Concussion is a traumatic brain injury, which is not a severe manifestation of it, but occurs quite often. This phenomenon is most common in children who are hyperactive. As a result, it disrupts the functions performed by the brain. However, this is easily reversible as it does not appear to be organic damage.
Concept
Concussion is a closed craniocerebral injury, as a result of which the following processes occur:
- changing the dynamics of the properties of neurons, which changes the spatial orientation of protein molecules;
- all brain matter suffers;
- between synapses (points of contact of brain cells) there is a temporary break in relations and signal transmission.
Classification
There are three degrees of concussion.
- Easy. Consciousness is notis violated. In the first 20 minutes, the patient notes nausea, dizziness and headache, disorientation in space, for a short period of time the body temperature may increase up to 38°C.
- Average. The same symptoms are observed, but they have been going on for more than 20 minutes. This may be retrograde amnesia, characterized by the fact that the patient cannot remember the last few minutes before he was injured.
- Heavy. Accompanied by loss of consciousness, which can range from several minutes to several hours. There is retrograde amnesia. The main symptoms are: loss of sleep, appetite, nausea, disorientation in space, fatigue, dizziness and corresponding pain, which are present in the patient for 7-14 days.
Concussion according to CTBI ICD-10
This classification has been in use by states party to the WHO agreement since 1994. The various ICD classes are grouped into 22 categories. It is planned that in 2018 the 11th edition of this classification will be released, while 10.
According to ICD-10, a concussion belongs to CTBI (closed craniocerebral injury) and has code S 06.0.
Reasons
The pathology under consideration can be caused by:
- intense motion sickness of the baby;
- fall on the buttocks;
- jumping to feet from a height;
- head bruises;
- falling from the height of your own body;
- sharp movementshead;
- a blow to the head with a heavy object.
Sudden movements or forceful blows lead to displacement of the substance of the brain, intracerebral fluid and blood vessels in the opposite direction. As a result, brain tissue is damaged. To date, there is no clear theory of the occurrence of concussion. However, there are several versions:
- the dynamics of the physicochemical properties of the substance of the brain and the colloidal equilibrium of cellular proteins are observed;
- disconnection occurs between cells and parts of the brain, which leads to disruption of its functions;
- suggest that it may also be functional in the brainstem and hemispheres without observing macroscopic and histological changes;
- the nutrition of brain cells may deteriorate, which leads to a shift in the brain tissue in the layers, which breaks connections between different centers;
- When struck, a shock wave propagates through the brain in the opposite direction with simultaneous pressure drops in the indicated directions.
Thus, there is no structural and morphological dynamics in the brain at the time of concussion. This is also detected with the help of computed tomography. If this absence is found, a brain injury will be diagnosed.
Symptomatics
Even a minor head injury can cause this problem.
The main symptoms are as follows:
- discoordination;
- heightened sensitivity to sounds;
- photophobia;
- double vision;
- when reading, there is pain in them;
- slurred speech that may be slurred and slow;
- marked confusion and lethargy;
- nausea may be present with occasional vomiting;
- weakness;
- tinnitus;
- headache throbbing;
- dizziness due to impaired blood flow in the vestibular apparatus.
Older people are characterized by disorientation in both time and space in the first days after injury, as well as dizziness and memory lapses. Headaches appear, which are pulsating in nature and located in the occipital region. The most dangerous injury for hypertensive patients. Symptoms of concussion in elderly patients resolve after 3-7 days.
Concussion Diagnosis
The doctor interrogates the incoming patient, as a result of which it turns out:
- whether neck tension is present, passing within three days;
- is there shakiness when doing the Romberg pose (feet together, arms extended forward at a right angle, eyes closed);
- Are small trembling movements of an involuntary nature detected when the eyes are turned to extreme positions; the doctor can pick up a small object and ask the patient to follow it - in the extreme positions, there is a slight return movement of the pupil;
- Is there a slight asymmetry of skin and tendon reflexes - this sign is unstable and changes fromover time;
- whether there is constriction or dilation of the pupils in the first few hours after injury with a normal reaction to light;
- Does the patient complain of pain when looking away.
Signs of a concussion in a child.
- In preschoolers, it often occurs without loss of consciousness, after 2-3 days there is an improvement in the general condition.
- In infants, the following symptoms pass within the same period: sleep disturbance, anxiety, vomiting, regurgitation during feeding.
- Paleness of the skin (mainly of the face), frequent pulse, then drowsiness and lethargy are noted during the injury.
Signs of a concussion in an older child can manifest as loss of consciousness, severe dizziness, repeated vomiting, post-traumatic blindness is observed, which disappears after a short time.
To rule out more severe conditions, radiography of the cervical spine and skull, EEG is prescribed to detect disorders in the cerebral cortex. A CT scan is performed to detect any effects of a concussion.
X-rays provide information about possible skull fractures during an injury. However, it does not give an idea of the state of the substance of the brain. Indirect information about this can be obtained during the echo-EG. It also provides information on hematomas and tumors. However, the method does not provide reliableresults. With the help of EEG, the bioelectrical activity of the brain is studied. It is used to determine the foci of epileptic activity, which leads to the occurrence of seizures of the same name in the future.
Little children (up to 2 years old) are often prescribed neurosonography, which is understood as an ultrasound of the brain. With its help, they get an idea about the substance of the brain and about the ventricular system. Edema of the brain, foci of bruises, hemorrhages, hematomas can be detected. The procedure is not effective for older children due to fusion of the skull bones.
Lumbar puncture is rarely prescribed in this case, it can only be prescribed as an additional measure when clarifying a complex picture. At the same time, CSF is withdrawn and the presence of blood in it is determined.
First Aid
When the victim is unconscious, you should immediately call an ambulance. Before her arrival, a person is laid on his right side on a hard surface with bent elbows and legs. The head tilts up and turns to the ground, which will prevent foreign objects from entering the respiratory tract during inhalation during vomiting and provide good air passage through them.
If there is bleeding from a wound on the head, treatment for a concussion consists of applying a hemostatic bandage.
In the absence of fainting or if the victim has regained consciousness, he must be laid horizontally, raising his head and making sure that he does not fall asleep.
After an injury, the victim needs totake him to the emergency room, where he will receive medical assistance in case of a concussion. Treatment can be carried out on an outpatient basis under the supervision of a neurologist or inpatient.
If it is impossible to determine the severity of the injury caused by a concussion, it is better not to touch the victim. In the presence of bulk substances, liquids that can enter the human body, measures must be taken to eliminate them.
It must be remembered that during the course of the disease, a period of imaginary well-being is allocated, during which the symptoms of injury are leveled for several hours or days. The patient's condition may worsen as an intracranial hematoma is formed.
Healing
How to treat a concussion at home? The most important thing is the observance of bed rest. At the same time, proper rest, sleep, lack of stress should be ensured, excluding them completely within a few days after the injury.
What pills does the doctor prescribe for concussion? First of all, those that contribute to the removal of signs of the disease and the normalization of the functions of the organ in question.
Concussion pills:
- "Pentalgin", "Baralgin", analgin - painkillers;
- "Cerucal", "Metoclopramide" - antiemetics, are prescribed symptomatically as the corresponding signs appear;
- "Phenazepam", Corvalol, motherwort tincture -sedatives;
- "Furosemide", "Diakarb" - in the presence of concomitant arterial hypertension or an increased risk of edema as diuretics;
- "Tanakan", "Betaserk" - to relieve symptoms of dizziness.
Symptomatic therapy is prescribed to prevent complications and restore impaired functions. It begins to be carried out 5-7 days after the injury was received.
Concussion pills in this case:
- vasotropic - Teonikol, Cavinton;
- nootropic - Piracetam, Nootropil.
With their help improves cerebral circulation and the activity of this body. They are accepted even after the patient is discharged from the medical institution, for several months.
In addition, the therapy involves taking tonic and vitamin preparations:
- "Schisandra";
- ginseng root;
- Eleutherococcus extract.
Within one month after receiving a diagnosis of "concussion", you can not do heavy physical exercises and difficult work. It is better to stop watching TV shows, movies, working on a PC and reading books for a long time. Relaxation should be achieved by listening to calm music without headphones.
Forecast
He is good for early treatment.
In some patients, residual effects are felt throughout life. As a rule, they soften after oneof the year. These include:
- sleep disorder;
- persistent headaches;
- memory violation;
- depression;
- fatigue;
- irritability;
- decrease in concentration.
If you ignore the advice of your doctor, serious conditions can occur, characterized by constant migraines, epilepsy, insomnia, etc.
Complications
They can develop a huge variety. With repeated concussions, for example, in boxers, encephalopathy is sometimes observed. Her first symptoms are associated with the work of the lower extremities. The state of balance is disturbed, there is staggering. Movement may slow down, mental confusion may occur.
Symptomatics in some patients may remain severe even after recovery:
- noticeable shuffling;
- slow motion;
- changes in the psyche;
- tremor of the head and hands;
- depletion of vocabulary.
In traumatic brain injuries, including concussions, the following constitutional features are observed.
- When taking alcohol or exposure to an infection, mental disorders can appear on the body: the appearance of visual hallucinations, impaired consciousness with delirium, severe arousal.
- Persistent headache, aggravated by sudden movements, because there is a constant flow of blood to the head. There is intense sweatingpallor of the epidermal integument, and this can appear only on one side of the face. All this can be accompanied by rapid fatigue and inability to concentrate on anything.
- Increased irritability and excitability with fits of rage with pronounced aggression, followed by embarrassment and apologies for imbalance.
- Paranoid traits.
- Epileptic-like seizures appear.
- Neuroses arise, accompanied by fears and anxiety.
Sometimes dementia can develop against the background of progressive psychosis.
Besides this, concussion is characterized by the presence of a postcommence syndrome, which means that a patient who has undergone this ailment begins to complain of a very severe headache with irritability and anxiety after some time. Painkillers in this case can be addictive.
Prevention
Preventing a concussion is hard enough. However, by following certain recommendations, you can reduce the likelihood of injury.
It is necessary, if possible, to refuse to engage in traumatic sports:
- football;
- hockey;
- boxing and more
Sports such as horseback riding, skateboarding, ice skating and inline skating should use helmets with proper tabs and fittings.
While making auto walks, you must buckle upseat belts. Children must be transported in car seats designed for them.
In winter, use anti-slip devices or canes with sharp tips on shoes.
In closing
Concussion is the result of a head injury. It comes in mild, moderate and severe stages. The first two are not accompanied by loss of consciousness, and, as a rule, end favorably. The severe stage is characterized by loss of consciousness and the presence of symptoms for a long time. Usually after it various complications can develop. Treatment mainly consists of providing bed rest and maintaining rest. To prevent the occurrence of this disease, it is necessary to limit occupations by traumatic sports, in winter to wear shoes with special devices that prevent slipping. You also need to learn how to fall correctly.
