A mild concussion is a traumatic brain injury in which there are short-term changes in the functioning of this organ. The pathological condition occurs as a result of blows and bruises. The initial symptoms are almost invisible, but a mild concussion can later lead to severe consequences in the form of headaches or Parkinson's disease. Timely, correct assistance and accurate fulfillment of doctor's prescriptions will avoid unnecessary complications.
What is a concussion
Closed mild traumatic brain injury (TBI) is a concussion of the brain (lat.commocio cerebri). At the same time, no significant disturbances occur in the work of the brain, the symptoms are fleeting. These concussions account for 70 to 90% of all TBI cases. It is difficult to make a diagnosis, so the disease often goes unnoticed.
Approximately a third of patients receive a concussion while intoxicated, the victims are unable to understand what happened in time and seek help after a long time. In this case, errors in the diagnosis can reach 50%. With a concussion, no macrostructural changes occur, and the integrity of the tissues does not change. Violation of interneuronal interaction is of a short-term nature, tissue damage is diffuse in nature.
Causes
Concussion is a consequence of mechanical impact: indirect (acceleration injury, inertial), direct (shock head injury). As a result, the mass of the brain is displaced relative to the axis of the body and the cranial cavity, the synaptic apparatus is damaged, and the redistribution of tissue fluid occurs. Common causes of head injury include:
- Road accident (road traffic accidents);
- criminal cases;
- injuries at home, at work,
- playing sports.
Signs of a concussion
Symptoms depend on the severity of the injury. The pathological condition is divided into degrees:
- First: clouding of the state, confusion of speech without loss of memory.
- Second: amnesia is acceptable, but without fainting.
- Third: the patient loses consciousness.
Concussion is considered a mild form of TBI. The pathological condition has 3 stages:
- Acute period. It lasts from the moment of injury to the stabilization of the condition, on average about two weeks. At this time, metabolic processes in damaged tissues are faster, autoimmune reactions are triggered in relation to companion cells and neurons.
- Intermediate. It lasts from the moment of stabilization of the disturbed brain functions to their normalization, the duration is about two months. In the intermediate period, homeostasis is restored, the formation of other pathological conditions is possible.
- Remote (residual) period. The patient is recovering (the progression of neurological diseases caused by trauma is possible, duration: 1.5–2.5 years. The well-being of the period is individual, determined by the capabilities of the central nervous system (central nervous system), the presence of neurological pathology before TBI, and the peculiarities of the immune system.
In an adult
The main symptom of a concussion in an adult is a disorder of consciousness at the time of the injury. Immediately after the incident, the following may still be observed:
- partial or complete amnesia;
- headache; dizziness;
- ringing, tinnitus;
- vomiting, bouts of nausea;
- oculostatic phenomenon of Gurevich (with certain movements of the eyeballs, statics is disturbed);
- insomnia;
- weakness;
- dystonia of the vessels of the face (pallor turning into hyperemia);
- excessive sweating;
- neurological manifestations: asymmetry of the corners of the mouth, rapidly passing, dilation or narrowing of the pupils;
- nystagmus (oscillatory eye movements);
- unsteadiness of gait;
- poor facial expressions.
Amnesia is common after injury and concussion. Loss of memories differs in terms of time of occurrence:
- Retrograde: the circumstances and events that occurred before the injury are forgotten.
- Congradnaya: the patient's memory disappears from the memory of the length of time corresponding to the injury.
- Anterograde: there is a loss of memories of events that occurred after the injury.
In children
The clinical picture in children is rapid, signs of concussion are more indicative. The pathological condition has symptoms due to the compensatory capabilities of the central nervous system, incomplete calcification of the sutures, elasticity of the elements of the skull. The ailment in older children often proceeds without loss of consciousness, vegetative symptoms are present: the color of the skin changes, tachycardia occurs. The pain is localized at the site of injury. The acute period is shortened (has a duration of 10 days). The following symptoms are observed:
- temperature increase;
- cold sweat;
- pallor of the face;
- loud crying, after the child falls asleep.
In babies, due to slight differentiation of the central nervous system, there may be no symptoms.... In children from 2 years of age, ringing in the ears, short-term blindness are possible. For babies 2-5 years old, the following symptoms are characteristic:
- bouts of vomiting, nausea, desire to constantly drink;
- impaired coordination;
- temperature rise, the child begins to sweat:
- nystagmus;
- lack of facial expressions;
- lethargy, lethargy.
Complications
Post-concussion syndrome is a commonly diagnosed consequence of a concussion. The condition develops against the background of a previous TBI, accompanied by drowsiness, headache, attacks of dizziness, numbness of the extremities, paresthesia, memory loss, increased sensitivity to noise and light. The following complications after traumatic brain injury are possible:
- somatoform autonomic dysfunction;
- asthenic syndrome;
- memory problems;
- emotional instability, behavioral disorders;
- insomnia.
Diagnostics
The circumstances of the injury must be taken into account when making a diagnosis. Brain injury often goes away without objective signs. In the first hours after the incident, the doctor may notice loss of consciousness, nystagmus, unsteadiness of gait, double vision. With a concussion, there are no bone fractures, there are no deviations in the pressure and composition of the cerebrospinal fluid, the ultrasound examination does not reveal the expansion and displacement of the median structures of the brain, computed tomography will not detect traumatic abnormalities.
Diagnosis of concussion is difficult due to the paucity of objective data. The main diagnostic criterion is regression of symptoms within a week. The following instrumental studies are often carried out:
- X-ray (will show the absence of fractures);
- electroencephalography (the doctor will notice diffuse changes in the bioelectrical activity of the brain);
- computed tomography, magnetic resonance (will show if there are changes in the density of white and gray matter).
Treatment for concussion
Patients with suspected TBI are subject to hospitalization, in the hospital they are under observation for about two weeks (the period depends on the severity of the injury). Inpatient treatment is compulsory for victims if:
- fainting lasted more than 10 minutes;
- there is neurological focal symptoms that complicate the pathological condition;
- the patient denies the fact of loss of consciousness;
- convulsive syndrome;
- suspicion of a fracture of the skull, fracture of the base of the skull, penetrating injury;
- confusion is observed for a long time.
When the initial degree is shaken, the victim is sent for treatment at home, having previously examined him. The pathological condition is detected using CT or X-ray. The therapist may order an MRI (magnetic resonance imaging), ultrasound examination, examination by an ophthalmologist or neurosurgeon.
Home treatment after a concussion involves a medication course lasting 2-3 weeks. The patient needs the following conditions:
- dim lighting;
- bed rest;
- peace;
- refusal to watch TV, computer games, listen to loud music;
- lack of physical exertion, overexertion (mental, emotional);
- a balanced diet, with the exclusion of foods that provoke pressure surges (caffeine, spices, fatty foods, sweets, alcohol).
If you follow the doctor's recommendations, the patient will feel an improvement on the second day. After a week, the pathological symptoms should disappear. After the course of treatment, it is better for the patient to refrain from exertion, lifting weights for a while, and to be more in nature. Rest and a sparing attitude towards oneself will help prevent the development of complications such as dizziness, migraines, and disturbances in the work of blood vessels.
First aid
If there is a suspicion of a concussion, and consciousness quickly returned to the victim, he should be positioned in a prone position with his head slightly raised. If a person does not come to his senses, then he must be placed in a saving position:
- place on the right side;
- tilt your head back so that your face is directed towards the surface;
- bend the left arm and leg at a right angle, provided that there are no fractures of the spine and extremities.
First aid for concussion will save the victim from serious consequences. In this position, air easily passes into the lungs, and any liquid that accumulates in the mouth, be it saliva, blood or vomit, flows out. In this situation, the possibility of a tongue sinking is excluded. Obvious wounds should be treated immediately. Then the victim is taken to the hospital on duty to clarify the diagnosis. Bed rest is recommended for three days.
Drug therapy
Treatment with medications for concussion is rarely required and is symptomatic. Pharmacotherapy is aimed at normalizing brain functions, relieving migraines, dizziness, getting rid of insomnia, nervousness. In case of concussion, the following groups of drugs are prescribed:
- improving the blood flow of the vessels of the brain (Cinnarizine);
- analgesics (Pentalgin, Analgin, Sedalgin, Dexalgin, Maxigan);
- nootropics (Pyridol, Piracetam, Glycine, Nootropil);
- sedatives, antidepressants (motherwort, valerian, Corvalol, Valocordin, Afobazol, Sibazon, Grandoxin, Phenazepam);
- improving metabolic processes in the brain (Instenon, Nicotinat);
- normalizing the work of blood vessels (Cavinton, Sermion, Instenon);
- relieving dizziness (Cinnarizin, Tanakan, Platyphyllin with Papaverine);
- sleeping pills (Relaxon, Donarmil);
- fortifying agents (vitamins, tonics, antioxidants).
Metabolic and vascular therapy promotes rapid recovery of brain function after a concussion. Doctors recommend combining vascular with nootropics. Among the possible combinations: taking Cavinton 1 tablet and Nootropil 2 capsules or 1 tablet of Stugeron and Noopept three times a day for two months. Neuroprotective agents provide metabolic support to the brain.
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