Symptoms after a concussion. Concussion: Symptoms and Treatment

How to understand that you have had a concussion? What to do and where to go? Is it possible to play sports after a concussion, and what should be the general treatment? Traumatologist Dmitry Snopkov answers these and other questions in detail.

Dmitry Snopkov

Concussion is a form of closed traumatic brain injury. It is generally easily reversible. dysfunction of the brain, resulting from a bruise, blow or sudden movement of the head. It is believed that due to a concussion, there is a temporary disruption of interneuronal connections.

As a result of contact of the substance of the brain c bones of the skull, as a rule, occurs:

• changes in some physical or chemical properties of neurons (brain cells), which can change the spatial organization of protein molecules;
• the entire substance of the brain is susceptible to pathological effects;
• temporary disconnection of relationships and signal transmission between synapses (synapse is the place of contact between two neurons or between a neuron and the receiving effector cell. Approx. ed.) neurons, cells and cerebral divisions. This contributes to the development of functional disorders.

Depending on the severity of the patient's condition and clinical symptoms, three degrees of concussion are distinguished:

• mild concussion... HThere is no disturbance of consciousness, the victim may experience disorientation, headache, dizziness, nausea during the first 20 minutes after the injury. After that, the general state of health returns to normal. Perhaps short-term temperature rise (37.1-38 ° C);
• moderate concussion. There is no loss of consciousness, but there are pathological symptoms such as headache, nausea, dizziness, disorientation. They all last more than twenty minutes. There may be short-term memory loss (amnesia), most often retrograde amnesia with the loss of a few minutes of memories before the injury;
• severe concussion. It is necessarily accompanied by loss of consciousness for a short period of time, usually from several minutes to several hours. The victim does not remember what happened - retrograde amnesia develops. Pathological symptoms disturb a person for one to two weeks after an injury (headache, dizziness, nausea, fatigue, disorientation, impaired appetite and sleep).

Concussion symptoms

The first thing to remember is that even a mild head injury can lead to a concussion. Consequently, the fact of the presence of an injury may already indicate a possible concussion.

Symptoms of a concussion include:

• short-term confusion of consciousness;
• dizziness. It is observed at rest, and with a change in the position of the body, turning or tilting the head, it increases. Its cause is a violation of blood circulation in the vestibular apparatus;
• headache of a throbbing character;
• noise in ears;
• weakness;
• nausea, single vomiting;
• lethargy, confusion, delayed incoherent speech;
• diplopia (double vision). When trying to read, pain is felt with eye movement;
• photophobia. The eyes can react painfully to normal light levels;
• hypersensitivity to noise, even mild sounds can be annoying;
• violation of coordination of movement. The easiest way to diagnose is that a person standing with their eyes closed and their hands raised to the sides should touch the tip of the nose with their index finger. The second option is to put one foot behind the other and walk in a straight line, close your eyes, raise your arms in different directions and take a few small steps. It is not recommended to do this on your own in order to avoid repeated injury.

How to properly diagnose a concussion:

• the victim complains of pain when moving his eyes to the sides, cannot take them to the extreme position;
• in the first hours after the injury, slight dilation or constriction of the pupils may be found. The reaction of the pupils to light is normal;
• slight asymmetry of tendon and skin reflexes - they are different on the left and right. This sign is very labile (changeable. - Approx. ed.). For example, during the initial examination, the right knee reflex may be somewhat more lively than the left, upon repeated examination - after a few hours - both knee reflexes are identical, but there is a difference in the Achilles reflexes;
• small horizontal nystagmus (involuntary trembling movements), if you take your eyes to the most extreme positions. The patient is asked to trace a small object in the examiner's hands. In extreme positions, slight return movements of the pupil are noticeable;
• unsteadiness in the Romberg position (legs together, straight arms extended forward to a horizontal level, eyes closed);
• there may be a slight tension in the occipital muscles, which disappears within the first three days.

Particular attention should be paid to the diagnosis of concussion in infants and young children - inthem, it often proceeds without impairment of consciousness:

• at the time of injury, the skin turns pale (primarily of the face), the heartbeat increases, then lethargy, drowsiness appears;
• infants have regurgitation during feeding, vomiting, anxiety, sleep disorders. All manifestations disappear in 2-3 days;
• in children of younger (preschool) age, concussion often proceeds without loss of consciousness. The general condition improves within 2-3 days.

In older people, primary loss of consciousness with a concussion is much less common than in people of young and middle age.At the same time, pronounced disorientation in space and time is quite often manifested.Headaches are often pulsating in nature, localized in the back of the head. Such violations last from 3 to 7 days, differing in significant intensity in persons suffering from hypertension. Such patients should be given more careful attention during the examination.

First aid for concussion

If the victim is unconscious, call an ambulance immediately.An unconscious person should be laid on a hard surface on the right side with bent legs and elbows. Tilt his head up and turn towards the ground - this position will provide good air permeability through the respiratory tract and prevent aspiration (penetration of foreign substances into the respiratory tract during inhalation. - Approx. ed.) fluids in case of vomiting.If the victim is bleeding from a head wound, a hemostatic bandage should be applied.If the person regained consciousness or there was no fainting at all, lay him down horizontally with his head elevated; constantly monitor your consciousness, do not let the victim fall asleep.

It's important to know: vAll patients with head trauma - regardless of severity and health - should go to the emergency room. By the decision of the traumatologist, they can be sent for outpatient observation to a neurologist or hospitalized in the neurological department for diagnosis and monitoring of the condition.

Remember: if a person is unconscious and you cannot determine the severity on your own, it is best not to touch him or try to turn or turn over again. If there are factors that threaten his life, for example, liquids, loose substances, small objects that can enter the respiratory tract, they must be eliminated.

What to do after a concussion

The main thing in the treatment of concussion is adherence to bed rest, adequate sleep and rest, the absence of any physical and mental stress, especially in the first few days.If the patient followed all the medical recommendations and the treatment was started on time, the concussion almost always ends in full recovery and restoration of working capacity.

Some patients may still have long-term residual effects of trauma. Among them - decreased concentration of attention, irritability, increased fatigue, depressive disorders, memory impairments, persistent headaches, migraines, sleep disturbances. As a rule, after the first year, all these symptoms are alleviated, but there are times when they bother a person throughout his life.Prescribe drugs that improve cerebral circulation, relieve headaches, relieve dizziness and nausea. In parallel, drugs are used that have neuroprotective properties and improve the course of various processes in the brain. They also use sedatives and sleeping pills.At the stage of rehabilitation, general tonic and nootropic drugs are prescribed.

For a month after the concussion, it is not recommended to do heavy physical work, it is necessarylimit sports. Hand in no case should you break bed rest, it is recommendedrefuse to watch TV, stay at the computer and read books for a long time. Betterlisten to calm music, whiledo not use headphones.

A concussion is a sudden, short-term dysfunction of the brain. Concussion usually occurs after a headbutt or fall. Sometimes there are no external signs of injury: no bumps, no bruises, no wounds. And there is a concussion.

Concussion symptoms may not appear immediately after injury. A few weeks will pass, and your head will start to hurt, dizziness will appear, and you will not understand why.

Due to trauma, the work of the reticular activating system is disrupted. It is this system that is responsible for consciousness, regulates sleep and awakening, and helps to highlight the necessary information from the general noise.

When the brain temporarily changes its habitual position due to a shock, there is interference in the electrical activity of the nerve cells that form the reticular activating system. Concussion symptoms appear.

When to Seek Help

After a head injury, a person should be examined by a doctor. Even if there is no visible damage to the skull, the brain could be severely damaged. The doctor must exclude hemorrhage or cerebral edema (these are more complex consequences of trauma).

You cannot diagnose concussion yourself and think that everything will pass.

Concussion symptoms fall into several categories because trauma affects almost the entire body.

Thinking and Memory Concussion Symptoms

1. The person lost consciousness for a few seconds or minutes.
2. Doesn't remember what happened to him and what happened immediately after the injury.
3. Is inhibited, slowly answers questions, does not understand what is being said to him.
4. Can't concentrate.
5. Difficulty reading or writing.
6. Can't remember new information.

Symptoms of a concussion from the general condition of the body

1. Headache.
2. Violations: flies fly before the eyes, the image is double and blurred.
3. Nausea and vomiting.
4. Dizziness.
5. Sensitivity to bright light and noise.
6. Balance problems, wobbly gait.
7. Sleepiness or, conversely, insomnia.

Emotional and Mood Shake Symptoms

1. Unreasonable irritability.
2. Depression.
3. Increased emotionality: a person's mood changes quickly.
4. Fatigue, lack of energy.

You can notice the trauma in a child if his behavior has changed: the baby does not respond to external stimuli, cannot concentrate, is capricious, cries, refuses water and food.

If a person is sick, he cannot stay awake, falls asleep, does not answer questions, do not try to take him to the hospital on your own, call an ambulance.

If a drunk person or taking tranquilizers is injured, he must be taken to the emergency room, because the symptoms of a concussion in such a situation are easy to miss.

What to do while you are waiting for doctors

1. Apply a cold compress to the impact site for 20 minutes to reduce swelling. Wrapping a bag of frozen vegetables in a towel is the quickest way to make an ice pack.
2. Lay the person on their side, bend their legs, place one palm under the head, and bend the other arm at the elbow. The position must be stable so that the person does not accidentally roll over onto his back if consciousness is switched off.
3. Don't give medicine.

Important! If someone is unconscious, then by default they are considered to have a serious head or neck injury. Do not shake, overturn, or carry the person. Call an ambulance.

Signs of complications of a concussion

Head injuries are insidious in that symptoms may not appear immediately. Even if a person with a concussion was sent home from the emergency room, it is imperative in these cases:

1. The headache does not go away and increases.
2. Severe weakness rolls over, coordination is impaired.
3. Vomiting is repeated.
4. Speech becomes slurred.
5. One pupil becomes larger than the other.
6. The person cannot be woken up.

How to treat a concussion

There are three degrees of severity of concussion. With mild, you can be treated at home, and moderate and severe means that you need to lie down in the hospital.

A person with a concussion should not be left alone for two days, because complications may appear at this time.

The main principle of treatment is rest. After an injury, you need to rest more and not worry. The patient should not read, watch TV, play computer games. You can listen to music, but without headphones.

Return to work only when you are fully recovered. You will also have to wait for the cure to get behind the wheel of a car or ride a bike. Contact sports - after the permission of the attending physician.

Full recovery will take from three months to six months.

How to protect yourself from concussion

Concussion occurs most often in children between the ages of 5 and 14. The causes of injury are sports and cycling.

Adults earn concussions in road accidents and falls. It is also a common injury among athletes, especially if the sport is extreme or contact (boxing, rugby).

You don't have to fall on your own to get a concussion. It is enough to catch something heavier than a soccer ball with your head.

It seems that no one is immune from an accident. But conventional safety precautions reduce the chances of a concussion in the head. What to do?

1. Always wear protective equipment when playing sports. Even if you are just cycling, wear a helmet.
2. On a motorcycle - only wearing a helmet.
3. Do any contact sports (boxing, rugby, hockey) only under the supervision of a professional coach.
4. Always wear your seat belt.
5. Keep stairs clear and clear of snow from porch steps.
6. Use stable supports to change the bulb.
7. Always clean up any puddles on the floor immediately. Don't wait for someone to slip.

Concussion is the mildest form of traumatic brain injury, often accompanied by short-term loss of consciousness. Concussion can be caused by traffic accidents, sports, domestic, industrial and criminal injuries. This type of traumatic brain injury is never accompanied by organic changes in the brain.

Concussion symptoms

With a concussion, the patient is worried about severe headache, dizziness, nausea and vomiting.

• Confusion of consciousness, lethargy;
• headache, dizziness, ringing in the ears;
• incoherent inhibited speech;
• nausea or vomiting;
• impaired coordination of movements;
• diplopia (double vision);
• inability to concentrate attention;
• fear of light and sound;
• memory loss.

There are several types of concussion:

• 1 degree (lungs) - symptoms persist for no more than 15 minutes, while the victim does not have an episode of loss of consciousness;
• Grade 2 (moderate) - the symptomatology persists for more than 15 minutes, but, as with a mild degree of concussion, there is no episode of loss of consciousness;
• Grade 3 (severe) - the victim had a loss of consciousness (even for a few seconds), regardless of how long the symptoms persist.

Diagnostics

Diagnosis of a concussion is usually straightforward for a neurologist. Anamnesis and examination data are sufficient to suggest that the patient has this condition. However, an examination is recommended in the event of a concussion to rule out more severe traumatic brain injury.

X-ray of the skull and cervical spine is necessary in order to exclude fractures and fissures of the bones of the skull, as well as displacement and fractures of the cervical vertebrae.

Electroencephalography is a research method that allows you to identify the most insignificant dysfunctions of the cerebral cortex.

In difficult cases, computed tomography may be needed, with the help of which almost any abnormalities in the structure of the brain can be detected.

Treatment

Each victim, regardless of the estimated severity of the disease, should be referred to a hospital to clarify the diagnosis and exclude more serious brain damage.

In the acute period of trauma, patients should receive treatment in the neurosurgical department. Patients are shown strict bed rest for 5 days, which subsequently expands depending on the clinical course of the disease. With the effectiveness of the prescribed therapy and the absence of complications, discharge from the hospital is possible 7-10 days after injury. Further, the patient needs to undergo outpatient treatment for 2 weeks.

Drug therapy for concussion is aimed at normalizing brain functions and relieving symptoms of the disease (headache, dizziness, insomnia). Usually, pain relievers are prescribed (Analgin, Baralgin, Pentalgin, etc.), antiemetic drugs (Cerucal), sedatives (motherwort, Corvalol, Phenazepam, etc.)

In addition to symptomatic treatment, therapy is usually prescribed, aimed at restoring impaired brain functions and preventing complications. The appointment of such therapy is possible no earlier than 5-7 days after injury. Patients are advised to take nootropic (Nootropil, Piracetam) and vasotropic (Cavinton, Theonikol) drugs. They have a beneficial effect on cerebral circulation and improve brain activity. Their use is indicated for several months after discharge from the hospital.

Also, patients are shown vitamin therapy and taking tonic drugs (eleutherococcus extract, ginseng root, lemongrass).

Prevention measures

To reduce the risk of concussion, a safety helmet should be worn when engaging in traumatic sports.

It is almost impossible to predict and prevent concussion, but if you follow some guidelines, you can reduce the likelihood of injury.

It should be remembered that engaging in traumatic sports (boxing, hockey, football, etc.) increases the likelihood of head injury.

When rollerblading, skateboarding, horse riding, you must use head protection - a helmet with a special insert. The size and use of the helmet must be correct.

When driving a car, it is necessary for all passengers in the car to wear a seat belt. Children should be transported in special restraints (infant car seat, car seat). After drinking alcohol, taking certain medications that affect the reaction speed and concentration, you should not drive a car.

The number of people seeking medical care as a result of traumatic brain injury increases dramatically in the winter, when falls on slippery streets are likely. The use of special anti-slip devices for shoes is recommended, and the use of a cane with a sharp tip is recommended for the elderly.

Which doctor to contact

In case of a concussion of the brain, it is necessary to call an ambulance, which will take the patient to the neurosurgical department. Additionally, he will be examined by a neurologist, an ophthalmologist, and, if necessary, a traumatologist.

At the same time, there are no visible changes in brain tissue (for example, with computed tomography of the brain), all violations occur at the cellular and subcellular level.

In severe cases rupture of blood vessels in the brain may occur but, which leads to hemorrhage, which can end in coma and death, since compression of vital centers in the brain can occur.

Also, in some cases, observe cerebral edema- This is an increased accumulation of fluid in the brain tissue. Concussions are especially dangerous, in which the brain stem, which is responsible for breathing and blood circulation, is injured.

Causes of injury

All concussions, one way or another, are associated with the acceleration or deceleration of the movement of the brain inside the cranium.

Cause of concussion I can be a fall, a blow received in a fight (and not necessarily in the head), a consequence of traffic accidents, injuries received at home, during sports events or at work.

Pathogenesis

The following mechanical factors influence most of all - fixation of the head at the moment of concussion or it was in motion, the second moment is associated with a rise in intracranial pressure, which causes transient ischemia (oxygen starvation) of the brain.

All this causes different biochemical and biophysical changes in cells, which are often reversible. There are also symptoms that combine into post-concussion syndrome- This is dizziness, headaches and various manifestations of apathy and depression.

What are the signs of a concussion

What are the symptoms of a concussion?

The main signs of a concussion in adults:

1. Almost always, with SHM, a person loses consciousness. The stronger the damage, the longer the period of fainting, in extreme cases a coma occurs.
2. The manifestation of disorientation, memory is also impaired. The duration of the segment of memory loss can also be judged on the damage received.
3. Nausea, vomiting, pallor, dizziness and headache, background in the ears, blurred vision, rapid breathing are also signs of a concussion. The condition of the eyes can also say a lot - constricted or, on the contrary, dilated pupils are a sign of concussion, since the nerve pathways responsible for vision are disrupted. Also, by the reaction of the pupils to light, one can judge the degree of concussion - they react sluggishly - a weak concussion, do not react - a severe concussion. If only one icon reacts to light, one of the cerebral hemispheres is damaged.

Loss of consciousness, nausea and vomiting are always the first and main signs and symptoms of a concussion.

According to the duration of the manifestation of symptoms, three degrees are distinguished. SGM:

• Easy- the patient is unconscious for no more than 5 minutes. Signs and symptoms of a mild concussion of the brain: pallor of the skin, decreased or lack of muscle tone in the arms and legs. The heart rate can either increase or slow down. Some people vomit.
• Average- loss of consciousness from 5 to 15 minutes. Disintegration of consciousness, retrograde amnesia, nystagmus (shifting eyes), nausea and vomiting, headaches and dizziness, weakness and asthenia are observed.
• In case of loss of consciousness for an interval of more than 15 minutes or falling into a coma, they state severe degree of SHM.

Delayed symptoms- These are symptoms that appear weeks or even months after the injury. To them include:

• squeezing headache, usually appearing after a week and a half after injury, less often after a month;
• unreasonable dizziness;
• fatigue develops into asthenia;
• irritability;
• increasing memory and attention disorders;
• an unreasonable feeling of anxiety, aggressiveness, tearfulness;
• hearing loss, vision, the appearance of extraneous noise;
• stress resistance falls, there is a craving for alcoholism;
• disorder of sexual functions.

Features of concussion in children

For infants, more frequent regurgitation is characteristic, and loss of consciousness is not observed at all. There may be increased excitability, sleep is disturbed, and in the first minutes after the impact, increased pallor is characteristic.

After trauma, preschoolers are more likely to experience such "adult" symptoms like loss of consciousness, nausea and vomiting.

The child has a headache, the pulse may become faster or slower, there are jumps in blood pressure, sweating and pallor.

Sleep disturbances, tearfulness and moodiness can also be observed.

Some children experience post-traumatic blindness - immediately after injury or later, loss of vision occurs from a couple of minutes to several hours - then it goes away. The nature of this disorder is not clear.

It is worth remembering that in children, the compensatory capabilities of the body can suppress the manifestation of symptoms for a long time, but then the picture deteriorates sharply. The child can fall during the day and only in the evening the increase in symptoms will begin.

Read more about the symptoms of concussion in children in our article.

As we all know, the child's body is very mobile. Rarely, children develop without receiving blows and bruises with abrasions. Among all types of injuries, the first ...

First aid

At least the first 2-3 days of bed rest.

The best cure for SHM is this is a dream, if you have problems with it, you can take sedative medications based on valerian and motherwort.

You also need to reduce the load on the brain - it is worth giving up reading, working on a computer and watching TV for a few days.

You should also avoid bright lighting - curtains on the windows and a night light in the evening will help you with this.

A common consequence of SHM is cerebral edema - to prevent it it is recommended to drink less, leave mineral water from the drink, and exclude coffee and tea. in the diet, it is worth adhering to the fermented milk and vegetable directions, citrus fruits, bananas, walnuts are useful.

Avoid household chores, exercise, and driving for two weeks.

Treatment after a concussion

From the point of view of human physiology and anatomy, a concussion is a violation of functional connections between the nerve cells of the cerebral cortex ...

Effects

It is worth noting such effects:

1. In some patients, there is a clouding of consciousness when drinking alcohol or an infection of the body (for example, with the flu).
2. Headaches that are aggravated by physical exertion or certain bending of the body. There may be flushes of blood to the head, followed by paleness, while accompanied by sweating.
3. Loss of ability to concentrate and fatigue very quickly.
4. Uncontrolled outbursts of aggression, after which the patient experiences awareness and remorse for what he has done.
5. Seizures similar to an epileptic seizure may appear.
6. The appearance of paranoid qualities - constant anxiety, fear, worries for any reason. This leads to insomnia and general personality degradation.

Read more about the consequences in our article.

Consequences and complications after a concussion - psychosis, parkinsonism and others

A concussion is a violation of the integrity of the bones of the skull or soft tissues. An accident can happen to a person in which ...

Injury prevention

It must be remembered what:

1. When playing contact or rollerblading, cycling, ice skating, skiing, skateboarding, wear a helmet.
2. If you like to practice martial arts - pay due attention to head protection.
3. When driving a car - wear your seat belt.
4. At home, consider the situation so that you do not stumble over the elements of the interior or these elements do not fall on you. Do not block the passageways in the rooms and corridor along which you move in the dark.
5. Exercise caution in situations where there is a risk of head injury.

Remember! If you or someone close to you fell unsuccessfully or hit your head hard, do not let this incident take its course - see a doctor... If all is well, then you can sleep soundly, if not, then you can avoid all the consequences described above.

And do not pay attention to the profound statements of the learned neighbors - you got a concussion, now you will suffer headaches to death - with timely treatment, headache is observed in only 1% of patients in a year.

Video: What happens from a concussion?

What processes occur during a concussion. How to help with such an injury. The video contains answers to these and many other questions.

Concussion of the brain (CHM) is a delicate pathology that is located at the intersection of traumatology and neurology. When a person hits his head, and for several days after that experiences apathy, discomfort, absent-mindedness, diffuse headache, nausea and decreased performance, it is obvious that he has "something with the brain", or rather a concussion.

But for the doctor, there are no clinical symptoms and signs that can distinguish concussion from simulation, especially in the case when there are no witnesses, and even the fact of the accident cannot be confirmed.

Hence, there are a lot of speculations and various incomprehensible questions that arise with the possible formulation of this diagnosis, and the first of them is what to do in case of a concussion? Let's consider everything in order.

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SGM - what is it?

What is a concussion and how is it diagnosed? First of all, a concussion is a closed craniocerebral injury, or craniocerebral trauma in a commonly used abbreviation, which is often found in certificates and discharge reports.

This is the name of any injury in which the integrity of the bones of the skull is not violated, and if there is a fracture or indentation of the bones, then the space that is under the dura mater does not communicate with the environment.

In other words, if a person has an open, penetrating trauma to the skull, then it is almost always combined with either a concussion or even a contusion of the brain. Of course, its danger is much higher, since, among other things, there is a risk of a secondary infection, even under equal other conditions.

About examples of formulating a diagnosis

A concussion is a diagnosis that can easily change its place in the "hierarchy of diagnoses." A concussion can be combined with a bruise of the soft tissues of the head, a hematoma, or wounds that do not penetrate deeper than the aponeurosis. In this case, in the first place in the diagnosis (in importance) will be exactly SHM, for example, like this: "CCI, concussion, contusion of the soft tissues of the face."

But in the event that there are more serious problems, for example, fractures of the skull bones, then the concussion immediately fades into the background, since it is in this case the least severe condition.

Many people often ask: which is more severe, a concussion or a contusion of the brain? Of course, the contusion is more severe: the diagnosis of concussion can be made if the loss of consciousness is less than 5 minutes. As soon as this time exceeds 5 minutes, then the diagnosis of a brain injury, which refers to moderate and severe traumatic brain injury, is already "in progress".

It is with a brain injury that patients can be unconscious in intensive care for several days, while most patients with concussion do not lose consciousness at all. How does a concussion manifest in classic cases?

Concussion, or concussion (from Latin commotio), can occur for various reasons. So, the "leaders" of the list of reasons are spring falls of icicles from roofs, slipping on ice with a blow to the head, and road accidents. Whatever mechanism arises in this case, a typical shaking pattern is manifested by the following signs:

• Loss of consciousness for no more than 5 minutes (this "critical" time helps to assess the witnesses of the trauma "). If they are not there, then it is difficult to assess whether there is a concussion, or if we are talking about a bruise;
• The appearance of retrograde amnesia. The patient has difficulty remembering how he fell and what events preceded the immediate trauma. The longer the loss of consciousness, the longer the period that is amnesic;
• The appearance of symptoms of irritation of the meninges and centers of the cranial nerves. Most often, it is manifested by nausea, or vomiting. Vomiting, as a rule, once, which brings relief, but vomiting before this can take several hours;
• Hyperesthesia may occur: the patient is disturbed and irritated by loud light, bright sound;
• Headache. It is necessary to distinguish between local soreness of the head, which is felt at the site of the impact, and pain resulting from a concussion. As a rule, it is dull, of low or medium intensity, and is "spilled" all over the head;
• Symptoms of weakness, difficulty concentrating, appear, and performance drops sharply;
• Dizziness, "ringing" or "cotton wool" sensations in the ears may occur.

It is important to remember that the symptoms of a mild concussion can appear without any loss of consciousness, or with a momentary dullness. Sometimes the patient does not even have time to fall. In this case, there may be no amnesia and vomiting.

Could there be a temperature with a concussion?

Concussion temperature is uncommon. Of course, with a very severe traumatic brain injury, which was complicated not only by intracerebral hemorrhage, but also by the breakthrough of blood into the ventricles of the brain, a sharp rise in temperature may occur, up to 39 degrees and above.

But this is due to hyperthermia, which is fundamentally different from fever in that the basic parameters of vital activity are "unregulated", and the brain is unable to control the vital processes of the organism.

In this condition, the patient is in a deep coma, does not respond to stimuli and pain. This condition has a high potential for lethality, or a transition to a chronic vegetative status.

Also, with an open craniocerebral injury, in which the tissues are contaminated and sediment, and the integrity of the meninges is disturbed, a rise in temperature may occur associated with the development of a secondary infection. This indicates the presence of signs of purulent meningitis, which is a complication of traumatic brain injury.

Concussion in a child, features

Speaking about the symptoms of a concussion in a child, it should be remembered that the difficulty arises when adults do not witness trauma, no external signs (wounds, or bruises) were noted, and the baby still does not know how to speak.

A concussion is a condition that, in principle, heals "on its own", and the main thing that parents need to manage is, if there is suspicion and an alarming clinic, to carry out additional diagnostics so as not to miss complications.

Signs of a concussion in a child under one year old are as vague and vague as the signs of intracranial hypertension syndrome. The baby refuses to breast, becomes restless and tearful, regurgitation may occur, or even convulsive syndrome may occur.

In children, the bones of the skull are not as hard as in adults, therefore, although the brain tissue is immature, the risk of severe concussion is much less, since the bone often “dampens the impact”, undergoing temporary deformation.

The greatest danger arises when the baby develops a state of increased and incomprehensible sleepiness, which arose after a probable injury.

With a concussion in a child of 2 years of age, verbal and verbal contact may be difficult, the pulse may be slowed down, which indicates an increase in intracranial pressure, or even vomiting may occur. With these signs, you need to urgently call an ambulance in order to exclude possible complications.

Concussion diagnostics, analyzes

In standard cases, a thorough examination by a neurologist is sufficient, who, during the examination, makes sure that there are no focal neurological symptoms. This indicates that there is no "catastrophe in one place" in the brain. As a rule, with an ordinary, not severe concussion, the following symptoms may appear:

• nystagmus (trembling of the eyeballs);
• uncertainty in the Romberg position (staggering, in a standing position, heels and toes together, arms extended forward in front of you), first with open eyes, and then with closed;
• uncertainty during the finger test (mimicking when trying to find your nose with your finger, standing in the Romberg pose with your eyes closed);
• anisoreflexia (small irregularities in tendon and abdominal reflexes).

Sometimes, on examination, other neurological signs are also revealed, but, as a rule, the patient will not have pathological foot signs, indicating a violation of the central neurons, and the muscle tone will not change.

Further, the necessary examination of the fundus is carried out (in principle, abroad this is carried out by the same neurologist or emergency doctor). The diagnosis ends with an X-ray of the skull, so as not to miss fractures or cracks in the bones, which may go unnoticed against the background of general cerebral symptoms, and, especially, in a state of alcoholic intoxication, when the patient is not aware of the severity of his condition.

What to choose: CT or MRI?

As a rule, a person who has been examined by a neurologist, after a normal X-ray picture and examination of the fundus, should go and be treated at home if the condition is stable. But, in some situations, an urgent tomography is needed.

If the patient has pathological reflexes, and he is "loaded", that is, periodically loses the coherence of speech, complains of drowsiness and is indifferent, and this condition grows, then an additional procedure is urgently needed - computed x-ray tomography.

Many people ask: which is more informative for a concussion - CT or MRI? X-ray tomography, of course. The fact is that MRI shows soft tissues well, but does not see fresh blood well. And on CT, any hematoma is clearly visible - both subdural, and subarachnoid, and intracerebral hemorrhage. And this is exactly what can lead to a sharp deterioration in the patient's condition.

In addition, CT is done in one "run" of the head in the tomograph ring, and it takes no more than a minute. In an MRI - tomograph, you need to lie for at least 15 - 20 minutes, which is very difficult in a serious condition, and especially in young children (they simply cannot help but spin), and they need anesthesia.

Home treatment for concussion

In the case when SHM is the main diagnosis, and the rest is soft tissue bruises, concussion is treated at home. In some conditions, hospitalization is required, at least for 1 - 2 days for dynamic observation. For example, there may be the following indications for this:

• additional injuries, for example, bone fractures, bruises of internal organs;
• incomprehensible clinical picture, the possibility of complications;
• suspicion of a hematoma inside the cranial cavity;
• severe concomitant diseases (diabetes mellitus, unstable angina pectoris);
• the appearance of seizures after traumatic brain injury.

With these and some similar conditions, as well as pregnancy, hospitalization is possible. In other cases, with a slight concussion, treatment at home is necessary, where, as they say, “walls help”. What should the patient and his loved ones do?

The brain has a high ability to heal itself, and with SHM, the brain does not have any organic damage to its structure. But the brain needs to create all the conditions that are sometimes difficult for an active person to withstand, and the hardest thing is to spend several days without a computer, headphones, cell phone and visual stress. It is important to comply with the medical and protective regime:

• A semi-bed mode is prescribed, in a quiet room, with muffled diffused lighting and unperturbed air;
• It is recommended to refrain from any visual and mental stress for several days. Realizing how hard it is for a modern person, we can recommend listening several times to either quiet, melodic music, the noise of nature, or audiobooks calmly recited in the voice of the announcer;
• It is necessary to slightly limit fluid intake in order to prevent an increase in intracranial pressure and cerebral edema;
• It is shown to "sleep at will", since restful sleep is the best medicine for such conditions.

Medicines

With mild severity, you can do without medication altogether. The patient can be given sedative herbal teas (Fitosedan), Corvalol, drugs such as Novo - Passit, or Persen - Forte. You can take cytoflavin, as well as glycine, which is absorbed under the tongue and has an inhibitory effect on the cerebral cortex.

In case of nausea, "Cerucal" is indicated, in case of headache - non-steroidal drugs, for example, "Sedalgin".

After 2 - 3 days, you can begin treatment of concussion in an adult by taking drugs such as Nootropil and Cavinton, which help in the recovery of the brain and microcirculation in the blood capillaries. It is advisable to take a course of taking B vitamins, for example, Neuromultivitis.

What should not be done in case of a concussion?

The patient should not drink coffee and alcoholic beverages, since against their background a sharp deterioration of the condition can occur, it is better to give up smoking. Naturally, in no case should you take drugs, as they can "finish the job" and cause cerebral hemorrhage.

You can not take a hot bath and shower, and go to work, especially when doing physical work on the night shift, so you need to take sick leave. Sex is not recommended in the first days after the injury, and in general, any mobilizing activity.

No need to take nootropic drugs with an activating effect, for example, "Phenibut". Light sedation is reasonable for the first few days.

Forecast and dangers of concussion

As a rule, during the usual course, the patient recovers in a week, and after 10 days he is already quite able to work, of course, if we are not talking about severe cases of inpatient treatment. And this may well happen if you underestimate the severity of the situation. For example:

• possible leakage of clear fluid from the nose and ears.

It is easy not to pay attention to this, and this is a symptom of a fracture of the base of the skull, and cerebrospinal fluid flows from the torn meninges. The severity of this condition is the rapid increase in brain stem edema with progressive disturbances in breathing, swallowing and cardiac activity, leading to death.

• the presence of a "light gap"

The patient at the appointment is euphoric, underestimates the severity of the condition, and does not have a CT scan. And at home, at night, he suddenly develops a coma and in the morning, in an extremely serious condition, he is taken to intensive care, and CT is performed for health reasons.

He is found to have massive cerebral hemorrhage, with ventricular compression and deep unilateral paralysis. In these cases, an operation performed a day ago, when the patient was conscious, and the hematoma was small, would have given a very good long-term result.

Given the above, it is very important to make the right decision regarding the prognosis and severity of the condition. It is advisable for all patients to undergo CT, and on the first day not to leave them alone with themselves, because sometimes, although rarely, the complication develops after a few hours, and at a very fast pace.