Brain Contusion - Causes, Symptoms and Treatment .MF .

August 12, 2017 17:52 | Emergencies

brain contusion - a head injury with brain damage structures.

Classification cranio - brain injury:

• concussion - 80 - 90%;
• brain injury - 5 - 12%;
• brain impaction - 3 - 5%.

Signs of traumatic brain injury

Trauma can be obtained in a road - traffic accident, injury at work and at home, with the beating and beating, falling from a height, often after falling from balconies and windows during alcoholicintoxication during an epileptic attack while diving, falling on his head heavy objects, while blockages in mines, caves hostilities.

brain injury with a broken skull bones of .

As a result, the injury is a disturbance of higher nervous activity, which is manifested by cerebral and focal symptoms.Bruising of the brain may develop at the site of the impact and application in the area of ​​the opposite impact (impact on the skull) - protivoudar.Damaged brain cells, blood vessels, and their relationship, the brain of toxic action of the decay products of the affected cells and hemoglobin.In

severe cases, there is crushing the substance of the brain.The heaviest damage - diffuse axonal injury, which occurs when a sudden change in the speed of movement of the head, when the brain is attached to the rotary motion.Thus the axons of the cranial nerves are pulled from the brain or breaks occur axons in the white matter in the brain tissue revealed multiple small focal hemorrhage.The patient falls into a deep coma, mortality of this condition - 90%.This is often at road - traffic accidents, falling from a height or at strong blow to the chin.

Symptoms of brain injury

Traumatic brain injury may be open to a violation of the integrity of the skin and bones, and closed, at which preserved the integrity of the skin, the bones of the skull may be compromising the integrity or may not have, and brain function is impaired.For fractures of the skull base may develop likvorrei - leakage of cerebrospinal fluid from the ears and nose, and bleeding from the ear.This is a very serious sign of severe traumatic brain injury.



Bleeding from the ear with a brain contusion and a fractured skull.

cerebral contusion can be mild, moderate and severe course.
mild brain injury is characterized by loss of consciousness a few minutes to an hour, retrograde amnesia (loss of memory on events preceding the trauma, the trauma itself, and some time after the injury), vomiting, hyperthermia, cardiac - vascular system - increase in blood pressure, rapid or slow heartbeat, lack of appetite, sleep disturbances, dizziness, staggering.Vital functions are not violated.On examination, the neurosurgeon or neurologist detect diffuse neurological symptoms - nystagmus may anizokariyu, pyramidal insufficiency, possible meningeal signs.
may be fractures of the skull and subarachnoid hemorrhage.
When lumbar puncture elevated cerebrospinal fluid pressure.
regression of neurological symptoms occur within 2 - 3 weeks - up to 2 months.

moderate brain injury is characterized by disconnecting the consciousness from a few tens of minutes to 4 - 6 hours, severe retrograde amnesia, headache, repeated vomiting, mental disorders, violation of life (vital) functions - bradycardia to 45 per minute, tachycardia up to 120per minute, blood pressure increase to 180, tachypnea (rapid breathing) to 30 per minute without disrupting cross-tracheobronchial tree, meningeal symptoms.Neurologist see meningeal signs, changes in muscle tone, difference of tendon reflexes, pathological pyramidal signs, focal symptoms that indicate the injury - oculomotor disturbances - restriction of movements of the eyeballs, convergence, strabismus, double vision, ptosis, paresis of the extremities.

When lumbar puncture - elevated cerebrospinal fluid pressure.When subarachnoid hemorrhage - blood in the cerebrospinal fluid.
regression of symptoms occurs within 4 - 5 weeks to 2 months.

brain contusion to severe characterized by prolonged shutdown of consciousness from a few hours to weeks, restlessness, severe impairment of vital functions - bradycardia below 40, tachycardia above 120, tachypnea over 40, heart rhythm disturbances, violation of tracheobronchial patency, hyperthermia up to 40 degrees.In the neurological status prevails stem symptoms - floating eyeballs, anizokariya, nystagmus, swallowing disorder, strabismus vertical gormetonicheskie changes in muscle tone (periodic tonic spasms with a sharp increase in tone in the extremities), decerebrate rigidity (increased tone of extensor muscles (extensors) and relativerelaxation of the flexor muscles), bilateral pathological signs may develop epileptic seizures.
When lumbar puncture significantly increased pressure.When subarachnoid hemorrhage - blood in the cerebrospinal fluid.
When computed tomography and magnetic resonance imaging is determined hypotensive hearth brain injury, symptoms of cerebral edema, small foci of hemorrhage.There may be a set of broken bones and skull base, subarachnoid hemorrhage.

Missing strabismus with severe traumatic brain injury.

survey

When a head injury, even a minor you think you need to see a doctor to rule out head - brain injury or early treatment in the presence of a brain injury.When loss of consciousness as a result of trauma need to call an ambulance.Necessary inspections will be x-ray - X-rays of the skull and cervical spine to computed tomography (depending on the detected neurological symptoms), visit an ophthalmologist, electroencephalography, inspection neurosurgeon, lumbar puncture - maybe more than once.When the diagnosis of brain injury 100% required hospitalization in a specialized neurosurgical department.Bed rest from 7 days to 2 weeks depending on the severity of the brain injury.In severe contusion of the brain needed resuscitation, a bruise of the brain crush with the substance of the brain, or in severe swelling of the brain shown neurosurgical surgery - osteoplastic trepanation, the imposition of burr holes.

visible on the CT scan hematoma, brain surrendering

substance Brain Injury Treatment

Treatment is prescribed depending on the severity of the disease and the clinic.Use neuroprotective - Cerebrolysin, somazina, tserakson, cortexin semaks antioxidants - solkoseril, aktovegin, mildronat, vitamin E, mexidol venotonicheskie drugs - L-lysine aescinat, cardiovascular drugs to improve microcirculation - cavinton, Sermion, trental, dehydration, sedatives, vitamins, antibiotics.In severe cases, diligent care is important for the prevention of pressure ulcers and the possible formation of hypostatic pneumonia.In open injuries may join the infection and the development of meningitis, encephalitis, which greatly complicates the course of injury and worsen the prognosis.

consequences of brain injury

periods of traumatic brain injury:

- sharp - 2 - 3 weeks - until stabilization functions;
- subacute - 2 (with minor injuries) - 4 (with an average severity of injury) - 6 (in severe brain injury) months;
- long-term consequences - more than 6 months - indefinitely - a vegetative-vascular symptoms (dystonia), asthenic-neurotic, liquorodynamic, epileptic, psycho-organic syndromes, disorders of movements of the eyeballs, strabismus and double vision (diplopia), paresis and paralysis of limbs, skull defects, traumatic brain cysts, traumatic encephalopathy 1 - 2 - 3 degrees with a variety of symptoms.

Often there is a full functional recovery of affected disability.In severe traumatic brain injury mortality rate is 30 - 50%.After a severe injury is possible disability due to mental changes - cognitive disturbances (intellectual), the development of epileptic seizures, the presence of defects of the skull bones, persistent violations liquorodynamics, paresis of limbs, blurred vision.Patients are sent to neyrooftalmologicheskuyu MSEK, which determines the% of disablement or disability.

undergoing traumatic brain injury seen in a neurologist, take courses of medical treatment - mainly neuroprotective (evidence base of effectiveness has neuroprotective cerebrolysin, glycine), vitamins, cardiovascular drugs, venotoniki, sedatives, in the dynamics of EEG done.If necessary, the treatment involved doctors - psychiatrist, ENT, optometrist.Displaying sanatorium - resort treatment in not very hot time of year, psychotherapy, acupuncture, aromatherapy.

Doctor's consultation on brain injury

Question: Do I need to be hospitalized with a broken skull bones, if the state of health does not suffer?
Answer: obligatory hospitalization in neurosurgical department.Ambulatory treatment is possible only with the concussion from the easy flow type.

Q. before discharge after a brain injury without skull fracture prescribed me re-examination - CT scanner.What for?
Answer: To determine the outcome of brain injury - a full recovery, or cerebrospinal fluid cyst is formed (to determine its size, location, presence of intracranial hypertension) occurred or cystic - glial changes with the development of arachnoiditis.It is necessary to address disability, further rehabilitation.

neurologist highest category Kobzev Svetlana V.