Symptoms of concussion in the child's brain

Among all diseases of childhood, in first place are SARS and injuries. Craniocerebral trauma beats all records of hospitalizations in children's medical institutions, leaving the leading place for concussion of the brain (90% of cases).

The child differs from an adult in that it is not a "small adult". He actively learns the world, he has no fear of uncertainty and pain. When falling, there is no protective reflex of "hand insurance and natural curiosity and restlessness in the absence of control by parents can lead to sad consequences. We will tell in this article about the symptoms of brain concussion in a child.

There is a specificity of craniocerebral trauma, depending on age. Trauma in infancy is associated with a fall from the height (changing table, strollers, beds, etc.), with just a second, and the mother can even stand side by side. Therefore, the baby can never be left alone on the bed or changing table, it is better to put it in the arena.

When the child begins to walk, it is characterized by falling from the height of his own growth, trees, windows, roofs and all that you can climb.

Most often head injuries occur in schoolchildren (in 45% of cases), often during careless games. Since children seldom lose consciousness, fear of punishment can hide the very fact of damage. And if the child is small and was under the care of nannies or neighbors, they often also do not report what happened. The peculiarity of the child's trauma is the so-called "Shaken Child Syndrome" - brain damage in the absence of external head injury (typical for children under 5 years old). Such injuries are characteristic of sudden acceleration or deceleration - when jumping from height to foot, excessive rough handling.

Symptoms of brain concussion in children

Some time after the injury, the child may have complaints of nausea and vomiting.

The main feature of the concussion is that with this lesion there is no serious brain damage, and the changes are reversible and are found only at the molecular level. Children have their own peculiarities of anatomy: the presence of fontanelles, the suppleness of the skull bones, the hydrophilicity of the brain tissue, the high regenerative capacity. Based on these features, the manifestations of concussion of the brain can differ significantly from adults, and especially this depends on the age of the child.

At the infantsa concussion can occur almost asymptomatically. Loss of consciousness does not happen, the child screamed and fell asleep. During the day, alerting increased drowsiness, refusal to eat, and the presence of vomiting or regurgitation should necessarily serve as an excuse for hospitalization. Naturally, the baby does not complain of a headache, and the manifestation of it can be unmotivated anxiety and crying, refusal to eat and bad sleep.

The advantagein preschool childrenis the fact that they are already talking and can describe the very fact of injury and their feelings. Loss of consciousness - just "turned off" for a few seconds. The child complains of nausea and vomiting, not associated with eating, but appeared immediately after the injury. The victim looks pale, the pulse is fast or slow, the arterial pressure is unstable, and excessive sweating is possible. Changes in behavior will not keep you waiting: the child is whimsical, tearful and sleepy.

At schoolboyssymptomatology is similar to adults, i.e., loss of consciousness for several minutes with the presence of retrograde amnesia, dizziness, nausea, vomiting, diffuse headache, lability of pulse and blood pressure, easy nystagmus. A feature of this age is that the child can conceal the fact of injury, so that he is not scolded and, unfortunately, valuable time will be lost.

When falling on the back of the head, a so-called posttraumatic blindness is possible, which can develop after a while. Its development is associated with the presence of cortical centers of vision, which are located in the occipital region. It passes by itself.

A traumatic event took place, the child cried, calmed down, fell asleep, and through for some time there may be a deterioration, so do not treat lightly to complaints, especially if they are accompanied by nausea and vomiting.

Diagnostic measures

If there is a head injury, the child should call an ambulance. In the waiting room he will be examined by a neurologist, traumatologist, and, if necessary, a neurosurgeon. In addition to the generally accepted mandatory tests, it is necessary to conduct additional examinations. These include:

• Radiography of the skull in two projections (performed for the detection of bone lesions. In young children, even with a satisfactory condition, it is possible to detect linear fractures of the skull bones);
• neurosonography of the brain - examination by ultrasound. It is relevant for children under the age of two. With its help, you can ascertain the swelling of the brain substance, identify areas of hemorrhage, contusion of the brain tissue, evaluate the ventricular system, the presence of hematomas. The advantage is the absolute safety of the procedure and the possibility of multiple execution;
• echo-encephalographic study - an auxiliary method that allows one to indirectly judge the presence of volumetric formations in the cranial cavity;
• Computed tomography is a modern X-ray method for studying any damage to the cranium. According to CT, it is possible to accurately verify the diagnosis. A significant disadvantage is the high cost and lack of it in most medical institutions;
• magnetic resonance tomography is a very accurate modern and expensive method of studying diseases of the central nervous system. For the study of craniocerebral trauma, it fits less than CT, because with it the skull bones are poorly visualized.
• an electroencephalographic study of the brain - with its help you can evaluate the bioelectric currents of the brain. It is used to identify foci of epileptic readiness, which are responsible for the occurrence of convulsive seizures;
• lumbar puncture - diagnosis of cerebrospinal fluid (spinal fluid that flushes the spinal cord and brain). It is carried out only on strict indications. With its help, traumatic injuries in the brain (trauma, hemorrhage) and inflammatory lesions are evaluated.

Therapeutic tactics

As already mentioned above, in children, brain concussion is not the same as in adults, and accordingly the approach to treatment is different. The cornerstone of treatment is mandatory hospitalization in the hospital - even if it seems that everything is fine, and the head does not hurt anymore, and the child does not cry. This is the peculiarity of the children, that everything seems not so bad, and after a while the condition can sharply worsen. Therefore, the child must necessarily be examined by a doctor (neuropathologist, traumatologist), if necessary, to conduct a survey and, even if everything is good, still go to the hospital under observation. Parents should clearly realize that, refusing hospitalization, they are fully responsible for the health of the child, moreover, a criminal offense. A lucky or unlucky - it's only God knows. The purpose of hospitalization is to prevent the development of possible complications and a rapid response to these complications.

Treatment in the hospital takes an average of a week, then the child is discharged home, where for several more weeks he observes the protective regime. Safety mode: psycho-emotional stress should be avoided, bed rest (as far as possible in the case of children, even without jumping and running), refusal of TV and games for computer.

From medicamental therapy the following groups of drugs are appointed:

• diuretic (to eliminate cerebral edema);
• sedatives;
• painkillers;
• at the stage of recovery may be prescribed nootropics and multivitamin preparations.

The concussion of the brain is a reversible phenomenon, which will take place in three weeks, and the child will return to his habitual way of life.

Dr. E. ABOUT. Komarovsky talks about a brain concussion in children: