Life after a concussion of the brain: rehabilitation of the patient

Concussion( etymology comes from the Latin «commotio».) - is the easiest of all the variants of brain injury( and the skull) flowing without( macroscopically) visibleViolation of the brain structure, manifested by impaired brain function, decreased efficiency.

The most common cause of the shock is a drop - most often in the winter with icing - and head-on, household fights, injuries in the workplace, injuries when playing sports( especially shock types).Recovery after concussion proceeds more quickly and is more complete than after concussion and other severe TBI.Concussion of the brain requires hospitalization in a hospital neurological or neurosurgical profile.

Symptomatic of concussion of the brain

To reliably talk about a concussion, in addition to the fact of injury, you need a triad of signs or one of them:

1. Consciousness disorder( absence for a few seconds or minutes).The longer the consciousness is gone, the more severe the trauma and the consequences.
2. Retrograde amnesia( the patient does not remember the moment of injury, the circumstances of the receipt, the near time before and after the injury is "erased" from memory).Subsequently, memories return.
3. Vomiting( "brain", not bringing relief), headache, noise in the head, painful movements of the eyeballs, sleep disturbances.1-2 weeks after injury, the symptoms regress, the patient's condition improves. The lack of improvement can be a sign of the presence of organic pathology in the brain. Lability - emotional, vegetative - persists for up to a month or more.

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Why complications arise after concussion of the brain? Causes of pathology.

survey when it is shaken

brain On examination, a neurologist can be identified: nystagmus( horizontal), increased reflexes tendon symptoms meningism( not always detected in the presence of usually disappear after a few days in a period of recovery after brain concussion) Brudzinskogo, Kernig, Stiff neck muscles.

Anisocoria is an unfavorable indication indicating a possible presence of a contusion focus in the brain( i.e., anisocoria is more common in brain contusion, but may also occur with com- munication).

Focal changes are not detected( loss of sensitivity, paralysis and paresis, decrease in strength).When examining the cerebrospinal fluid( with lumbar puncture), no hemorrhagic and other impurities should be detected. The pressure of the cerebrospinal fluid may be elevated.

To avoid damage to bones( arch, skull base, facial skeleton), radiography of the skull is performed. To exclude probable organic changes, a CT scan( MRI) of the brain or ultrasound is performed to exclude the displacement of the median structures. In this case, the following should not be revealed:

1. Subdural hematoma( of different volume).
2. Epidural hematoma.
3. Parenchymal hematoma.
4. Subarachnoid hemorrhage( SAH).
5. A foci of concussion( hypodense, discussed by the presence of detritus - dead organic matter).
6. The focus of concussion mixed( detritus and blood).
7. Breakthrough of blood in the ventricles.
8. Dislocations and compression of brain structures.
9. Deformation and compression of the ventricles of the brain.
10. Fractures of the skull bones.

If any of these conditions are identified( except, perhaps, the last one - fractures of the skull bones are not always accompanied by changes in the parenchyma of the brain, hemorrhages), this is not a concussion, but a brain contusion - a more serious condition requiring inpatient care and, Neurosurgical intervention( for example, puncture of the ventricle for the purpose of aspiration of the contents, opening and draining of the hematoma).

Recovery

Depending on the severity of the damage, the brain restores a different time. In mild trauma, it takes a few days for the symptomatology to disappear completely. In more severe cases, recovery is long, treatment in a hospital is necessary. During rehabilitation, the principles that will allow you to recover faster after a concussion of the brain, minimize to a minimum possible complications:

1. Peace, silence, horizontal position, lack of physical, mental, emotional stress during at least an early recovery period. Treatment in a hospital. Analgesics, NSAIDs( pentalgin, ibuprofen, etc.), sedatives, tranquilizers( as directed by a doctor) are shown to reduce the severity of pain.
2. To reduce the severity of disorders of the brain functions - vascular( stegeron, cavinton) and metabolic means, nootropics( picamylon, pyracetam, phenibut).
3. Purpose of fortifying agents( eleutherococcus, vitamins).

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Result of

It is not recommended to prescribe any medication for suspected concussion of the brain. After any CCT, you need to see a doctor( traumatologist, neurologist), undergo CT scan( MRI) of the head to identify possible organic changes in the brain, exclude a heavier pathology - brain contusion, hematomas( parenchymal, sub- and epidural), SAK.In the case of timely detection of complications, early treatment is quick to recover after a concussion of the brain is usually easier than in the case of untimely care.