Delayed harm. Serious consequences of the simplest injuries

Head trauma is a common injury.

You can get it anywhere: at home, on the street, in the gym.

It doesn’t matter if a person slipped during icy conditions, missed a punch in a fight, or lost his balance and straightened the corners of furniture.

Injury resulting from a blow to the head is extremely dangerous.

Damage to the parietal region can result in a concussion or fracture of the skull bones. A bruise of the temporal part ends in fainting.

Types of traumatic brain injuries

Injuries caused by a head impact are called TBI for short. There are several types of damage.

Concussion (CHM)

With a strong impact on a hard surface, the gray matter is displaced and after a second returns to its original position. This is how a double displacement of the brain occurs.

FMS is reported equally often in adults and children. This is the most common head injury. It accounts for 70% of all registered TBIs. Symptoms that may indicate a concussion:

• feeling of weakness;
• short-term (up to 15 minutes) loss of consciousness;
• vomiting, feeling of nausea;
• headache;
• inability to remember how the injury occurred;
• dizziness;
• respiratory dysfunction;
• blurred vision;
• Pain in the eyes.

SMG can happen even after a blow to the jaw. Then pain when chewing and talking is added to the symptoms.

Body temperature and blood pressure are restored in a short time after injury. But unpleasant consequences in the form of nausea and dizziness make themselves felt for a long time. The matter is aggravated by problems with falling asleep, up to complete insomnia.

If there is a suspicion of a concussion, a doctor's examination is required. If the symptoms of injury are minor, the patient is allowed treatment at home. It is allowed to use folk remedies, such as head massage and a special linen patch. In some cases, hospital treatment is recommended.

Brain compression

The main risk is damage to the stem formations in the cerebellum area. This area of ​​the brain is responsible for breathing and regulates blood circulation.

Therefore, it is extremely important to examine the patient and conduct an MRI. If the presence of internal hematomas is determined, they are urgently removed. Hemorrhages increase pressure on the brain and aggravate the patient’s condition.

Brain contusion

A common injury among boxers. It also develops after a beating, a fight, or a strong blow to the head. As a result:

• cranial vault injury;
• damage to brain tissue;
• necrosis of affected areas.

The presence of a brain contusion can be judged by the following signs:

• loss of consciousness (always);
• disorientation in space;
• feeling dazed;
• memory impairment;
• cephalgia;
• bouts of vomiting;
• disruptions in heart function and breathing;
• neurological symptoms (Kernig's syndrome, nystagmus);
• throbbing pain in the occipital region.

If the injury results in a fracture of the skull bones, it may look like a dent in the back of the head. Remember, if there are fragments that get into the brain matter, life support functions will be affected. Roughly speaking, a person can die or go into a vegetative state.

There are three degrees of severity for brain contusion. A mild degree occurs in children. High activity combined with carelessness leads to damage. Moderate and severe damage most often occurs in adulthood. More often these are fights and traffic accidents.

As therapy, neurologists prescribe:

• neuroprotectors;
• antioxidants;
• drugs that strengthen blood vessels.

Axonal damage

Severe injury causing contusion. After this, brain activity stops. The man falls into a coma. The injury is not treated, but only supported by the vital functions of the body. Making predictions regarding recovery is extremely difficult. The individual characteristics of the organism play a decisive role.

How is a noise in the head diagnosed after a head impact?

If there is a history of recent TBI, then this is the main possible cause of noise in the head. The doctor conducts a physical examination, studies the patient’s complaints, conducts neurological testing: checks reflexes, identifies motor and speech disorders.

With mild concussions and bruises, patients often do not seek medical help, which is why the consequences of TBI are delayed.

The doctor must prescribe an additional instrumental examination, which includes the following diagnostic methods:

• Radiography. Shows the integrity of the skull bones. It is performed in two projections: direct and lateral.
• Computed tomography (CT). Informative regarding skull fractures, brain contusions, hematomas.
• Magnetic resonance imaging (MRI). Allows you to identify swelling of soft tissues, areas of hemorrhage, structural changes, and determine the dislocation of the cerebral hemispheres. It is carried out to diagnose post-traumatic complications, which include frequent headaches and noise in the head, and is the most informative method. You can get an MRI at the SmartMed clinic, where a new MRI scanner is installed. The examination has a high degree of accuracy, so you can reliably determine the cause of noise in the head.
• Angiography of cerebral vessels. Allows you to identify all vascular disorders that can cause noise and headaches.
• Encephalography. Designed to assess the functional activity of the brain in order to identify functional disorders that arose after TBI.

Based on the examination results, the doctor determines the cause of the headache and ringing.

Since the appearance of these symptoms may be associated not only with damage to blood vessels or nervous tissue, increased intracranial pressure, but also with stress and a depressive state after a TBI, you should visit a psychologist or psychotherapist.

Classification of TBI by severity

There is a special Glasgow scale. It helps determine the severity of the head injury. Experts conduct tests and evaluate:

• motor reactions;
• speech reactions;
• opening the eyes.

For each test, points are awarded and summed up:

• 14-16 - mild degree;
• 9-13 - average;
• 8 - heavy;
• 3 or less - deep coma.

Regardless of the severity of the injury, it is important to seek help promptly. Timely and adequate therapy reduces the risk of complications and improves the prognosis.

Moderate brain contusions

This injury usually involves a fracture of the skull bones and is accompanied by subarachnoid hemorrhage. She shows herself:

• loss of consciousness for 1–3 hours, psychomotor agitation;
• amnesia;
• severe dizziness;
• nausea;
• vomiting;
• intense headaches;
• high blood pressure, rapid heartbeat;
• increased body temperature;
• meningeal symptoms;
• severe focal neurological symptoms (changes in muscle tone, paresis, loss of sensation in the limbs, epileptic seizures, speech impairment, etc.).

Signs of moderate brain contusions persist from several weeks to 2 months. The consequence of this condition may be irreversible changes that occurred during the injury.

Peculiarities of manifestation of traumatic brain injuries in children

In babies under one year of age, there is a sharp increase in temperature to 38°C and above. This reaction is associated with:

• wound infection;
• inflammation;
• suffered stress;
• inappropriate use of medications.

The child is not able to clearly describe his feelings, so it is quite difficult to make a diagnosis. There is a risk of underestimating the severity of the injury. Warning signs in this case are:

• pale skin;
• lethargy, drowsiness;
• increased heart rate.

Over time, vomiting, regurgitation, tearfulness, and capricious behavior appear. The baby sleeps restlessly and often gets up at night. If it is SHM, then the symptoms go away within a week.

Please note that infants and the elderly do not experience fainting during SHM.

Tailbone injury

Injuries to the coccygeal-sacral region are characterized by pain in this place and the lower back, varicose veins in the lower extremities, in the rectum or pelvis. So-called “bones” will form on the legs, while the feet, knees and hip joints may hurt, and the legs will constantly swell. An injured tailbone can have a negative impact on pregnancy and childbirth. Sometimes it is impossible to completely eliminate the damage. But the treatment will definitely help a woman carry a child more easily and give birth by caesarean section.

First aid

After a head impact, signs of TBI appear quickly. The main thing is to be careful. The most striking symptoms: vomiting, nausea, fainting. It is very important not to get lost, to act confidently and quickly:

• Call the doctors.
• Apply something cold to your head (ice, compress). This will help narrow the blood vessels, minimize the risk of hematomas, hemorrhages, lumps, and prevent or reduce swelling.
• Carefully examine the victim. Sharp pain in the neck may indicate damage to the vertebrae. It is important to fix the position and not change it until the ambulance arrives.
• In case of fainting, bring ammonia to your nose. Wipe with cool water. It is strictly forbidden to hit people on the cheeks. Such an action will increase the consequences of damage.
• Treat wounds. The use of chlorhexidine and hydrogen peroxide is allowed.
• If heavy bleeding begins in the temple area (spouts like a fountain), pinch the vessel with your fingers. After this, apply a bandage with furatsilin or miramistin. After attaching the bandage with a bandage, wrap your head with a bandage.
• If vomiting occurs, place the person on their side. This is necessary for the random flow of vomit so that the victim does not choke. It is advisable to place a clean cloth and change it periodically when it gets dirty.

Having done everything necessary, you need to wait for the doctors. If a person has not lost consciousness and feels more or less normal, you can not call an ambulance, but take him to the hospital yourself. The main thing to remember is that the consequences of TBI can be quite serious. Only a doctor can assess the condition, so a visit to the clinic should not be neglected.

Treatment

For severe TBIs, surgery is usually performed. The procedure may consist of primary surgical treatment. But sometimes, you have to do craniotomy, pump out fluid, remove hematomas, restore (assemble) the skull. After surgery, it is treated with medications.

If the victim is vomiting, it is stopped with an injection of Metoclopramide or Etamzilate. Pain is relieved with analgin. If there is no vomiting, they give a tablet (no more than 2 per dose), otherwise it is administered by injection.

In order to normalize blood circulation and metabolic processes in the brain, Etamzilat and Piracetam are prescribed. The standard dose is 2 tablets (varies depending on the patient’s age).

In addition, based on the nature of the injury and its clinical manifestations, he may prescribe:

Even if the patient is at home, it is important to follow the following recommendations:

• avoid sudden movements;
• stay in the shade, do not overheat;
• ensure silence;
• get plenty of rest and sleep.

Treatment of noise in the head after injury

If the noise in your head does not go away after the injury is healed, something needs to be done. Complex therapy will be required. Treatment methods:

• Taking medications. The doctor chooses medications taking into account the existing problems. These can be anti-inflammatory non-steroidal drugs, analgesics, nootropics, drugs that normalize the tone of blood vessels and improve blood circulation, neuroprotectors. For cervical muscle spasms, muscle relaxants are prescribed, and vitamin and mineral complexes are prescribed to maintain good health.
• Physiotherapeutic procedures. Electrophoresis, electrical stimulation, magnetic therapy, ultrasound therapy and others are used.
• Head and neck massage. It can be done only after the end of the acute period, if there are no contraindications, which include high blood pressure, inflammatory and oncological processes, vascular thrombosis, etc.

The severity of the consequences, and, consequently, the duration of treatment depends on the degree of damage to the brain structures. Chronic headaches and noise in the head will take a long time to be treated. In general, full recovery after a TBI takes about 1.5-2 years, but symptoms disappear within a few months.

If after a traumatic brain injury the headache does not go away within 3 months, treatment is required

To increase the effectiveness of therapy, the following doctor’s recommendations should be followed:

• stop drinking strong tea and coffee, alcoholic beverages, and smoking;
• get enough sleep, sleep at least 8 hours at night, fall asleep before 22:00;
• switch to easier physical and mental work;
• stop watching TV or computer;
• walk in the fresh air more often;
• avoid stress, noisy and crowded places;
• switch to proper nutrition, do not eat fatty and fried foods.

After a concussion and other head injuries, the patient is less able to tolerate changes in weather conditions, any stress, his memory deteriorates, and diligent mental activity is accompanied by headache and dizziness. Mood and blood pressure swings are not uncommon.

How a person will feel after hitting their head depends on the timeliness and correctness of medical care.

Diagnosis of TBI

Even if you provided first aid, know how to treat, and have previously encountered similar injuries, do not be arrogant. Examination of the victim by a qualified physician is mandatory. If you don’t want to call an ambulance, take him to the clinic yourself. Just before doing this, make sure that the spine is damaged and the skull bones are not cracked.

The most accurate conclusion can be made using magnetic resonance therapy and computed tomography of the head. The procedures are painless. With their help, you can thoroughly study the structure of the brain, look for the presence of hemorrhages, hematomas, etc.

If it is not possible to do MRI and CT (the clinic does not have machines), diagnostics should include:

• X-ray of the skull.
• Encephalography of the head.
• Examination by an ophthalmologist.

Encephalography will also help detect hemorrhage. In this case, hospitalization cannot be avoided.

If, after an injury, the patient has liquor leaking from the ears or bruises under the eyes in the form of glasses, you should consult a doctor immediately. Self-medication or lack of help, in this case, often leads to death.

You can undergo an MRI or CT scan in Moscow at any time of the day and regardless of the day of the week. You can find a clinic with 24-hour service, close to the patient, using the service: https://msk-mrt.ru/articles/. There are hundreds of medical centers operating in different modes here. Within a few minutes you can find a clinic and make an appointment by phone. Registration through the website allows you to get a discount on the examination.

Neck injury

During a strong blow to the back of the head, compression occurs on the jugular vein and the vagus nerve, with which the occipital bone contacts. The vagus nerve travels to the intestines and along the way gives off branches to the heart and lungs. Infringement of the vagus nerve is fraught with constipation - this is the most common option. In addition, tachycardia and arrhythmia are possible, which manifest themselves in adulthood. If the branches of the vagus nerve leading to the lungs are infringed, then a person may develop an unreasonable cough, he will be prone to colds and suffer from something similar to bronchial asthma.

Compression of the jugular vein in the jugular foramen leads to stagnation of fluid in the cranial cavity (after all, it is through this vein that the outflow of venous blood from the head mainly occurs), and intracranial pressure increases. Such people often have a pale, sallow complexion and dark circles under the eyes. Since the occipital bone is directly connected to the sacrum, when it is injured, the sacrum is also blocked. It is especially important to eliminate this problem for women, because a stationary sacrum negatively affects the course of labor.

Severe injuries to the back of the head may be accompanied by visual impairment. Displacement of the occipital bone often leads to impaired blood circulation in the vertebral arteries, which leads to frequent dizziness. The occipital bone determines the position of the temporal bones, and they, in turn, determine the position of the lower jaw. With severe injuries to the back of the head, the lower jaw shifts to the side. A sagging chin also signals an injury to the back of the head: tense muscles under the back of the head compress the lymphatic vessels, which causes stagnation of lymph and swelling under the chin.

Indications for hospitalization

A doctor may refer you for hospitalization if there are the following grounds:

• post-traumatic amnesia;
• prolonged loss of consciousness;
• coma;
• epileptic seizure;
• bleeding;
• disorientation;
• obvious disorders of the nervous system;
• the patient is pregnant (even if she feels normal).

During treatment for TBI, the patient's condition may fluctuate. Periodically, the symptoms intensify and subside. Predictions can only be made after a full course of therapy. Unfortunately, the mortality rate for TBI reaches 25%. The main cause of death is inadequate first aid and reluctance to go to the hospital.

Severe brain contusions

Such an injury poses a threat to human life. The consequences of a severe brain injury are serious, and recovery takes several months. Often the victim never fully recovers.

The following signs indicate a severe brain injury:

• loss of consciousness, after which the person is in stupor or a state of stupor;
• temperature rise to 41°C;
• psychomotor agitation, convulsive syndrome;
• disturbances in the respiratory and circulatory system (up to the need for artificial ventilation);
• neurological symptoms (dilation or constriction of pupils, “floating” eyeballs, difficulty swallowing, paralysis, loss of speech);
• pronounced meningeal signs.

Severe brain effects regress extremely slowly. Recovery takes a long time. In some cases, the patient becomes disabled.

The most common consequences of brain contusions are:

• inflammation of the meninges;
• epilepsy;
• atrophy (decrease in tissue volume) of the brain;
• hydrocephalus accompanied by intracranial hypertension;
• scars on the meninges and tissues;
• cerebrospinal fluid cysts;
• post-traumatic porencephaly;
• liquorrhea (due to a skull fracture).

These conditions are accompanied by movement disorders, dizziness, impaired coordination, speech, mental disorders, headaches, decreased intelligence, and convulsive seizures.