When concussion symptoms. Could be a concussion without hitting the head

Concussion (CCM) is a delicate pathology located at the intersection of traumatology and neurology. When a person hits his head, and within a few days after that he 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 a doctor, there are no clinical symptoms and signs by which one can distinguish a concussion from a simulation, especially in the case when there are no witnesses, and even the fact of an accident cannot be confirmed.

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

Quick page navigation

SGM - what is it?

What is a concussion and how is it diagnosed? First of all, a concussion is a closed craniocerebral injury, or CBI in common abbreviation, which is often found in certificates and discharge summaries.

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 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 bruise of the brain. Of course, its danger is much higher, because, in addition, there is a risk of secondary infection, even under otherwise equal conditions.

About examples of the formulation of the diagnosis

A concussion is a diagnosis that can easily change its place in the “hierarchy of diagnoses”. A concussion can be combined with a contusion 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) it will be CGM, for example, like this: “CTBI, concussion, contusion of the soft tissues of the face.”

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

Many people often ask: what is harder, a concussion or a bruise of the brain? Of course, the bruise is more severe: a concussion can be diagnosed if the loss of consciousness is no more than 5 minutes. As soon as this time exceeds 5 minutes, the diagnosis of brain contusion is already in use, which refers to moderate and severe traumatic brain injury.

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

Concussion, or concussion (from the 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 occurs in this case, a typical concussion pattern is manifested by the following features:

Loss of consciousness for no more than 5 minutes (this "critical" time is helped by witnesses of the injury). If they are not there, then it is difficult to assess whether there is a concussion, or whether 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 injury. The longer the loss of consciousness, the longer the period that is amnesiac;
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, is single, which brings relief, but it can be nauseating for several hours before that;
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 impact, and pain resulting from a concussion. As a rule, it is dull, of low or medium intensity, and is “spilled” over the entire head;
There are symptoms of weakness, difficulty in concentrating, performance drops sharply;
Perhaps the appearance of dizziness, a feeling of "ringing", or "cotton wool" in the ears.

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

Can there be a temperature with a concussion?

Temperature during concussion is uncharacteristic. Of course, with a very severe traumatic brain injury, which was complicated not only by intracerebral hemorrhage, but also by a breakthrough of blood into the ventricles of the brain, a sharp rise in temperature can 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 “deregulated”, and the brain is not able to control the vital processes of the body.

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

Also, with an open craniocerebral injury, in which the tissues are contaminated and sedimented, and the integrity of the meninges is broken, 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 the injury, there were no external signs (wounds or bruises), and the baby still does not know how to speak.

A concussion is a condition that, in principle, is cured “on its own”, and the main thing that parents need to do is, if there is a suspicion and a disturbing clinic, to conduct additional diagnostics so as not to miss complications.

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

In children, the bones of the skull are not as hard as in adults, so even though the brain tissue is immature, the risk of severe concussion is much less because the bone often absorbs shock by being temporarily deformed.

The greatest danger arises when the baby has a state of increased and incomprehensible drowsiness that has arisen 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 the presence of 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, tests

In standard cases, a careful examination by a neurologist is sufficient, which, 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 a normal, not severe concussion, the following symptoms may appear:

nystagmus (trembling of the eyeballs);
insecurity 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 ones;
uncertainty during the finger-nose test (missing when trying to find your nose with your finger, standing in the Romberg position with your eyes closed);
anisoreflexia (minor unevenness in tendon and abdominal reflexes).

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

Next, the necessary examination of the fundus is carried out (in principle, this is carried out abroad by the same neurologist, or an emergency doctor). Diagnosis ends with X-ray of the skull, so as not to miss fractures or cracks in the bones, which may go unnoticed against the background of cerebral symptoms, and especially in a state of 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 was examined by a neurologist, after a normal x-ray picture and examination of the fundus, with a stable condition, needs to go and be treated at home. But, in some situations, an urgent tomography is needed.

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

Many people ask: what is more informative in concussion - CT or MRI? Of course, X-ray tomography. 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 scanner, you need to lie down 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.

Treating a concussion at home

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

additional injuries, for example, bone fractures, bruises of internal organs;
incomprehensible clinical picture, the possibility of complications;
suspicion of hematoma inside the cranial cavity;
severe concomitant diseases (diabetes mellitus, unstable angina pectoris);
occurrence of convulsive 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 family do?

The brain has a high ability to self-repair, and with CGM, 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 endure, and the hardest thing is to stay for several days without a computer, headphones, cell phone and visual load. It is important to comply with the medical and protective regimen:

Half-bed rest is prescribed, in a quiet room, with muffled diffused lighting and unstale air;
It is recommended to refrain from any visual and mental stress for several days. Understanding how difficult it is for a modern person, we can recommend listening to quiet, melodic music, the noise of nature, or audiobooks calmly stated by the voice of the announcer several times;
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 in plenty", since restful sleep is the best medicine for such conditions.

Medications

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

For nausea, Cerucal is indicated, for headaches - non-steroidal drugs, for example, Sedalgin.

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

What can not be done with a concussion?

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

You can not take a hot bath and shower, and go to work, especially during 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 nootropics with an activating effect, such as Phenibut. Light sedation is reasonable for the first few days.

Concussion Forecast and Hazards

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

possible outflow of clear fluid from the nose and ears.

It is easy to ignore 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 in the rapid increase in swelling of the brain stem with progressive disorders of 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 undergo 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 the intensive care unit, and a CT scan is performed according to vital indications.

He is found to have a massive cerebral hemorrhage, with ventricular compression and unilateral deep 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 have a CT scan, and not to leave them alone on the first day, because sometimes, although rarely, a complication develops after a few hours, and at a very rapid pace.

A concussion is a sudden but short-term loss of mental functions that occurs as a result of a blow to the head. This is the most common and least severe type of traumatic brain injury.

Most cases of concussion occur among children aged 5–14 years, most often injured during sports or when falling from a bicycle. Falls and car accidents are the most common causes of concussions among adults. The risk of concussion is higher among people who regularly participate in competitive, group, and contact sports such as football or hockey.

With a concussion, confusion or loss of consciousness is possible, there are memory lapses, clouding in the eyes is observed, and the reaction to questions is slowed down. When performing a brain scan, a concussion is diagnosed only when there are no pathologies in the picture - for example, traces of bleeding or swelling of the brain. The term "mild traumatic brain injury" may sound ominous, but in reality the brain damage is minimal and usually does not lead to any permanent complications.

At the same time, studies have shown that repeated concussions can lead to long-term deterioration in mental abilities and provoke dementia. This type of dementia is called chronic traumatic encephalopathy. However, only those who have received head injuries several times, for example, boxers, have a significant risk of such a complication. This condition is sometimes referred to as "boxer's encephalopathy".

In some cases, after a concussion, post-concussion syndrome develops - a poorly understood condition in which the symptoms of a concussion do not go away for several weeks or months.

The consequences of a more severe traumatic brain injury can be a subdural hematoma - an accumulation of blood between the brain and skull, as well as a subarachnoid hemorrhage - bleeding on the surface of the brain. Therefore, within 48 hours after a concussion, it is necessary to be near the victim in order to suspect the development of a more serious condition in time.

Symptoms of a concussion

Concussion symptoms can vary in severity, and sometimes emergency medical attention is required. The most common signs of a concussion in children and adults are:

confusion, for example, a person does not understand where he is, answers questions asked with a delay;
headache;
dizziness;
nausea;
loss of balance;
shock or amazement;
blurred vision, for example, a person doubles or becomes cloudy in the eyes, he sees "sparks" or flashes.

A characteristic symptom of a concussion is also memory impairment. The person is unable to remember what happened just before the injury, usually the last few minutes. This phenomenon is called retrograde amnesia. If the victim cannot remember what happened after a blow to the head, they talk about anterograde (antegrade) amnesia. In both cases, the memory should recover within a few hours.

Less common signs of a concussion in children and adults include:

loss of consciousness;
slurred speech;
behavioral change, such as unusual irritability;
an inappropriate emotional response, such as suddenly bursting out laughing or crying.

Causes of a concussion

A concussion occurs when a blow to the head causes a part of the brain called the reticular activating system (RAS) to suddenly malfunction. It is located in the central part of the brain and helps to manage perception and consciousness, and also acts as a filter, allowing a person to ignore unnecessary information and concentrate on what is important.

For example, RAS helps to do the following:

falling asleep and waking up as needed;
hear an announcement in a noisy airport about landing on the desired flight;
Pay attention to interesting articles when skimming through a newspaper or online news site.

If the head injury is severe enough to result in a concussion, the brain is briefly displaced from its normal position, disrupting the electrical activity of the brain cells that make up the RAS, which in turn causes concussion symptoms such as memory loss or short-term loss or clouding of consciousness.

Most often, a concussion occurs in car accidents, when falling, as well as playing sports or during outdoor activities. The most dangerous sports in terms of getting craniocerebral injuries are:

hockey;
football;
a ride on the bicycle;
boxing;
martial arts such as karate or judo.

Most doctors believe that the health benefits of these sports outweigh the potential risk of a concussion. However, the athlete must wear appropriate protective equipment, such as a helmet, and exercise under the supervision of a coach or referee experienced in concussion diagnosis and first aid. The exception is boxing, as most doctors - especially those who treat traumatic brain injuries - say that the risk of severe brain damage during boxing is too high, and this sport should be banned.

Concussion Diagnosis

Due to the nature of the injury, most often the diagnosis is made in the emergency department of a hospital, by an ambulance doctor at the scene of the accident, or by a specially trained person at a sporting event.

The caregiver should perform a careful physical examination to rule out more severe traumatic brain injury, which may be indicated by symptoms such as bleeding from the ears. It is important to ensure that the victim's breathing is not difficult. If the person is conscious, they are asked questions to assess their mental state (especially memory), such as:

Where are we?
What were you doing before the injury?
List the months of the year in reverse order.

To determine whether the injury affected the coordination of movement, a finger-nose test is performed. To do this, a person must stretch his hand forward, and then touch his nose with his index finger.

If a person is unconscious, he is not moved until a special protective bandage is put on. Since he may have a severe injury to the spine or neck. It is possible to carry the victim unconscious to the side only as a last resort, if he is in immediate danger. You need to call an ambulance by calling 03 from a landline phone, 112 or 911 from a mobile phone and stay with him until the doctors arrive.

Additional examinations for concussion in children and adults

Sometimes, if there is reason to suspect a more severe traumatic brain injury, the doctor prescribes an additional study, most often a computed tomography (CT). If possible, they try not to do CT scans for children under 10 years old, but sometimes it is necessary. A series of x-rays of the head are taken and then put together on a computer. The resulting image is a cross section of the brain and skull.

If damage to the bones of the neck is suspected, x-rays are prescribed. This usually results in faster results.

Indications for CT for concussion in adults:

the victim does not recover speech, he does not follow commands well or cannot open his eyes;
presence of symptoms suggestive of damage to the base of the skull, for example, a clear liquid is discharged from the nose or ears, or very dark spots appear around the eyes (“panda eyes”);
more than one bout of vomiting after injury;
the person does not remember what happened in the last half hour before the injury;
symptoms of neurological disorders, such as loss of sensation in certain parts of the body, impaired coordination and gait, and permanent vision changes.

CT is also indicated for adults who lost consciousness or memory after injury and also have the following risk factors:

age 65 years and older;
a tendency to bleed, such as hemophilia or taking the anti-clotting drug warfarin;
severe circumstances of injury: accident, fall from a height of more than one meter, etc.

Indications for CT for concussion in children:

loss of consciousness for more than five minutes;
the child cannot remember what happened immediately before the injury or immediately after it, for more than five minutes;
severe drowsiness;
more than three bouts of vomiting after injury;
seizure or convulsions after injury;
the presence of symptoms suggestive of damage to the base of the skull, for example, "panda's eyes";
memory loss;
a large bruise or wound on the face or head.

A CT scan is also usually ordered for infants under one year of age if they have a bruise, swelling, or wound larger than 5 cm on their head.

Concussion treatment

There are a number of methods for self-relieving the symptoms of a mild concussion. If more severe symptoms occur, seek medical attention immediately.

apply a cold compress to the injury site - you can use a bag of frozen vegetables wrapped in a towel, but never apply ice directly to the skin - it is too cold; a compress should be applied every 2-4 hours for 20-30 minutes;
take paracetamol to relieve pain - do not take non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, as they can cause bleeding;
get plenty of rest and avoid stressful situations if possible;
refrain from alcohol and drugs;
return to work or school only after full recovery;
driving or cycling again only after full recovery;
do not engage in contact sports, hockey and football for at least three weeks, and after that - consult a doctor;
the first two days with a person should always be someone - in case he develops more severe symptoms.

Sometimes the symptoms of a more severe traumatic brain injury do not appear until several hours or even days later. Therefore, it is important to pay attention to signs and symptoms that may indicate a worsening condition.

You should go to the emergency department of the nearest hospital as soon as possible or call an ambulance if you experience the following symptoms:

loss of consciousness or inability to open eyes;
confusion, such as being unable to remember your name and location;
drowsiness that does not go away for more than an hour, during periods when a person is usually awake;
difficulty speaking or understanding;
lack of coordination or difficulty walking;
weakness in one or both arms or legs;
visual impairment;
a very severe headache that does not go away for a long time;
convulsions;
discharge of clear fluid from the ear or nose;
bleeding from one or both ears;

When can I exercise after a concussion?

A concussion is one of the most common injuries in sports, yet experts cannot agree on when a person can return to a contact sport such as football after a concussion.

Most doctors advise using a step-by-step approach, in which you should wait until the symptoms are completely gone, and then start low-intensity training. If you feel well, you can step by step increase the intensity of training and then return to full-fledged classes.

In 2013, at a conference of specialists in the field of sports medicine, the following system for increasing the pace of training for athletes after a concussion was proposed:

1. complete rest for 24 hours after concussion symptoms have passed;

2. light aerobic exercise, such as walking or cycling;

3. sport-specific drills, such as running soccer drills (but no drills that involve hitting the head);

4. non-contact training, for example, practicing passes in football;

5. complete training, including physical contact, such as interception of the ball;

6. return to the playing lineup.

If there are no symptoms, you can return to classes within a week. If you feel worse again, you should rest for 24 hours, return to the previous step and try to move on to the next step again.

Complications after a concussion

Post-concussion syndrome is a term that describes the complex of symptoms that can persist in a person after a concussion for weeks or even months. It is likely that post-concussion syndrome occurs as a result of a chemical imbalance in the brain provoked by trauma. It has also been suggested that this complication may be caused by damage to brain cells.

Symptoms of postconcussion syndrome are divided into three categories: physical, mental and cognitive - affecting mental abilities.

Physical symptoms:

headache - often compared with migraine, as it has a pulsating character and is concentrated on one side or in front of the head;
dizziness;
nausea;
increased sensitivity to bright light;
increased sensitivity to loud sounds;
blurred or double vision;
loss, alteration, or dullness of the sense of smell and taste.

Mental symptoms:

anxiety;
irritability;
lack of strength and interest in the world around;
sleep disturbance;
change in appetite;
problems expressing emotions, such as laughing or crying for no reason.

Cognitive symptoms:

decreased concentration;
forgetfulness;
difficulties with assimilation of new information;
decreased ability to reason logically.

There is no specific treatment for post-concussion syndrome, but anti-migraine medications have been shown to be effective in treating headaches caused by a concussion. Antidepressants and talking therapy, such as psychotherapy, can help manage psychological symptoms. In most cases, the syndrome disappears within 3-6 months, only in 10% of poor health persists for a year.

Concussion Prevention

To reduce the risk of traumatic brain injury, a number of reasonable precautions should be taken, namely:

be sure to wear appropriate protective equipment when playing contact sports, hockey or football;
engage in traumatic sports only under the supervision of a qualified specialist;
be sure to fasten the seat belt in the car;
wear a helmet when riding a motorcycle and a bicycle.

Many people tend to underestimate how often a concussion can result from a fall at home or in the garden - especially older people. The following tips will help make your home and garden as safe as possible:

do not leave anything on the stairs so as not to stumble;
use personal protective equipment during repairs, carpentry work, etc.;
use a folding ladder when changing a light bulb;
wipe the wet floor dry so that it cannot be slipped on.

When to see a doctor for a concussion?

Seek medical attention after a head injury if:

there was an episode of loss of consciousness;
unable to remember what happened before the injury;
worried about constant headache since the injury;
there is irritability, restlessness, apathy and indifference to what is happening around - these are the most common signs in children under 5 years old;
there are signs of disorientation in space and time;
during periods when a person is usually alert, he overcomes drowsiness, which does not pass for more than an hour;
there is a large bruise or wound on the face or head;
vision is impaired, for example, a person has double vision;
unable to write or read;
impaired coordination, difficulty walking;
weakness in one part of the body, such as an arm or leg;
a bruise appeared under the eye in the absence of any other damage to the eye;
sudden hearing loss in one or both ears.

When taking warfarin after a traumatic brain injury, you should consult a doctor even if you feel well. A person under the influence of alcohol or drugs should also contact the emergency department of the hospital when receiving a traumatic brain injury. Often, people around you do not notice the signs of a more severe head injury.

Certain factors make a person more vulnerable to the consequences of a traumatic brain injury, namely:

age 65 years and older;
underwent surgery on the brain;
a disease that increases bleeding, such as hemophilia, or increases blood clotting, such as thrombophilia;
taking anti-clotting drugs (such as warfarin) or low doses of aspirin

Diagnosis and treatment of concussion and its consequences is carried out by a neurologist, who is found.

You should call an ambulance by calling 03 from a landline phone, 112 or 911 from a mobile phone if a person has the following symptoms:

loss of consciousness after a concussion;
a person hardly remains conscious, speaks poorly or does not understand what is said;
seizure;
bouts of vomiting since the injury;
discharge from the nose or ears of a clear liquid (this may be the cerebrospinal fluid that surrounds the brain), bleeding.

Localization and translation prepared by site. NHS Choices provided the original content for free. It is available from www.nhs.uk. NHS Choices has not been reviewed, and takes no responsibility for, the localization or translation of its original content

All materials on the site have been checked by doctors. However, even the most reliable article does not allow taking into account all the features of the disease in a particular person. Therefore, the information posted on our website cannot replace a visit to the doctor, but only complements it. Articles are prepared for informational purposes and are advisory in nature.

25.03.2016

When talking about a mild degree of concussion, one should not think that mild means insignificant, something that should not be paid attention to. The consequences of such an “insignificant” incident can be very serious, because any damage to the skull area eventually leads to disruptions in the functioning of the nerve cells of the brain.

Moreover, there is always the possibility of rupture of blood vessels, and the formation of an internal hematoma. Precisely in order to prevent or at least mitigate possible health problems in the future, one should clearly understand what an initial concussion is, what is its treatment, including at home, and what symptoms to pay attention to after undergoing treatment .

Before you begin to eliminate a mild concussion, you need to find out what it actually is. Doctors call a concussion in the initial degree a reversible short-term violation of the basic functions of the brain, resulting from a severe bruise of the head. A concussion can occur at any age - during sports competitions, as a result of negligence or an accident, even after a long trip on a bad road.

Concussion is most difficult to tolerate in adulthood and old age - in older people it can lead to problems with pressure, Alzheimer's disease, amnesia and even dementia. Children recover from a concussion much easier and faster, but such incidents happen to them much more often.

Symptoms

The signs of a first-degree concussion are very similar to those of oxygen starvation or stroke, but it is natural that a head injury always precedes a concussion. So, the typical symptoms of a concussion are:

Pallor;
Dizziness, inability to stay upright;
Buzz in the head and severe throbbing pain, which can not be removed at home;
"Asterisks" and a split in the eyes, the inability to focus on one subject; white veil before the eyes;
Increased sweating;
Loss of motor coordination, weakness;
Nausea, possible vomiting;
short-term memory lapses;
Unsteady pulse;
Loss of appetite.

It is also possible violations of diction, emotional instability, slow reaction, including in response to simple questions.

Symptoms of concussion in children

As already mentioned, concussion can be acquired at any age, and very young children are no exception. So the difficulty in diagnosing a concussion lies not only in the fact that babies are not able to explain what they feel, because they still cannot speak at all, but also in the fact that the symptoms of a concussion in children are somewhat different than in adults. Here, for example, are the symptoms of a concussion in an infant:

A sharp increase in temperature, cold sweat breaks out;
Pale skin of the face;
Loud crying, and then sudden calming down and falling asleep.

After all this, there may be poor sleep, blurred vision, frequent regurgitation, lack of appetite. With a serious concussion, the fontanel swells.

Children from 2 years of age often experience short-term blindness, ringing in the ears, but they themselves can’t really name these signs. You need to calmly ask the child if he sees “stars”, spots, stripes, if he can hear well. For children 2-5 years old, the following concussion symptoms are most characteristic:

Coordination disorders, disorientation;
Fever, sweating:
Chaotic movement of the pupils;
Lethargy, lethargy:
Lack of facial expressions;
Vomiting, nausea, intense thirst.

First aid for mild concussion

If the injured person is able to move independently, it should be carried out to the nearest first-aid post. It is better to carry the child in your arms, supporting his head. If the person is unconscious, they must be quickly taken to the hospital on a rigid stretcher.

Before the arrival of the ambulance, the victim must be carefully laid on his side to avoid clogging the throat with vomit. In no case should you put anything soft under your head, even if the pain is very strong. It is also strictly forbidden to try to calm the pain by applying compresses, even if it's just a wet towel. Any brain injury is dangerous not caused by pain, but by possible internal damage to nerve structures.

Treatment

More often, with a concussion of the initial degree, outpatient treatment is prescribed, but before that, you still need to undergo a full diagnosis. The presence of a concussion is usually detected using a CT scan of the brain or X-ray. Depending on what signs are available at the moment, the doctor may prescribe a magnetic resonance imaging procedure, an ultrasound examination, as well as an additional examination by a neurosurgeon or ophthalmologist.

If a patient with a diagnosis of "mild concussion" is in an extremely unstable condition, then he receives treatment in a hospital under the supervision of medical staff, but even in such cases, after two weeks, the patient's condition, as a rule, returns to normal, and he is discharged to continue treatment. at home.

Folk methods

Treatment at home includes mandatory bed rest for 2-3 weeks for an adult, for a child - about a month. For the patient, it is necessary to create the most comfortable environment, exclude any overvoltage, restrictions on watching TV and computer games are mandatory for the child. It is not uncommon for a person to experience light and sound intolerance due to a concussion for some time - these symptoms should also be taken into account when organizing home treatment.

In stock, traditional medicine has a lot of tips for restoring health after a concussion. First of all, this is the use of such plants as aloe vera, cinquefoil, succession, St. John's wort, ginseng and eleutherococcus. The simplest and most popular recipes to help treat the effects of trauma are listed below:

1 tbsp Aralia herbs insist without access to light in 100 ml of medical alcohol for 21 days. Take 30 drops in the morning and before lunch.
Strained infusion of thyme herb take half a cup before meals. The effect will be noticeable after 4-5 months.
Pharmaceutical arnica, brewed as a tea in half with the leaves of the world, is able to restore memory after an injury.

Medications for mild concussion

All drugs, including painkillers, should be taken by patients only as prescribed by a doctor in exactly the prescribed dosage, which may vary in accordance with changes in symptoms. Sometimes, in the presence of symptoms such as insomnia, apathy, irritability, sedatives or antidepressants may be prescribed. The main drugs prescribed for mild concussion, including for children:

Nicotinate or other products based on nicotinic acid;
Cinnarizine;
Piracetam and its derivatives, such as pyriditol or nootropil, are the most popular neuroprotective drugs today;
Actovegin, mildronate or other antioxidants for intravenous administration;
Xanthinol, instenon and the like;
Dehydrants such as diacarb in tablet form;
Cerebrolysin or somazin, which are administered intravenously or in the form of saline;
Cavinton to stabilize the work of blood vessels;
Vitamins and amino acids, such as folic acid for the speedy recovery of brain cells, ascorbic acid, and phosphorus.

With such symptoms mentioned above as insomnia, nervous disorders and apathy, drugs such as dormiplant, adaptol and their other sedative analogues work well. Noopept tablets help very well in the treatment of not so much the symptoms as the immediate consequences of the concussion itself. Treatment with them can be carried out not only in a hospital, but also at home. The course of admission is usually two months.

In addition to drug therapy, a course of physiotherapy, massage and reflexology sessions are prescribed, which will help restore the lost functions of the nervous system. For more effective rehabilitation, the doctor may advise you to purchase massagers for home use.

Prevention

After a concussion, a person can suffer from intermittent throbbing headaches for quite a long time. This condition can be alleviated by taking conventional painkillers - pentalgin, analgin, citramon. As for dizziness, they are advised to treat it by taking tanakan, papaverine or belloid. If you need to take sedatives, then it is better to choose drugs on a natural basis - tinctures of motherwort or valerian.

Asthenic manifestations, if any, occur after an injury, are relieved by taking drugs such as cogitum (20 ml 1 time per day), vasobral (2 ml twice a day) or pantogam (50 mg three times a day). If you need to take tonics (eleutherococcus, ginseng, saparal, lemongrass), they are recommended to be taken in very small doses so as not to cause new headache attacks.

A person who has suffered a concussion should refrain from drinking strong coffee, nicotine and alcohol for a certain period. And if the patient has a tendency to epilepsy, he needs to regularly undergo a dispensary examination.

After an injury and treatment, doctors strongly recommend that such people take a vacation and start restoring their health until all signs of injury disappear - spend more time outdoors, just walk, get enough sleep. To improve blood supply, you should drink more clean water.

Concussion is manifested by a set of characteristic symptoms. Their set may vary as well as the degree of severity, everything will depend on the specific situation.

How does the disease begin immediately after a head injury?

It is very important to identify a concussion immediately after an injury has occurred, the effectiveness of treatment will depend on this.

Pay attention to these signs:

There is a slight expansion or narrowing of the pupils, which is present for several hours after the injury.
Dizziness develops.
Tinnitus.
The occurrence of nausea or vomiting.
Pain is felt in the back of the head, which intensifies during movement.
Feeling weak and sleepy.
Loss of consciousness.

How does it manifest itself in the first hours after a blow or fall?

The eyeballs are in a trembling state.

Tendon reflexes may be impaired.

Is it possible to recognize after a few days?

If not treated, or ignore the recommendations of the doctor, as well as making an erroneous diagnosis after 3-5 days, the person will experience the following symptoms of a concussion:

Hypersensitivity to light and sound, even if they are moderate enough.
Psycho-emotional disorders. They can manifest as irritability, bad mood or even depression.
Sleep disturbance, a person may wake up at night, suffer from insomnia, or the depth of sleep changes.
Rarely amnesia develops.
The concentration of attention decreases, it is difficult for a person to focus on one thing.

Signs according to severity

Depending on the severity of the condition, the symptoms of a concussion are divided into three degrees.

Light

The symptoms are as follows:

Consciousness is not disturbed.
Possible disorientation in space.
Pain in the head and dizziness.
In the first 20 minutes after the injury, nausea is felt.

Gradually, the general state of health is normalized. In some cases, a short-term increase in body temperature up to 37.1-38 ° C is possible (read more about the increase in temperature during a concussion).

Medium

Has these symptoms:

Consciousness is not disturbed.
There is nausea, sometimes a single vomiting develops.
Headache and dizziness.
Disorientation.

Attention! These symptoms are present for more than 20 minutes. Sometimes a person may lose their memory for a short time. Often there are cases of retrograde amnesia, when the patient for a few minutes forgets what happened to him immediately before the injury.

heavy

Symptoms in this case may coincide with the first two degrees, but the person also loses consciousness. This state can last from 5 seconds to several hours..

How to determine yourself?

To correctly diagnose a concussion in adults, you need to remember the characteristic signs:

When moving the eyes to the side, the victim feels pain.
In the first hours after the injury, pupils of different sizes, dilated or narrowed, may be observed.
Tendon reflexes can be variable, that is, they are different on the left and right.
Immediately after the impact, a person feels pain, mainly in the back of the head.
With sudden movements, dizziness begins.
Nausea is felt, and sometimes vomiting occurs.
Small horizontal nystagmus, that is, involuntary tremulous movements.

All these signs should prompt the victim or his relatives to seek medical attention.

diagnostic test

Initially, you need to ask the patient a series of questions, which will confirm the concussion that has occurred. Among them:

Do you feel pain in your head?
Is there nausea?
Is there eye pain?
Are there memory lapses?
Is your head spinning?
Is there double vision?

If the answers are positive, then we can talk about the concussion that happened. But in order to make an accurate diagnosis, you need to contact a specialist and undergo additional diagnostics that will help determine the degree of this condition. Only in this case the correct treatment will be prescribed.

First aid

Delivered on time and correctly first aid can determine the success of further treatment:

If the injury was minor and the person feels more or less tolerable, then he will need to be comfortably seated or laid down with a hard cushion tucked under his head. Then you need to wait for the ambulance to arrive.
If a person is in serious condition, then it is better not to move him at all, as this is fraught with complications.
If there is blood from the nose, the head does not need to be thrown back, on the contrary, it falls forward or to the side so that the blood can drain freely.

This is where the first aid ends, since the rest of the manipulations will be carried out by doctors.

Diagnostics

All clinical manifestations can only make a preliminary diagnosis. It is necessary to contact a neurologist or traumatologist.

X-ray of the head - is necessary to determine the absence of damage to the bone tissue.
Examination of the pupils of the patient, their shape and size, the reaction of the eyeball.
MRI for the presence of hematomas and the integrity of brain tissue.
Spinal puncture to check the composition of the CSF.
The patient's diagnostic test, which consists of important questions to detect a concussion.
Checking for Gurevich's oculostatic phenomenon, when a person falls forward when looking up, down or back, which indicates a TBI.
Checking for Romberg's symptom, when a person is asked to stand up straight with his legs closed and his eyes closed, while stretching his arms forward. If the patient has a concussion, then he will not be able to stand straight due to the trembling of the limbs and eyelids.

The hand-chin reflex is also assessed.. This study is done 3-14 days after the injury. In this case, the doctor strokes the patient's palm with dashed lines in the thumb area. If TBI is present, then the person will begin involuntary contractions of the muscles of the chin.

Modern helpfully presents any person with many opportunities to get injured. Rushing to work in the morning and home in the evening, a resident of the metropolis sometimes does not notice the surroundings at all. at work is no less traumatic. And how many situations arise in everyday life! Sport also presents a person who has not calculated his strength with an unpleasant surprise. Well, I don’t even want to touch on criminal situations.

In all circumstances, the result, as a rule, is one - a traumatic brain injury. In this case, the main thing is to be able to correctly recognize the symptoms of a concussion in adults and provide the necessary assistance in a timely manner. At the same time, it is very important that the measures taken do not cause harm to the patient.

What is going on in the brain?

In the human body, this organ is placed in a liquid. It protects the brain from impacts on the skull bones. But, unfortunately, with strong shocks or bruises, such a protection mechanism is not enough. As a result, injury occurs. In this case, all the symptoms of a concussion in adults are present.

The phenomenon disrupts the work of the body. At the same time, it does not lead to irreversible processes. Quite rarely, during a concussion, damage to the bones of the skull, soft tissues, blood vessels, or membrane occurs.

The characteristics of each stage that occurs in the brain have not been determined by modern doctors even today. However, most doctors argue that the phenomenon leads to disruption of the normal functioning of nerve cells. After all, with a concussion, their nutrition worsens, tissue layers shift, and the connection between the centers is lost. As a result, the smallest hemorrhages, microcontusions, and edema appear. Unfortunately, even MRI does not show such changes.

Types of injury

Any head injuries are initially divided into open and closed. In the first type of injury, the soft tissues and bones of the skull are affected. Closed injuries are less dangerous. However, they require no less attention. In turn, they are divided into light concussion and heavy, squeezing, bruising.

A serious injury is quite dangerous. After all, a severe concussion is diagnosed with significant damage to individual areas or rupture of blood vessels. This condition often leads to the time during which the patient was in the above condition, determines the severity. Coma is the most serious stage. The patient, regaining consciousness, quite often does not remember those around him and does not understand what happened to him.

Severity

In medicine, there is a classification of this phenomenon, proposed by doctors from Colorado and accepted at the international level. According to her, there are three degrees of concussion. Each of them characterizes directly the defeat of an important organ.

So, the accepted gradation:

1 degree. This stage is a mild concussion. Symptoms that characterize the patient's condition are confusion. The loss of the latter is completely uncharacteristic of the first degree. Amnesia is also not observed in patients.
2 degree. This form refers to moderate injuries. With this degree, confusion is noted, as a rule, without loss of consciousness. However, the main symptom is the manifestation of amnesia.
3 degree. The most severe category of injury. A striking sign of this stage is the loss of consciousness.

The time interval in the classification is indicated rather vaguely. A "small gap" of unconsciousness can vary from a few seconds to tens of minutes, according to Russian doctors. This symptom is considered in conjunction with other signs characterizing a concussion. The severity is determined only by the general picture of the patient's condition. All signs are taken into account.

Main symptoms

It is very important to correctly and timely identify the signs of concussion in adults. After all, an injured person needs medical attention.

It should be understood that the following symptoms of concussion in adults may not appear immediately and not all. And some signs (depending on the severity of the injury) will not occur at all.

The most obvious symptoms include:

Headache. This sign is quite obvious, because the victim was injured.
Hyperactive behavior or severe drowsiness.
Nausea, vomiting.
Failures in coordination of movements. The symptom directly indicates a brain injury. As a rule, dizziness is also connected to the phenomenon.
Noise in ears. A sign caused by a violation of the blood supply to the brain.
Double vision.
Loss of consciousness. This is the main symptom that characterizes a concussion. As previously stated, the time interval may vary.
Pupil size. It is recommended that you check it out. Sometimes, with concussion, the pupils can take on a different shape.
Seizures. A sign that directly indicates the presence of a concussion.
Irritable to loud noises and bright lights. Upon regaining consciousness, the patient may experience serious discomfort from the strong sources mentioned above.
During the conversation, one may come across the fact that the patient does not even remember what happened to him.
"Slurred" speech.

For a long time, the patient has a headache. It may be accompanied by a variety of symptoms. It may be lack of appetite, fluctuations in pulse, pressure, or weakness. Patients are characterized by instability of mood. It varies from complete apathy to severe irritability.

Often the question arises - what is the temperature during a concussion? After all, it is not mentioned in the list of the main symptoms. And this is no coincidence. After all, as a rule, the temperature during a head injury remains within the normal range. Therefore, often attention is not focused on it at all, if we mean concussion.

Symptoms and treatment in their duration cover about two weeks. After the specified period, the patient feels significant relief. Although a longer time interval cannot be ruled out.

Prohibited measures in the provision of assistance

According to medical statistics, a concussion is a fairly common injury. Therefore, almost every person can face such a phenomenon. And on how correctly he will help the victim with a concussion, the further prognosis depends. It is important to realize that the health of the patient depends on this.

Therefore, it is worth dwelling on measures that are completely unacceptable in case of concussion. After all, they not only do not help a person, but worsen the condition of the victim.

It is strictly forbidden to move a person with a head injury sharply.
Until the examination of the doctor, the victim should not be transported.
Under no circumstances should the patient be given water or food.
It is strictly forbidden to use drugs.
The victim should be examined by a neurologist. Only he can make a diagnosis on the basis of the clinic.

First aid

The main symptoms after an injury are: headache in various areas and varying degrees of severity, loss of consciousness. Based on such clinical manifestations, the doctor will be able to conclude that the victim has a severe or mild concussion. Symptoms can sometimes be hidden by the patient himself. In this case, only diagnostics will show the true picture.

First aid for a concussion involves ensuring complete rest for the patient. The victim should be laid down. It is necessary to unbutton the buttons and buckles on the clothes. This ensures normal airway patency. The victim's head should be turned to the side. Sometimes it is necessary to stretch out the tongue. No drugs should be given to the victim.
If the patient complains of dizziness, tinnitus, then he must be laid down. If a neck injury is suspected, it is necessary to fix the immobility of the latter with improvised means. Clothing can be used as a splint by rolling it tightly into a roll. It is located under the neck and head.
Be sure to call an ambulance. The victim cannot be transported independently. Delivery of the patient by specialists is less dangerous. If it is impossible to call a help team, then transportation should be carried out with extreme caution. The patient should be exclusively in the supine position. The back seat of the car is best suited for these purposes.
If the victim loses consciousness, ammonia can be brought to the nose. At the same time, it is completely unacceptable to shake the patient, to whip in the face.
A person may complain of an increase in symptoms - increased headache, nausea, vomiting. In this case, there is a progressive deterioration of the condition. First aid for a concussion in this case is the fastest delivery of the victim to a medical facility. This symptomatology may characterize intracranial hemorrhage. Unfortunately, in this case, conservative treatment is powerless. This is where neurosurgery can help.

Diagnostic methods

Usually this question is not difficult for a neurologist. To make a diagnosis, it is enough to examine the patient and anamnesis. However, testing is still recommended. This allows you to exclude craniocerebral injuries of a severe nature.

The survey includes the following main measures:

Radiography. Allows you to identify cracks or fractures of bones. The examination will also conclude about possible displacements or fractures of the vertebrae of the neck.
Electroencephalography. A study of the cerebral cortex, giving an idea of even minor violations or malfunctions.

If the patient has a severe form of concussion, the doctor will send for a more detailed examination.

Treatment Methods

There can be no talk of an independent struggle with the disease. Calling an ambulance is required. It should be understood that only a doctor can make a diagnosis, carefully examine the symptoms characteristic of such a phenomenon as a concussion. And the treatment will directly depend on the clinical picture.

As a rule, the actions of doctors include measures such as:

Hospitalization of the victim (with any degree of severity) with the appointment of exclusively bed rest.
Connection of drugs aimed at restoring normal functioning. Means can relieve pain, relieve insomnia, dizziness. As a rule, prescribed drugs have a sedative effect.
Along with the main therapy, symptomatic treatment is prescribed. It enhances metabolism. Thus, it contributes to the restoration of blood vessels and cells.
It is important to adhere to the recommendations of the doctor on the diet.

Possible consequences

A victim who has suffered a concussion is at risk of various complications. It can be post-traumatic neurosis or a more serious illness. For example, epilepsy.

That is why it is very important not to self-medicate, but to turn to a neurologist for competent help. In this case, it is advisable to pass all the prescribed examinations. This will allow the doctor to prescribe effective treatment.

Preventive measures

Unfortunately, no one is 100% safe from injury. But if we touch on the main reasons due to which craniocerebral injuries most often occur, then a few simple rules can be distinguished.

These include:

head protection with a helmet, if required by activities (hockey, roller skating or cycling, boxing);
use of seat belts in the car;
maintaining a safe environment in your own home (avoid hitting furniture, wipe up liquid spilled on the floor, “unload” passages between rooms as much as possible).

Conclusion

Knowledge is a huge power. The information provided will make it easy to identify the symptoms of a concussion in adults. And, no less important, do not get confused, do not panic, but act correctly and professionally. Thus, you will alleviate the condition of the victim.