranial structures.
- These magnetic resonance imaging in brain concussion and did not reveal any lesions.
concussion masks often more severe traumatic brain injury patients, and therefore are subject to immediate hospitalization neurosurgical profile (or other profile, which is neyrotravmatologicheskaya aid) mainly for the examination and surveillance.
Thus, concussion of the brain can be identified on the basis of:
- Observed or reported by the patient data on the loss of consciousness at the time of injury.
- Nausea, vomiting, complaining of dizziness and headache.
- Lack of evidence of a more severe injuries (loss of consciousness over 30 minutes, seizures, paralysis of limbs).
The first action in suspected concussion:
- Call an ambulance or go to the emergency room.
- There the patient will be examined by a traumatologist and neurologist to be carried out X-ray of the skull. And if necessary and if possible, or CT MRI of the brain (Desirable conduct these surveys - a chance to avoid underestimating the severity of the injury, but this equipment is not always available), in the absence of CT or MRI is performed M-echoscopy.
- Upon confirmation of the diagnosis of the patients hospitalized in the neurosurgery and trauma unit for observation, not to miss a serious injury and to avoid complications.
Treatment of concussion
First aid for a jolt
The first aid to the victim with a concussion when he quickly regained consciousness (which is usually the case in brain concussion), it is easy to give it a horizontal position with slightly elevated head.
If a concussion is still in an unconscious state, preferably a so-called saving position -
- on the right side,
- head thrown back, his face turned to the ground,
- left arm and leg bent at a right angle at the elbow and knee (previously necessary to exclude fractures of the spine and extremities).
This position providing the free passage of air into the lungs and unimpeded fluid outflow mouth outwardly prevents respiratory failure due to the tongue, flowing into the airways of saliva, blood, vomitus. If the color has bleeding, apply a bandage.
All the victims with a concussion, even if it is from the beginning seems easy to be transported to the hospital on duty, which specifies the initial diagnosis. Affected with concussion set bed rest for 1-3 days, which is then, taking into account features of the disease gradually extend over 2-5 days, and then, in the absence of complications can extract from hospital to outpatient treatment (lasting up to 2 weeks).
drug therapy
Medical treatment for concussion is often not required, and is symptomatic (primary treatment - rest and good sleep). Pharmacotherapy is aimed mainly at the normalization of the functional state of the brain, relieving headaches, dizziness, anxiety, insomnia and other complaints.
Generally designated at receipt range of drugs include analgesics, sedatives and hypnotics, preferably in the form of tablets, and, if necessary, and injections. Among analgesics (analgin, pentalgin, deksalgin, sedalgin, maksigan et al.) Select the most effective medication for this patient. Likewise receives and dizziness, selecting that any one of the available drugs (Belloidum, cinnarizine, papaverine with platifillin, Tanakan, micrograins, and the like).
As used soothing valerian, motherwort, Corvalolum, valokordin and tranquilizers (afobazol, grandoksin, sibazon, phenazepam, nozepam, rudotel et al.). To eliminate insomnia at night or appoint donarmil relakson.
Conducting exchange vascular and metabolic therapy for jolt promotes more rapid and complete restoration of brain function disorders. Preferably the combination sosuditstyh (Cavintonum, stugeron, Sermion, instenon et al.) And nootropic (glycine, Nootropilum, pavntogam, Noopept et al.) Preparations.
As the range of possible combinations can be represented by three-time daily cavinton reception on 1 tab. (5 mg) and 2 nootropil caps. (0,8) or stugeron 1 tab. (25 mg) and noopept 1 tab. (0.1) for 1-2 months. The positive effect brings inclusion in course of therapy preparations containing magnesium (magnesium B6 Magnelis, Panangin) and antioxidants Citoflavin 2 m 2 p daily Mildronat 250 mg 1 m 3 per day p.
To overcome the frequent asthenic effects after concussion appoint: Fenotropil 0.1 1 times in the morning, kogitum 20 1 ml once a day, vazobral 2 ml, 2 times daily multivitamin polimineraly-type "Unicap-T", "Centrum" "Vitrum" etc. by 1 Tab. 1 per day. From tonic preparations using ginseng, Eleutherococcus extract, schisandra fruit, Saparal, Pantocrinum. Individuals elderly undergoing concussion enhance protivoskleroticheskim therapy. Also pay attention to the treatment of various comorbidities.
To prevent possible deviations in the successful completion of concussion requires clinical supervision for a year by a neurologist on a residence.
Forecast
With adequate adherence and lack of injury aggravating circumstances concussion completed recovery of patients with complete recovery of disability.
A number of patients can avoid the acute period of a concussion are marked weakening of concentration, memory, depression, irritability, anxiety, dizziness, headaches, insomnia, fatigue, increased sensitivity to sound and light. Through 3-12 months after the concussion, these symptoms disappear or significantly smoothed.
disability expertise
According to the forensic medical criteria concussion refers to bodily harm and the percentage of disability is generally not defined.
When medical labor examination determined temporary disablement of 7 to 14 days. Long-term and permanent disability usually does not occur.
However, 3% of patients after acute brain concussion and decompensation due to already existing chronic diseases, as well as multiple repetitive traumas moderate disability arises especially in non-compliance with recommended treatment regimen and behavior.
