What is the severity of a concussion. All legal consultations are free.

Head injuries account for half of all bodily injuries. From total number closed craniocerebral injuries (CTBI) 80% of cases are concussion - the most light look brain damage. Head injury statistics lethal outcome received by young people aged 20-30 years.

In this article, we look at the severity of concussions and the health damage they cause.

A concussion is the mildest type of brain injury.

Causes

Of course, CTBI is recorded in road traffic and domestic accidents. But even more often, head injuries occur in athletes and people. physical labor. A concussion does not only occur when the head is bruised. It also occurs when falling on the buttocks, back, or as a result of kicking the ground when jumping or falling with the head thrown back. A concussion occurs even when falling from a height of one's own height.

What Happens in the Head During an Injury

Traumatic brain injury is a physical injury to the bones of the skull, membranes, nerves and blood vessels. Violation of brain functions occurs due to vibration nerve cells, and in the zone opposite to the impact. Changes in neurons at the molecular level lead to dysfunction of the brain area.

In the experiment on monkeys, it was found that at the moment of impact, similar rotational movements of the hemispheres occur in several planes. There is twisting and tension of the axonal processes. At the moment of injury main force damaging energy falls on the border of the hemispheres and medulla oblongata. In this case, microhemorrhages are formed inside the brain tissue due to the pressure difference, due to damage to the cerebral capillaries.

Rupture of large intracranial vessels is one of the dangerous head injuries. The blood poured out of the vessels presses on neighboring areas and nerve endings, which is manifested by headaches, nausea and vomiting.

CTCI classification

Head injuries are divided into closed craniocerebral injuries - CBI and open, with lesions on the face and scalp. In Russia, skull injuries are divided into the following types:

brain concussion;
brain injury;
diffuse damage to the brain tissue;
brain compression.

The most frequent (80%) and light type PTBI is a concussion that varies in severity.

Injury severity

Distinguish concussion at the place of impact - in the back of the head, forehead and counter-strike, which occurs due to inertia. Classification of concussion according to severity:

With mild severity, there is no loss of consciousness or it lasts from a few seconds to 5 minutes. After this period, headaches appear. Sometimes there is a single vomiting. On examination, the patient's face is pale or hyperemic (redness), sweating is noted. The elderly have arterial hypertension. In hypotensive patients, the pressure may decrease. Clinical symptoms continue a short time up to 15 minutes and can pass without a trace. In people with alcohol intoxication during a disaster, symptoms persist for a longer time. In general, a mild degree is characterized by reversible functional changes.
At medium degree gravity loss of consciousness up to 5 minutes is noted. The headache is severe and accompanied by nausea. There is confusion, dizziness and ringing in the ears. On examination, the patient notices a hematoma in the eye area. There is photophobia and double vision, sound phobia and inability to concentrate. Signs of a moderate degree are reduced to symptoms of a violation functional ability neurons. The brain structure is not disturbed. Methods of instrumental research - CT, MRI and electroencephalogram do not reveal pathology.
Severe concussion. A visible symptom with this severity is extensive pronounced hematomas in the eye area. At the time of head injury, fainting is longer than with an average degree - more than 5 minutes. Severe headache with nausea and vomiting requires application curative measures in the neurosurgical department of the hospital. The patient has memory loss of varying duration and impaired coordination. This degree of severity of concussion causes significant harm to health. With a severe degree, the work of the heart is disrupted. Since the heart is a pump that sends blood to all organs, the circulation of the whole body suffers.

With a mild concussion, the patient does not realize the seriousness of the situation. However, even this condition harms the health of neurons and impairs their function. Therefore, with a slight concussion, to prevent harm to health, the best treatment is bed rest and medication.

A moderate concussion harms the health of the whole body and, above all, the cardiovascular and respiratory systems.

Severe severity harms health in the immediate and long-term period of the disease. In the near future, such formidable complications cause harm to health:

cerebral edema;
visual impairment;
impaired memory and thinking.

Severe concussion threatens with cerebral edema, impaired vision and memory

In the long term, harm to health manifests itself after several months or even years in the form of such diseases:

brain meningioma;
brain tumor:
migraine;
persistent memory impairment;
neuroses.

At the time of the catastrophe, brain neurons, which are the processor of our brain-computer, are damaged. It is in neurons that information is stored that we have received throughout our lives. Trauma causes harm to health in the form of a sharp impairment of a person’s memory. After a severe head injury, the patient does not remember what happened. If at the time of the catastrophe a significant number of neurons died, then the information received before the injury falls out of the person’s memory. In medicine, there are cases when a person, after an injury, forgot his native language, in which he spoke all his life.

Summing up, we recall that a concussion is the easiest type of CBI. According to clinical signs, concussion is divided into 3 degrees of severity - mild, moderate and severe. Do not forget, even in a mild degree, such an injury requires bed rest and the implementation of a doctor's prescription. Otherwise, in the near and distant future, the consequences of the disaster will harm health in the form of complications - cerebral edema, tumors or meningioma.

Concussion symptoms are signs that can accompany any traumatic brain injury (TBI). With different degrees of damage, depending on how severe or mild the general cerebral or focal neurological symptoms turned out to be, which gave rise to such a diagnosis, the symptoms may differ slightly. Doctors classify a concussion as a non-severe traumatic brain injury, because in this case there is no damage to the soft tissues or bones that accompanies severe TBI. This is a violation of the normal activity of the brain, which occurred as a result of mechanical injury skull, but not accompanied by vascular pathologies.

This is the most common type of injury, which is received, according to various sources, from 60 to 80% of people who have injured their heads. The symptoms of a concussion usually pass quite quickly, but behind the external harmlessness of the symptoms, the damage to the brain that it receives when it is bruised or hit on cranium, and despite the apparent absence of damage, brain cells still perform their functions poorly. The signs of a concussion should be among the mandatory medical knowledge of every adult, so that seeking medical help, preventive measures to provide assistance on the spot will help to avoid complications.

Many people who have not had to deal with such a phenomenon (or it took place in their mild degree, without giving a reason to go to the doctor), we are sure that any head injury is a concussion. A concussion is a mild craniocerebral injury, in which neurological, vascular, irreversible damage to the organ does not occur, but only functional disorders that are visible to the naked eye. Still not in medicine consensus about what disorders occur in the cells of the brain during its concussion.

According to the versions of different scientific schools, this may be a violation of the connections between the molecules of the brain tissue, a spasm of blood vessels (capillaries), disrupting the supply of oxygen to the brain, a violation of the connection between neurons, a violation of coordination between pillar structures and the cerebral cortex, a change chemical composition fluid that surrounds the brain. To date, no theory has received sufficiently substantiated scientific confirmation, and it is likely that all of them correspond to the truth to some extent. The only thing that can be stated with complete certainty is that the activity of the brain still undergoes changes in a negative direction, and they are easily recognized by a person with medical knowledge.

Doctors distinguish 3 degrees of concussion, depending on external symptoms manifestations, and contrary to the common misconception that any concussion is accompanied by loss of consciousness, this is observed only in severe (3) degree and occasionally in 2 (medium). A mild degree of concussion is not accompanied by loss of consciousness, but warning signs can be observed immediately after injury, in the first 15 minutes.

Appeal for medical assistance necessary in any case, because even very mild concussion symptoms in adults can have so-called side symptoms or post-stress disorder, also known as prolonged or prolonged Negative consequences. At the time of the onset of such complications, the body of an injured person should already be fully armed.

Signs of a concussion in an adult are visible to the naked eye, even in completely stranger, and for this it is not necessary to be a careful observer. With a concussion from the side, you can see the following characteristic features:

Stupor. The person is in a state of slight insanity, he seems to be stunned, his face has a frozen expression of confusion, his facial muscles are tense. This happens because the supply of nerve impulses to the cerebral cortex has stopped.
Loss of consciousness, characteristic of moderate and severe trauma. With a concussion, this happens because a short-term circulatory disturbance has occurred. Thus, the brain, as in any other case, reacts to a lack of oxygen.
Single vomiting. The consequence of circulatory disorders in the vomiting center and the vestibular apparatus.
Paleness, which is replaced by redness. This is a violation of the tone of the autonomic nervous system, resulting in a "game" of capillaries.
Increased or slow heart rate. That is why doctors always count the pulse as soon as they see the first signs. The reason is the same - a violation of the tone of the ANS.
Failure to coordinate movements associated with activity dysfunction vestibular apparatus transmission of nerve impulses to muscles.
Photophobia, a painful reaction to loud sounds, narrowing or dilation of both pupils, which is also easy to detect. All the same ANS, which briefly does not control optic nerve. For the same reason, a person's eyes tremble if he tries to look from side to side.
Asymmetry of tendon reflexes. This sign can be checked by a neurologist, but popularly it means that when you hit a kneecap you can get flexion or extension of the arm, and not the legs, as is normal.

If such symptoms appear when observing a person who has just fought, fallen, had a car accident, just hit his head, seeking medical help should take place immediately. Men get concussions much more often than women, but women endure the consequences worse, so women should be handled with special care in this condition. The degree of severity, the need for hospitalization, other medical subtleties, let the doctor determine, but the help of a physician is necessary in any case.

Manifesting signs that everyone can observe, hitting his head, fighting, having an accident, having a mild head injury:

nausea;
single, sudden, uncontrolled vomiting;
salivation, tears, increased, spastic sweating;
headache, dizziness, tinnitus;
painfully loud noises, unbearably bright lights;
misunderstanding of what is happening, which is typical after loss of consciousness:
pain when moving the eyes;
lack of coordination of movements (legs and arms do not obey).

All these signs appear in the first 15 minutes and indicate, like the signs visible to other people, that it is necessary to immediately seek medical help. Special medical measures with a mild degree of severity, it is not carried out, but the diagnosis by a traumatologist, and even better by a neurologist, of a concussion of the brain, will make it possible to determine that this is it, and not a more severe TBI, the consequences of which may be irreversible. Such a diagnosis is preliminarily set on the basis of a set of symptoms that the trained eye of a specialist will see and evaluate according to specific features(some of them will be visible only to a professional, and only a person who constantly encounters this can put everything together).

To exclude more severe damage, it is still good to do an x-ray, which will show that there is no damage to the skull, and other studies that determine that there are no hematomas, no focal, no diffuse injuries, no visible damage to blood vessels and tissues. Of the signs that only a doctor knows, there are many simply unique:

Gurevich's ocupostatic phenomenon (the patient falls forward when looking down and falls back when looking up);
neurological microsymptoms (impaired skin, cremasteric, abdominal, plantar reflexes);
asymmetry of the face, uneven smile, varying degrees of raising the corner of the mouth;
palmar-chin reflex - if you stroke the palm with a special movement, the muscle on the chin contracts;
Romberg's symptom - a person with arms outstretched and eyes closed almost immediately falls forward;
instability of the pulse, blood pressure, skin color, which are constantly changing;
retrograde amnesia, which can be detected even later than the trauma is diagnosed.

Some of them appear only the next day, or even later, and a visit to a doctor will help not only in diagnosis, but also in eliminating the consequences of shell shock, which can be much more severe than the injury itself. After all, for doctors, a concussion is considered a minor injury only because neither the skull nor the brain received visible damage. But the brain is such a subtle substance that there can also be a lot of harm from invisible damage. Previously, almost half of those who received TBI of moderate and severe severity suffered from the consequences of a concussion. It should also be taken into account that some of the victims did not seek medical help, considering a mild degree to be a very minor injury.

To date, the consequences of such concussions have significantly decreased, because people began to receive timely and necessary medical care. And this became possible because people learned what it is and what signs it manifests itself, thanks to medical education and elementary knowledge in the field of medicine.

First aid

The long-term consequences of a concussion are sometimes much worse than the trauma. They can manifest themselves in any way, ranging from emotional disorders, headaches and disorders of the vestibular apparatus up to vegetative dystonia and intellectual disorders. First aid is very important for a mild, minor TBI because it provides the victim with everything they need until the doctor arrives.

If at least one of the above symptoms manifested itself after a head injury, it is necessary to call an ambulance or take the victim to the emergency room.

The patient needs to ensure maximum peace, lay him on a flat surface, put a small pillow under his head, built from improvised means, be sure to unbutton clothes that interfere with air access, and ensure the flow fresh air. If the loss of consciousness lasts more than 2 minutes, more may be suspected. heavy damage, including a fracture of the spine, so it is best not to move an unconscious person. But it is better to lay the unconscious on its right side, bending left leg and hand. This position will not allow him to choke on vomit, will allow him to breathe freely.

If there are wounds on the head, they should be treated with improvised means, at least washed and applied with something to stop the bleeding. If there are no visible wounds, be sure to apply cold anything to the site of injury - even a bottle of water, even a frozen product.

Preventive measures in such cases are difficult to advise. If it is a sports or industrial injury, then attention should be paid to the application protective equipment. If domestic injury - reconsider safety measures in the house. If there is an accident, then it is difficult to advise anything. If an injury is received in a fight, any conflict can be resolved with words. But first aid is necessary in any case, until a doctor arrives who knows what to do next.

A concussion is sharp violation brain function, which occurs immediately after a head injury and is not associated with vascular damage. A concussion occurs in 60 to 70 people out of 100.

Concussion can be caused by blows, bruises and sudden (diffuse) movements, i.e. acceleration or deceleration.

loss of consciousness on short term(from a few seconds or minutes to half an hour, or maybe without it), nausea, vomiting (once, as a rule), retrograde amnesia, in which the patient cannot remember the events that preceded the injury - these are the main symptoms of a concussion. The duration of the loss of consciousness and the duration of the memory impairment determine the degree of concussion.

Degrees of concussion and their symptoms

The Colorado Medical Society has defined three levels of concussion severity. At the first there is confusion without amnesia and loss of consciousness. The second degree is characterized by confusion, which is accompanied by amnesia, but without loss of consciousness. At the third stage, the person loses consciousness.

As for the definition of "short-term loss of consciousness", there are disagreements between representatives of domestic medicine and Western experts on this score. The first are limited by time from a few seconds to 30 minutes. The second is assigned to similar condition up to 6 hours. Provided that the coma lasts more than 6 hours, the probability of brain tissue damage is almost 100%. A similar situation is typical for diffuse brain damage that occurs as a result of an acceleration/deceleration injury.

After consciousness is restored, the injured may complain of nausea, dizziness, tinnitus, general weakness, sweating, and a rush of blood to the face.

Also, a concussion may be accompanied by such autonomic symptoms like pain when moving the eyes, when reading, the eyeballs can sometimes diverge, vestibular excitability increases. On the part of neurology, there may be a non-permanent slight asymmetry of skin and tendon reflexes, minor shell symptoms that disappear after the first 3-7 days.

The first thing to do for the treatment of a concussion is to consult a neurologist or neurosurgeon, since only a specialist can definitely determine the correct diagnosis and prescribe the appropriate treatment.

The medical society in Colorado, mentioned above, has developed guidelines on how to help with different degrees of concussion.
At the 1st degree, it is necessary to immediately conduct an examination of the victim and repeat it every 5 minutes with a voltage of calm state to identify signs of amnesia and symptoms after a concussion. If no such signs are observed within 20 minutes, the patient can be allowed to go home. Bed rest should be observed for at least 2-3 days.

At the 2nd degree, it is necessary to regularly examine the injured person in order to identify the developing intracranial pathology. The examination should also be performed the day after the injury. Bed rest is recommended for at least 7 days, provided that there are no symptoms.

At the 3rd degree, the patient must be urgently taken to the nearest hospital, where urgent diagnostics victim's condition. If indicated, immobilize cervical region spine. If the diagnosis is confirmed, family members should be informed about organizing night shifts.

Concussion treatment

Bed rest is observed for at least 2 weeks if symptoms do not appear during this period.

Regardless of the degree of concussion, patients are prohibited from listening to music, reading, writing, watching TV, working or playing at the computer. The patient must strictly comply with all doctor's prescriptions, take painkillers and sedatives, as well as drugs that improve brain function. The state of the victim with a concussion of the brain is normalized in one, less often two weeks.

After the final recovery, it is imperative to do an electroencephalography and go for a consultation with a neurologist to avoid complications. If, after the patient is discharged, his state of health does not improve, as a rule, we are talking about damage to the joints and ligaments that connect the cervical spine to the skull, and / or elevation.

For this, magnetic resonance imaging of the brain is prescribed and X-ray examination cervical vertebrae. At the same time, some correction should be made in the treatment of this disease. So, for example, special gymnastics is added to medicines. After 1-2 weeks, the patient usually feels better. Total drug treatment with a concussion lasts up to two months.

Consequences of a concussion

The consequences of a concussion can be significant and varied, up to post-traumatic personality changes. Often, the patient becomes more sensitive to infection or alcohol, which may result in mental disorder kind of strong emotional arousal. Patients often complain of almost constant headache, which is aggravated by sudden movements and physical exertion; dizziness due to bending over or physical exertion; sudden rush of blood to the head, after which the person suddenly turns pale and sweats (such symptoms may extend to only one half of the face or head). In addition, a person quickly gets tired and cannot concentrate on ordinary activities.

Sometimes there are emotional swings, as a result of which a person becomes irritable, excitable. Unexpected, uncontrollable fits of rage mixed with aggression may appear.

Seizures similar to epileptic seizures are also possible.

Neuroses are not excluded, which manifest themselves in increased nervousness, anxiety, fear, inability to concentrate, headache, sleep disturbance, etc. Less often, psychoses can occur, which are accompanied by delusions, hallucinations, impaired perception. Sometimes memory and thinking are disturbed, disorientation and apathy occur, which are signs of dementia (dementia).

The most rare form of concussion complication is postconcussion syndrome, in which days or even months after the injury, the patient is plagued by severe headaches, dizziness, anxiety, sleep disturbance, irritability, inability to concentrate on doing the usual work. Psychotherapy is usually ineffective in such cases. And taking painkillers, especially narcotic drugs such as morphine or codeine, can lead to drug dependence.

If the concussion is repeated, then experts talk about such a phenomenon as boxer encephalopathy. G. Martland notes the following consequences of concussion, which are associated with dysfunction lower extremities: temporary slight slapping or lag of one leg; slight imbalance or staggering; retardation of movements. Sometimes the psyche is disturbed, as a result of which speech becomes impoverished; possible trembling of the head and hands.

This condition is caused by trauma. varying degrees severity, is diagnosed annually in 300 thousand people in Russia, many of whom did not immediately go to the doctors, failing to recognize violations in time brain activity. Of course, not every injury, even when it causes a violation cerebral circulation, stimulates the development of concussion, but nevertheless it is one of the most common damage to the nervous system. medical statistics, which is being conducted in developed countries, says that about 60% of the population has experienced this condition in varying degrees of severity.

It has been noticed that a concussion accompanies not just blows to the head or head, but its sharp movements with a simultaneous slowdown or acceleration of the whole body, with such a development of events, a concussion can be earned even if the injury may seem frivolous.

That is why it is important to know the symptoms in order to seek medical help in time.

The main signs that allow you to suspect a concussion are:

loss of consciousness, while longer man is unconscious, the greater the degree of damage
aggravated by bright lights or loud music
seizures that occur in severe cases
bouts of vomiting and nausea, incoordination, dizziness and uneven pupils
headache that may appear immediately after the injury and last for a long time
unstable blood pressure which causes redness or paleness of the skin
retrograde amnesia, in which a person does not remember parts of those events that immediately preceded the injury, in this case than longer period time has fallen out of his memory, the more serious the injury

First aid to the victim: lay him on a flat surface, slightly raising his head. In case of loss of consciousness, it is necessary to urgently call ambulance

It is clear that immediately after the event, it is quite difficult to judge what the degree of concussion is. The diagnosis can be unequivocally made only after comprehensive examination and qualified medical examination, especially since the person himself at this time is unable to adequately assess his condition. During medical examination about a concussion in the presence of these symptoms, one can speak only after tomography, when it showed the absence of focal and diffuse pathologies. Invisible on the tomogram, violations of intercellular connections, characteristic of a concussion, cause these symptoms.

Inflammation of the lymph nodes in the neck is the first alarm signal of a serious illness

Different degrees of severity of a concussion

The main criteria by which a doctor can subdivide this type of brain damage is the duration of the syncope and the period under the effect of amnesia, as well as the presence or absence of seizures. A clear gradation, of course, does not exist, but it is generally accepted that a slight concussion is characterized by an absence or a short, up to 5 minutes, loss of consciousness and a general satisfactory condition of the victim. With an average degree, consciousness may be absent for up to 15 minutes, and general state rated as moderate. A serious condition is accompanied by a coma or prolonged fainting, which lasts more than 15 minutes, while there is also a violation of vital functions.

Please note that only a specialist can diagnose a concussion, so a person who has had a head injury must be shown to a doctor

How to Treat a Concussion

Treatment of this condition requires bed rest, complete rest, and, in moderate to severe severity, medication. If the concussion is mild, it will be enough to spend 2 weeks at home in bed, protecting yourself from harsh sounds, bright light, loud music.

It is also forbidden to watch TV, spend time at the computer and books, straining your eyes

In more severe conditions, the duration of bed rest is determined by the attending physician in individually. Drug treatment consists in the appointment of vascular and diuretic drugs, sedatives and sleeping pills, multivitamin complexes. special diet in this case, no, but it is still better to exclude spicy, fatty, smoked and salty foods, you should make it easier for the body to recover and not distract it from digesting heavy food.

Consequences of a concussion

With timely diagnosis and timely prescribed treatment, the main consequence of a concussion is, in fact, the injury itself, which caused it. It can damage not only tissues and bones, but also the cervical vertebrae. In addition, after an injury, hemorrhages in the brain or even its isolated contusion may appear, which is fraught with post-traumatic epileptic manifestations, development asthenic syndrome and even personality change. It is important to detect such a danger in a timely manner, as well as to correct dislocations of the cervical vertebrae.

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In the article, we consider the severity of a concussion injury. This disease is one of the types of closed craniocerebral injury. Mostly this is an easily reversible defect in the functions of the brain, which occurs due to a blow, bruise or sudden movement of the head. It is accepted that because of this, interneuronal connections are temporarily disrupted.

What are the degrees of concussion, it is interesting to many.

Description

As a result of contact of the substance of the brain with the cranial bones, as a rule, the following happens:

a change in a number of chemical or physical signs of neurons, due to which the spatial organization of protein molecules may change;
the substance of the brain of the head as a whole lends itself to pathological influence;
temporary disconnection of signaling and relationships between synapses (a synapse is a place of contact between two neurons or a neuron and an effector cell that receives a signal) of cellular neurons and brain regions. This contributes to the appearance of functional defects.

Degrees of concussion

Depending on how serious condition patient, and what Clinical signs are observed, three degrees of the disease are distinguished:

Signs and symptoms

A concussion is characterized by the following symptoms:

Consciousness is oppressed immediately after contact with a traumatic force. And this is not necessarily a loss of consciousness, it may be a stupor (stunning), a kind of incomplete consciousness. The defect of consciousness is short-term, lasting from a few seconds to several minutes. This interval most often reaches five minutes. When the victim is alone at this time, he will not even be able to say that he was losing consciousness, because he simply does not remember it.
Amnesia (memory defect) for events that preceded the concussion, the concussion itself and a short time period after it. However, memory is restored quickly.
Single vomiting after injury. Vomiting is of cerebral origin, it is most often not repeated and is used as clinical way differences between concussion and mild contusion.
Slow or increased heart rate, higher blood pressure some time after injury. These changes usually go away on their own and do not require medical treatment.
Immediately after the concussion, breathing quickens. It normalizes earlier than the indicators of the system of the heart and blood vessels, so this symptom may go unnoticed.
The body temperature does not change (lack of changes is also a differential diagnostic criterion for head brain contusion).
Specific "game of vasomotors". This is a condition in which the pallor of the skin of the face changes to redness. It occurs due to a violation of the tone of the nervous autonomic system.

When consciousness is fully restored, the following symptoms appear:

Disorders of the neurological type, especially with a severe concussion of the brain, the following are observed:

pain when moving sideways eyeballs, inability to withdraw to the extreme position of the eye;
in the first hours after the injury, it is possible to detect a slight narrowing or dilation of the pupils, while their reaction to light is normal;
slight asymmetry of skin and tendon reflexes, they differ when called on the right and left. Moreover, such a sign is quite labile, for example, when initial examination the left one is somewhat livelier than the right one, when re-examined literally in a few hours, both knee reflexes are identical, however, there is a difference in the Achilles reflexes;
horizontal small nystagmus (tremulous involuntary movements) in the most extreme positions of the abduction of the apples of the eyes;
unsteadiness of the patient in (straight arms stretched forward to a horizontal level, legs together, eyes closed);
there may be a slight tension in the muscles of the back of the head, which disappears for three days.

Significant diagnostic criterion with a mild degree of concussion, the symptoms are reversible (except for subjective ones). All neurological signs disappear within a week. Asthenic complaints of dizziness, bad memory, headache, weakness, fatigue are not included in this account, as they may persist for some time.

It should also be noted that concussion of the head is never accompanied by fractures of the cranial bones, even if it is a small crack. If there is a fracture of the bones, the diagnosis in any case is at least mild degree brain injury.

How is the severity of harm to health detected in a concussion of the brain?

Diagnosis of pathology

This diagnosis is almost entirely clinical, since clinical signs become the main criteria for making the diagnosis. It is quite difficult to recognize the disease in cases where there are no witnesses to what happened, since most of the complaints in this condition are subjective in nature, the patient himself does not always remember the change in consciousness. In such a case come to the rescue external damage heads.

The degree of concussion in adults is established on the basis of anamnesis data on the time of loss of consciousness and trauma, patient complaints, the results of a neurological examination and instrumental examinations. In the immediate period after the injury in the neurological status, unstable and slight asymmetry of reflexes, small-scale nystagmus are observed, in young victims - Marinescu-Radovic syndrome (muscular homolateral contraction of the chin against the background of irritation of the elevation thumb hands), sometimes - mild meningeal (shell) symptoms. Since concussions can hide more serious brain damage, great importance is given to the observation of a person in dynamics. When correct established diagnosis deviations established during examination by a neurologist disappear 3-7 days after the incident.

Diagnosis in children and the elderly

Particular attention should be paid to diagnosing concussion in infants and children. early age, since it often passes without disturbance of consciousness:

the skin turns pale at the time of injury (primarily the face), the heart rate increases, after which drowsiness and lethargy appear;
in infants, vomiting and regurgitation occur during feeding, sleep disturbance and anxiety are noted; all manifestations disappear after 2-3 days;
in preschool children younger age most often, a concussion resolves without loss of consciousness, and the condition generally improves within 2-3 days.

In older patients, the initial loss of consciousness during a concussion is much less common compared to middle-aged and young age. At the same time, quite often there is a pronounced disorientation in time and space. Headaches often have a pulsating character and are localized in the occipital region. Such disturbances are noted from three to seven days, they are characterized by strong intensity in patients who suffer from hypertension. In this case, patients should be given Special attention during the examination.

In concussion, additional diagnostic methods are carried out for differential diagnosis to confirm the functionality of changes in the brain of the head. With any traumatic brain injury of a more severe nature, structural disorders are found in the brain, but this does not happen with a concussion.

For example, if the patient has tension in the muscles of the back of the head, which is a symptom of irritation meninges, there is a need to confirm the absence of subarachnoid hemorrhage. For this purpose, a spinal tap. With a concussion of the brain, the results of the analysis of the obtained cerebrospinal fluid from normal indicators do not differ, which makes it possible to exclude such a diagnosis as subarachnoid hemorrhage (if any, blood impurities are found in the cerebrospinal fluid).

Computed tomography as the main research method with craniocerebral injuries, also with concussion does not detect pathological changes thus confirming the correctness of the diagnosis. By analogy, neither echoencephalography nor MRI determines abnormalities if a person has a concussion.

The next retrospective confirmation of the correct diagnosis is the disappearance of neurological symptoms within a week after the injury to the victim. With a mild degree of concussion, they disappear almost immediately.

First aid to the victim

If the victim in unconscious need to call an ambulance immediately. The unconscious patient should be placed on the right side on a hard surface with elbows and legs bent. Tilt your head up, turn to the ground - this position allows you to provide excellent airway through the respiratory tract, prevents aspiration, that is, inhalation into Airways foreign matter, fluid during vomiting.

In case a person has a wound on his head there is blood, you need to apply a bandage to stop it. If the victim regained consciousness or there was no fainting at all, he should be laid horizontally, raise his head, monitor consciousness all the time and prevent him from sleeping.

Not everyone knows what the severity of a concussion is. It is important to remember that all patients with a head injury, regardless of their state of health and severity, must be taken to a trauma center. The traumatologist will decide whether they can be under outpatient observation by a neurologist, or whether hospitalization in the neurological department is required for the purpose of monitoring and diagnosing the condition.

It should also be noted that if the victim loses consciousness and it is impossible to self-determination severity, it is recommended not to touch it at all, not to try to turn it over again or turn it over. If there are factors that threaten human life, for example, bulk substances, liquids, small objects that can enter the respiratory tract, they must be eliminated.

Medical therapy

In the case of 1 and 2 degrees of concussion, drug treatment should be careful. It is mainly necessary to prescribe symptomatic drugs to the patient:

painkillers to relieve headaches combined preparations such as "Solpadein", "Pentalgin", anti-inflammatory nonsteroidal drugs);
drugs to relieve dizziness ("Platifillin" with "Papaverine", "Vestibo", "Betaserc");
sedatives (to calm the nervous system), their range is quite wide, depending on the individual need in each case: from plant extracts to tranquilizers;
with insomnia - sleeping pills;
general strengthening drugs (antioxidants, vitamins, tonics).

Metabolic maintenance of the brain is carried out through neuroprotectors. These include large group medicines. For example, it can be Nootropil (Piracetam), Pantogam, Encephabol, Glycine, Picamilon, Actovegin, etc.

The patient, on average, will have to spend in stationary conditions about a week, and then he is discharged and treated on an outpatient basis. In addition to symptomatic drugs at this time, drugs are prescribed that improve the blood supply to the brain of the head (Nicergoline, Trental, Cavinton, etc.).

Some patients will need a month of treatment for absolute recovery. medicines, others - three months. But in any case, if all the points listed above are observed, recovery occurs.

Within a year after the concussion has occurred, it is necessary to periodically be examined by a neurologist who will conduct dispensary observation behind the patient.

Is outpatient treatment possible for different degrees of severity of concussion?

Ambulatory treatment

Despite the fact that a concussion is classified as a mild traumatic brain injury, it requires mandatory treatment in an inpatient setting. This is due to the unpredictability of the course of the post-traumatic period, since there are situations when a patient has subarachnoid hemorrhage or intracranial hematoma(of course, this rarely happens, but it is possible). When the patient is on outpatient treatment he may not notice the first signs of a deterioration in his condition, which is fraught with a risk not only for health, but also for life. Staying in the hospital, he will be provided with qualified medical assistance throughout the entire period of treatment.

Actions after a concussion: treatment at home

The most important thing in the treatment of a concussion of the head is to adhere to bed rest, prevent mental and physical exercise especially in the early days good rest and dream. If the patient follows all the doctor's recommendations and starts treatment on time, a concussion almost always ends in an absolute recovery, his ability to work resumes.

Some victims may still have residual effects of the injury over time. Among them - a decrease in concentration, high fatigue, irritability, depressive disorders, headaches, memory disorders, sleep disorders, migraine. As a rule, everything indicated symptoms after a year they soften, but it happens when they bother the victim all his life.

Within a month after receiving a concussion, it is undesirable to do difficult physical work, you need to limit sports activities. Violation of bed rest is strictly prohibited, it is best to refuse to be at the computer, watch TV and read books for a long time. It is recommended to listen to calm music, but do not use headphones.

The prognosis depends on the severity of harm to health during a concussion.

Forecast

In 97% of all situations of concussion, a person recovers completely, without any consequences. The remaining three percent of cases are characterized by the development of postconcussion syndrome, which consists in various asthenic manifestations (impaired concentration, memory, increased anxiety and irritability poor tolerance different loads, dizziness, recurrent headaches, disturbances in appetite and sleep, etc.).

Statistically, there used to be a much higher percentage negative consequences concussion. Most likely, this is due to the fact that there was no computed tomography, some mild head brain contusions were defined as concussions. A bruise always damages the brain tissue, so it has consequences more often than functional changes.

We looked at the severity of injury in concussion.