Concussion: symptoms, treatment

Concussion refers to the most common craniocerebral trauma. His share is up to 80% of all skull injuries. Every day in Russia, according to statistics, more than , 00 people get a concussion. By itself, this trauma does not cause structural macroscopic changes in the brain. The resulting disorders in the concussion of the brain are purely functional. The concussion of the brain does not carry a danger to human life.

It may seem that, in view of the ease and functionality of this injury, it can not be treated at all, and it is not necessary to visit the doctor. This is a very erroneous opinion. Concussion of the brain, although it refers to minor craniocerebral injuries, nevertheless, being untreated, can leave behind some unpleasant consequences, which can complicate the life of the patient. From this article you can learn about the main symptoms, methods of treatment of concussion of the brain and possible consequences.

Concussion of the brain often occurs in young people, children and adolescents. This is due to childish pranks and adolescent recklessness, and in adults - by road, domestic and industrial injuries. Moreover, it should be taken into account that the concussion of the brain occurs not only with a direct blow to the head or a blow to the head. This trauma also occurs indirectly, for example, when, slipping, a person falls on the buttocks. The shock wave then darts to the skull, which can cause a concussion.

What is the basis of concussion?

The very name of the injury speaks for itself: under the influence of mechanical force, the brain shakes inside the skull. At the same time, the cortex of the cerebral hemispheres with the stem (deeper lying) divisions is temporarily disintegrated, there are disturbances in the neurons at the cellular and molecular level. Also there is a spasm of blood vessels with their subsequent expansion, which means that the blood flow changes for a while. All this causes the violation of brain functions and the appearance of various nonspecific symptoms. In the treatment after normalization of the processes in the brain, all functions return to normal, and the symptoms disappear.

Symptoms

Concussion of the brain is characterized by such symptoms:

• oppression of consciousness immediately after the impact of traumatic force. Moreover, it is not necessarily a loss of consciousness, perhaps stunning (sopor), as if incomplete consciousness. The disturbance of consciousness is brief and takes from a few seconds to several tens of minutes. Most often this interval is up to 5 minutes. If a person at this time was alone, then he may not report a loss of consciousness, as he may not remember this;
• memory impairment (amnesia) on the events preceding the concussion, the concussion itself and a short time after it. Memory is quickly restored;
• a single vomiting immediately after an injury. Vomiting has a cerebral genesis and is usually not repeated, which is used as a clinical criterion for distinguishing a concussion from a bruised brain contusion of mild degree;
• increased or slowed heart rate, increased blood pressure for some time after injury. Usually these changes pass independently and do not require medical correction;
• rapid breathing immediately after a concussion. Respiration normalizes before the cardiovascular system, so this symptom may go unnoticed;
• the body temperature does not change (the absence of changes is also considered as a differential diagnostic criterion for the brain contusion);
• the so-called "game of vasomotors." This condition, when the pallor of the skin of the face gives way to reddening. It arises from the violation of the tone of the autonomic nervous system.

After complete recovery of consciousness, the following symptoms occur:

• headache (can be felt both in the place of impact, and throughout the head, has a different character);
• dizziness;
• noise in ears;
• the flush of blood to the face, which is accompanied by a feeling of heat;
• sweating (constantly wet palms and feet);
• general weakness and malaise;
• sleep disturbance;
• swaying while walking;
• reduced concentration, rapid mental and physical fatigue;
• increased sensitivity to loud sounds and bright light.

Neurological disorders occur as follows:

• pain when moving the eyeballs to the sides, the inability to take your eyes to the extreme position;
• In the first hours after the injury, a slight enlargement or narrowing of the pupils can be detected. The reaction of the pupils to light is normal at the same time;
• slight asymmetry of tendon and skin reflexes, that is, they are different when called left and right. Moreover, this sign is very labile, for example, during a primary examination, the right knee reflex was somewhat more alive than the left one, at repeated examination in several hours both knee reflexes are identical, but there was a difference in the achilles reflexes;
• small horizontal nystagmus (involuntary trembling movements) in the most extreme branches of the eyeballs;
• shakiness in the Romberg pose (legs together, straight arms extended forward to horizontal level, eyes closed);
• there can be a slight tension of the occipital muscles, which passes during the first 3 days.

A very important diagnostic criterion for concussion of the brain is the reversibility of all symptoms (except subjective). That is, all neurological manifestations disappear after a week. Asthenic complaints of headache, dizziness, weakness, poor memory, fatigue, and so on, do not enter into this account, since they may persist for some time.

It should also be noted that the concussion of the brain is never combined with fractures of the skull bones, even if they represent a small crack. If there is a fracture of the skull bones, the diagnosis is always, at the very least, a mild brain contusion.

Diagnostics

The diagnosis of a shock is made by a doctor on the basis of objective survey data.

The concussion of the brain is almost completely a clinical diagnosis, because the main criteria for its formulation are clinical symptoms. Recognition of the disease is very difficult in cases where there are no witnesses to what happened. After all, most of the complaints under this condition are subjective, and the fact of the change of consciousness does not always remember the patient himself. In this case, visible damage comes to the aid in the head area.

Additional methods of investigation for concussion of the brain are carried out with the purpose of differential diagnosis, that is, to confirm the functionality of changes in the brain. Because, with any more severe brain injury, the brain shows structural lesions, which does not happen with a concussion. So, for example, if the patient has a tension in the occipital muscles, which is a sign of irritation of the brain membranes, it becomes necessary to confirm the absence of subarachnoid hemorrhage. For this purpose, a spinal puncture is performed. The results of the study of the obtained cerebrospinal fluid with a concussion of the brain do not differ from the normal parameters, which makes it possible to exclude the diagnosis of subarachnoid hemorrhage (when it is found in the cerebrospinal fluid admixture).

Computed tomography, as the main research method for craniocerebral injuries, with concussion of the brain also does not find pathological changes, which confirms the correctness of the diagnosis. By analogy - neither MRI nor echoencephalography reveal abnormalities in concussion.

Another retrospective confirmation of the correctness of the diagnosis is the disappearance of neurological symptoms within a week from the time of injury.

Treatment

Concussion of the brain, although it refers to light craniocerebral injuries, but requires compulsory treatment in a hospital. This is due to the unpredictability of the course of the post-traumatic period, since there are situations when against the background of signs of concussion of the brain, the patient develops an intracranial hematoma or a subarachnoid hemorrhage (rarely, of course, but this is possible). If the patient is on an outpatient treatment, the first signs of deterioration may not be noticed by him, and this is fraught with risk even for life. Round-the-clock stay in the hospital reliably provides qualified medical care throughout the stay.

During the first few days with concussion, you must observe bed rest. If there are signs of improvement in the state, then the regime is expanded.

Drug treatment with a concussion of the brain should be gentle. In general, the appointment of symptomatic agents is required:

• pain relievers to eliminate headache (non-steroidal anti-inflammatory drugs, combined preparations like Pentalgin, Solpadein);
• means to combat dizziness (Betaserk, Vestiubo, Platifillin in combination with Papaverin);
• sedatives ("calm" the nervous system). The spectrum is quite wide depending on individual needs: from plant extracts to tranquilizers;
• hypnotics for insomnia;
• fortifying agents (vitamins, antioxidants, tonic drugs).

Metabolic support of the brain is carried out with the help of neuroprotectors. This is a vast group of medicines. It can be, for example, Piracetam (Nootropilum),Encephabol, Actovegin, Pikamilon, Glycin, Pantogam and others.

On average, the patient has to spend about a week in a hospital, in the future the patient is discharged for outpatient care. In addition to symptomatic remedies, in this period, funds are used that improve the blood supply to the brain (Cavinton, Trental, Nicergoline, and a number of others).

One patient for complete recovery requires 1 month of taking medicines, another - 3 months. However, in any case, with observance of all the above listed points, recovery comes.

Within one year after the suffered concussion of a brain it is required to visit periodically the neuropathologist with the purpose of dispensary supervision.

Effects

97% of all cases of concussion of the brain result in complete recovery without consequences. In the remaining 3% of cases, it is possible to develop a so-called postcommunity syndrome (from the Latin "Сommotio" - a concussion). It consists in various kinds of asthenic manifestations (weakening of memory, concentration of attention, increased irritability and anxiety, poor tolerance of any load, periodic headaches, dizziness, sleep and appetite disturbances, and so on).

Previously, according to statistics, there was a much larger percentage of the consequences of a brain concussion. This, apparently, is due to the fact that there was no such method of research as computed tomography, and some of the cases of mild brain contusions were diagnosed as a concussion. A brain contusion is always accompanied by damage to the brain tissue, which, of course, often has consequences than functional changes.

Thus, concussion is the most common craniocerebral trauma, which, at the same time, is the easiest. All changes in the brain are functional, and therefore completely reversible. Diagnosis is made according to clinical manifestations. Treatment is conducted in a hospital with a minimum of medications. The concussion of the brain almost always ends in recovery.

Dr. E. ABOUT. Komarovsky tells of a brain concussion:

TV channel OTC, heading "PRO health" on the topic "Concussion":