Traumatic brain injury
Mechanical damage to the bones of the skull and brain of varying severity belongs to a separate section of medical traumatology - traumatic brain injury.
Today, complicated craniocerebral injuries are leading in the list of the most common traumatic injuries leading to complete or partial disability of the injured and to death. According to official medical statistics, craniocerebral injuries are ahead of cancer and cardiovascular diseases and are in first place among the causes of death of the working-age adult population under the age of forty-five.
This sad fact is caused by the inevitably increasing acceleration of the pace of modern life, leading not only to an increase in this type of injury, but also to an aggravation of the consequences.
The most common consequences of traumatic brain injury is the disruption of normal blood circulation in the brain, as a consequence, leading to partial or complete loss of brain function.
In order to return to a full life and save a person who has suffered from a traumatic brain injury, first aid should be provided immediately. The most important, and sometimes decisive, are the correct actions in the first minutes after the injury.
Types of traumatic brain injury
Injuries to the soft tissues of the skull are classified into two main types:
- closed injuries (hemorrhages, hematomas, bruises);
- open (injured).
The classification of traumatic brain injury is as follows:
- Closed craniocerebral injuries are characterized by damage to the brain and cranium without fracture of bone structures.
- Open traumatic brain injuries are subdivided into two subtypes:
- penetrating (with a violation of the integrity of the dura mater, leading to post-traumatic infection of the brain tissue);
- non-penetrating (with no violations of the integrity of the dura mater).
Types of brain damage in traumatic brain injury:
- concussion;
- brain contusion;
- compression of the brain.
According to the severity, traumatic brain injuries are classified as follows:
- mild traumatic brain injury (13-15 points according to Glasgow): bruises and concussions of the brain are mild;
- medium degree of craniocerebral injuries (9-12 points according to Glasgow): moderate brain contusions;
- severe traumatic brain injury (9 points according to Glasgow): severe bruises and compression of the brain.
Traumatic brain injury symptoms
The specific symptoms that appear after traumatic brain injury are in direct proportion to its clinical form:
- Brain concussion. This type of traumatic brain injury is characterized by the absence of damage and fracture of the cranial bones. The composition of the cerebrospinal fluid and its pressure remain normal. Symptoms are dizziness, tinnitus, weakness, increased sweating, facial flushing, sleep problems, and sometimes short-term memory loss.
- Brain contusion - refers to a more severe type of traumatic brain injury, the consequences of which can adversely affect the victim's health even after several decades. Symptoms - loss of consciousness, nausea, repeated vomiting, impaired hearing, vision, speech, etc. The symptoms of brain contusion are described in more detail in the corresponding section and depend on the severity of the traumatic brain injury (mild, moderate or severe).
- Compression of the brain. This injury is manifested by the following symptoms: headache of significant strength, repeated vomiting, high blood pressure, anisocoria (unilateral pupil dilation), focal epileptic seizures, impaired consciousness up to the onset of a coma.
Diagnosis of traumatic brain injury
The likelihood of a positive prognosis for a victim of traumatic brain injury depends to the greatest extent on timely and accurate diagnosis. Early diagnosis, combined with treatment adequate to the severity of the patient's condition, minimize the negative consequences of traumatic brain injury and serve as a guarantee of complete restoration of all life-supporting functions and systems of the body.
The special importance of early diagnosis of craniocerebral trauma is due to the significant risk of developing secondary (post-traumatic) brain injuries occurring against the background of hypotonic or ischemic syndrome.
The most important criterion is to clarify the neurological status of the victim. The state of the respiratory and cardiovascular systems of the body is assessed. Although the general examination of the patient is indispensable in terms of urgent assessment of his condition, it does not give a sufficiently complete clinical picture, therefore, experts use instrumental diagnostic methods:
- X-ray examination is mandatory for patients who have suffered a traumatic brain injury and are unconscious, in addition to the X-ray of the brain, they take pictures of the cervical spine;
- computed tomography is the most accurate diagnostic method for traumatic brain injuries;
- lumbar puncture;
- angiography;
- measurement of intracranial pressure.
Treatment of traumatic brain injury
The choice of patient management tactics and treatment of traumatic brain injury depend on its type and the severity of the patient's condition. The following fact remains unconditional - treatment of traumatic brain injuries, regardless of their severity, must necessarily be carried out in a neurological, neurosurgical or trauma hospital.
Emergency first aid for traumatic brain injury implies urgent transportation of the victim to the nearest trauma department of any medical institution.
First aid for traumatic brain injury at the scene is primarily in the normalization and maintenance of the respiratory and cardiac activity of the victim. To this end, it is necessary to ensure the free passage of air (to clean the oral and nasal cavities from blood, mucus, vomit and other impurities that hinder breathing). If the victim is in shock, the use of pain medications is necessary.
The terms of treatment of craniocerebral injuries with favorable dynamics suggest staying in a hospital for at least 2-4 weeks, and in the first ten days after the injury - with strict bed rest.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
